Graduating medical students face challenge of launching careers during pandemic
In a matter of eight weeks, Sharon Sun will be stepping into the role she’s been training for since 2016. On July 1, she’ll join a new class of residents in the anesthesiology program at NewYork-Presbyterian/Columbia Medical Center.
Under normal circumstances, the transition from medical student to physician is daunting. But members of the Class of 2020 have the added challenge of beginning their careers during the COVID-19 pandemic. For Ms. Sun, that means moving to an epicenter of the crisis, where more than 140,000 confirmed cases had been reported by mid-April.
Although Ms. Sun will be pursuing a career in anesthesiology, she’ll spend her first year as an intern training across various hospital departments – and will potentially treat COVID-19 patients.
“I think I am as ready as I will ever be in these circumstances,” Ms. Sun said. “While moving to New York is nerve-wracking, I’m excited to begin residency. It’s a tough situation, but I’ll do my best to take it in as a learning experience.”
Many graduating students said their residency programs have been diligent about providing as much support and information as possible regarding how the pandemic might impact their training. But because of the uncertainty of the medical crisis, leaders of programs are making decisions as the situation evolves.
Ms. Sun said although she has yet to learn of any specific changes for incoming residents, she is getting into the right mindset to begin her career.
“While I remain cautious about going into a hot spot for the pandemic, I trust that Columbia is doing its best for us and will communicate how we can be better prepared. So I am actually less worried than most,” she said.
Switching gears
Alexandra Pottorff, who will begin her residency in the Boston Children’s Hospital pediatrics program in June, said the virus has been a topic of discussion since the beginning of the year. It didn’t impact students, however, until mid-March.
“We had been hearing about the virus for a few months in other places across the world, but once it reached the U.S. it feels like the situation surrounding our classes changed very suddenly,” Ms. Pottorff said.
She had been completing a Residency Essentials course and working in the student-run free clinic when Dallas County issued a shelter-at-home order on March 23. Like many MS4s, she also planned to take a final clinical elective, which had to be canceled.
Despite the disruptions, the pandemic had the least educational impact on fourth-year students who had nearly finished their medical education by the time the restrictions took effect, said Dr. Robert Rege, Associate Dean for Undergraduate Medical Education.
The biggest impact to the Class of 2020 has been emotional.
“The most disappointing part of the timing is that the fourth-years who have worked so hard have had to forgo the many well-deserved celebrations that have been deep in tradition at UT Southwestern, including their senior banquet, AOA induction banquet, the premier of the senior film, the traditional hooding ceremony, and finally our 77th Commencement ceremony,” Dr. Rege said.
Commencement will be held as a virtual event on May 2, similar to changes made for Match Day in March.
Class President Oludamilola “Dami” Akinmolayemi said these losses have been felt hard. As a class leader, he was heavily involved in planning the senior banquet that had been scheduled for March 13 when the event was canceled just two days before.
“I really wanted to use these opportunities to celebrate with classmates and say final goodbyes, so it’s sad that we’re not going to have those last experiences as a class,” Mr. Akinmolayemi said. “But of course as humans, we adapt and accept that these things can’t happen right now.”
He had also been looking forward to taking a dermatology elective before starting residency at Columbia’s internal medicine program.
“It’s disappointing because that was one specialty I was hoping to gain more knowledge in to help me finish up my medical school education strong,” he said. “But everyone is impacted by this and while fourth-years don’t get the celebratory experience we want, you have to consider other classes are having their rotations and licensing exams possibly affected. So that makes me look at the situation from a broader perspective because I am still earning my M.D. and that’s the consolation.”
Future impact
As uncertainty surrounding the pandemic continues, UTSW is trying to find workarounds for both its remaining students and incoming trainees.
For the time being, clinical students have all been placed into courses and electives that can be provided online and specialty advisers in each department are looking at mechanisms to provide further mentorship online. Once clinical restrictions are lifted, time will be reserved for clinical encounters.
“The challenges facing the current third-year class are numerous and depend on the length that pandemic-imposed restrictions last,” Dr. Rege said. “Challenges include unknowns about when their national licensing exams (Step 2 CK and Step 2 CS) will resume, inability to currently begin clinical electives in specialties they are interested in, how the process and criteria for residency applications and interviews will alter this year, and currently the inability to complete visiting rotations at other institutions.”
Dr. Rege said UTSW is also working with the Association of American Medical Colleges constituent groups and committees to advocate for changes in the residency application timeline to support students at all medical schools nationwide during this extraordinary time.
Meanwhile, leaders in Graduate Medical Education are considering what changes might be needed for incoming residents scheduled to begin July 1.
“We are not very clear at this point as to how disrupted our functions will be around mid-June. However, we have been collaborating with the hospitals in creating a virtual onboarding for our many new trainees. There are very few things that require trainees to be physically here before July 1. The rest, we are already planning on going virtual. For those items that require a physical presence, we are planning on maintaining physical distancing,” said Dr. Larissa Velez, Associate Dean for Graduate Medical Education.
Dr. Velez said most UTSW residents are not involved in the direct care of COVID-19 patients. But they have experienced changes such as canceled rotations due to closed clinics and postponed elective surgeries. Long-term restrictions from the pandemic will impact senior-level residents’ ability to do research, travel for professional presentations, and interviews for fellowships and jobs.
Holding pattern
Meanwhile, as most Class of 2020 graduates plan long-distance moves, travel hampered by the pandemic has created a number of logistical problems for the future residents. Some students have opted to sign leases sight unseen to avoid being left without housing.
It’s an option Ms. Pottorff chose after viewing a rental video.
“It definitely feels kind of weird signing a lease without having actually seen the apartment or even being in that part of town before, but I’m very excited to have a place,” she said.
A separate issue for some students is how to handle current leases.
“The moving process is going to be difficult,” Ms. Sun said. “Even just moving out will be an issue because I was originally planning to sell or donate a lot of furniture, but nonprofits can’t send movers because they’re nonessential businesses under Dallas County’s stay-at-home order.”
Ms. Sun extended her current lease through June while she finalizes her moving plan. She’s hoping to secure housing through Columbia utilizing a lottery system, but is concerned about the pace at which the rental market moves if she’s not accepted.
Similarly, Mr. Akinmolayemi said he is trying to determine how to make the move to New York. He initially planned to travel during spring break to tour neighborhoods and apartments in person, but had to cancel.
Mr. Akinmolayemi’s immediate family lives in Nassau County, New York – an hour commute to the city. He said as a last resort he’ll commute from his family’s home until a more ideal living arrangement can be found.