Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., is one of some 130,000 medical residents in the U.S., many of whom have found themselves on the front lines of the COVID-19 pandemic. Max Lazarus hide caption

Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., is one of some 130,000 medical residents in the U.S., many of whom have found themselves on the front lines of the COVID-19 pandemic.

The coronavirus is leaving a lasting impression on a generation of young doctors.

In the U.S., there are some 130,000 medical residents doctors in their final years of training after medical school who make up a vital part of the workforce.

Now a global pandemic has become the centerpiece of their training.

Many are pulling long hours in emergency departments and intensive care units treating patients infected with the coronavirus, all while witnessing the health care system under unprecedented stress.

Their schedules are transformed. Family members must keep their distance. And some of the hallmarks of their clinical training suddenly feel tenuous.

Many recognize the pandemic as a formative moment, both for health care and their own careers. Some say it's also magnifying existing concerns about labor and mental health among doctors in training.

'Nothing is working'

Before the coronavirus crisis, Dr. David Lin, a second-year medical resident at the Mount Sinai Hospital in New York City, felt comfortable working in the intensive care unit.

Lin already knew how to manage a patient on a ventilator, when to adjust the settings, what to do if the person's kidneys needed help.

So much changed for him the day that coronavirus patients first streamed into his hospital, though.

"Every person that rolled in: tubed, unstable, respiratory failure, COVID ... anyone, young, old," he says. "It was just a deluge."

From then on, Lin was treating these critically ill patients all the time, week after week, as New York City hospitals saw a crush of coronavirus patients in March and April.

Lin soon discovered that some of the clinical know-how he had accumulated over years of training no longer applied in the same way to COVID-19. Instead of improving, patients would linger in the ICU for weeks, their recovery uncertain.

"You are trying to do something, and nothing is working," he says. "Now whenever I see someone intubated, you just know, 'Oh my God, they are probably going to die.' "

Day after day, Lin had the unsettling experience of leaving the hospital unsure of whether his efforts to help patients actually made a difference. "It has just been incredibly disheartening," he says.

Another challenge is that even Lin's attending physicians the seasoned doctors who train him don't have all the answers either.

"These leaders in critical care who I respect so much, they're telling me like, 'We don't know,' " he says. "That's terrifying."

"It reminds you there are always going to be things in medicine that you will never know," Lin says.

In Baltimore, Dr. Martha Frances Brucato, a second-year resident in pediatrics and internal medicine, says much of her education has emphasized that family members should be closely involved in a patient's care. But now hospitals generally bar visitors because the coronavirus is so contagious.

Dr. Martha Frances Brucato is a second-year resident in pediatrics and internal medicine in Baltimore. Martha Frances Brucato hide caption

"The really hard part of our jobs right now is how alone our patients are by necessity," she says.

The pace is different too. She can't rush to a patient's bedside without first putting on layers of protective gear: "That immediacy is such a part and parcel of ICU care, typically."

For many residents, the risk to their own health has never felt so immediate either.

Before working in the ICU with COVID-19 patients, Brucato made sure to remind her husband of her own medical wishes.

"Remember that I have a living will," she told him. "I would want to be ventilated as long as there was a chance for meaningful recovery."

That does not mean Brucato hesitated to be on the front lines of the pandemic.

In fact, she volunteered for the assignment.

Dr. Brendan McEvoy, an emergency medicine resident in Chicago, also jumped at the chance to work on COVID-19 in the ICU.

Then he caught the virus.

"There were a lot of people that were very concerned for me," he says.

It was nerve-wracking initially, he says, because he had seen otherwise healthy young people on ventilators during his shifts.

Soon after his recovery, he was put on a dedicated intubation team in the hospital.

"I hope we are going to look back at this like, 'How were we all not better prepared?' "

Pandemic magnifies labor concerns

For some residents, the pandemic is amplifying long-standing concerns about working conditions.

"It is really bringing to light a lot of the ways that residents have been mistreated for years," says Dr. Amy Plasencia, executive vice president of the Committee of Interns and Residents, a union representing more than 17,000 doctors in training.

Before the pandemic, the Committee of Interns and Residents was pushing for a bill of rights that focused on better pay, sick-time policies and other protections for residents.

"Now is the time that we most need those protections," says Plasencia, a resident at a hospital in Brooklyn, N.Y. "Because residents are really at the forefront doing so much of this work, they are in very large numbers becoming ill."

Generally, residents are reluctant to speak publicly out of concern that doing so could jeopardize their job and professional future. Since the pandemic began, more are taking to social media to air concerns about working conditions.

Medical residency is essentially a prolonged apprenticeship that generally stretches from three to seven years. Residents are expected to put in long hours as part of their education. The average salary is about $60,000 per year.

At the University of Washington, the union representing doctors in training is wrestling over a contract with the hospital system in an effort to get better pay and benefits.

"People can't work 80 hours a week, see really horrible things all day [and] not have access to mental health care, without having some sort of burnout," says Dr. Zoe Sansted, who is vice president of the University of Washington Housestaff Association.

Sansted, a family medicine resident in her third year, was assigned to work in the ICU as the pandemic spread in Seattle.

She says many residents are eager to work extra hours and be on the front line.

"These are wonderful instincts," she says. "Doctors are obsessed with professionalism, but it's also ripe for exploitation."

COVID-19 takes emotional toll

Before the pandemic, Dr. Murad Khan was already a bit nervous about his internal medicine rotation.

Khan is a psychiatry resident in his first year, known as an internship, at Yale New Haven Hospital. Suddenly his rotation coincided with a surge of COVID-19 patients.

Rules were changing constantly. At first, he says, it wasn't clear what residents would be asked to do or whether there would be enough personal protective equipment.

Dr. Murad Khan is a first-year psychiatry resident at Yale New Haven Hospital. Yvonne Uyanwune hide caption

"Initially, things were pretty frantic," Khan says. "I actually spent a lot of the first couple weeks having a hard time sleeping before going into work."

Khan says he found himself on edge, concerned that a COVID-19 patient would crash and he wouldn't know how to respond.

"There is something traumatic just about not knowing how sick a patient might get at any moment," he says.

Khan is much more comfortable working with coronavirus-infected patients since those early days of the pandemic in Connecticut. But he recognizes the psychological toll of caring for these sick patients, often being the only connection between them and their families.

"You are having these conversations on a regular basis. Do we want to focus on comfort care? Or do we want to focus on trying to make them live more?" he says.

Khan says the coronavirus has only underscored existing problems in American health care, from racial health disparities to the demands placed on medical residents.

"There was already an issue around how much residents work and how much they are supervised and whether or not that's good for their mental health," he says. "That's even worse now."

For many residents, the legacy of the coronavirus may be the emotional weight of so much unmitigated loss.

Dr. Max Lazarus, a resident at a hospital on Long Island, N.Y., went into emergency medicine exactly so he could respond to crises.

He remembers pushing stretchers around the lobby of Bellevue Hospital as a volunteer in the emergency room during Hurricane Sandy.

"This is what I signed up for," he says. "It forces you to grow in a way that I don't think anything else could."

Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., went into emergency medicine so he could help during crises. "This is what I signed up for. ... It forces you to grow in a way that I don't think anything else could." Max Lazarus hide caption

But Lazarus says nothing could fully prepare him to watch patients call their family members before going on a ventilator.

"You tell them that hopefully they will wake up but there is a chance they may not," he says. "It's not the way anyone should die, alone on a ventilator."

Lazarus, 29, still thinks about two patients he treated early in the pandemic one was a bit younger than he is, the other a bit older.

"And they died," he says. "They really stick out."

This story comes from NPR's reporting partnership with Kaiser Health News.

See more here:

Doctors In Training Learn Hard Lessons During The Pandemic - NPR

Burton Bud D. Rose had already written a textbook that his colleagues referred to as the nephrology bible. Still, he wasnt satisfied.

Rose knew his book could only stay accurate for so long before hed have to update it which, for most volumes, happened every five years.

But Rose wanted to keep his textbook up to date constantly. So he asked his publisher if theyd assist him in transferring the textbook to a computerized format, which could be regularly updated. They refused so he decided to do it himself.

In 1992, aided by his wife, Gloria, Rose created a computerized database of medical information called UpToDate from their home. Today, the digital platform is used by over 1.5 million clinicians worldwide.

Aside from his online pursuits, Rose worked as a professor at Harvard Medical School and a nephrologist at Beth Israel Deaconess Medical Center. He died on April 24, from Alzheimers disease complicated by COVID-19, at the age of 77.

Theodore I. Steinman, a professor at Harvard Medical School and a senior physician at Beth Israel Deaconess Medical Center, called UpToDate the first living textbook.

He was probably the most influential person ever in the world with regards to medical information and education, Steinman said.

Mark L. Zeidel, a professor at Harvard Medical School and physician in chief and chair of the Department of Medicine at Beth Israel Deaconess Medical Center, often calls Rose the Steve Jobs of Medicine.

In part, that moniker stems from the fact that Rose created UpToDate with a piece of technology from Apple, the hypercard. But Zeidel also saw UpToDate as an example of disruptive technology like the computers and phones Jobs created.

Both Steinman and Zeidel said that Rose could have been in contention for a Nobel Prize in Medicine, which cannot be awarded posthumously.

He really was deserving of the Nobel Prize in Medicine because of his worldwide impact on medical education and medical information technology, Steinman said.

I regret that it never occurred to me, but we could have actually put him up for the Nobel Prize in Medicine and he might have won it because of the significance of this contribution, because people around the world are using it constantly, Zeidel said.

Zeidel said that most of the 170 interns and fellows at Beth Israel Deaconess regularly use UpToDate.

When I come in and do rounds, they don't quote the textbook, he said. They quote UpToDate. Because at two in the morning, they can call it up on a computer right at the point of attack where they're working, and they can look up what they need to find, find it quickly, and get the authoritative information.

Isaac Kohane, the chair of the Department of Biomedical Informatics at Harvard Medical School, said Roses creation revolutionized medicine.

Rose had a unique mix of vision and pragmatism that allowed him to create such an impactful technology, he added.

That resource was so singular, and the editorial process that was put together was so rigorous and so strongly academic, yet because of his leadership, so determinately practical and focused, that it became the unquestioned standard, Kohane said.

Despite the fact that UpToDate took more and more of his time, Rose remained active as a clinician and professor.

He always took time to be an attending physician on the renal service at Beth Israel Deaconess Medical Center, and he was always a wonderful one on one teacher, Steinman said.

Martin Pollak, a professor at Harvard Medical School and chief of the Division of Nephrology at Beth Israel Deaconess Medical Center, called Rose a beloved teacher.

He just had a very clear, concise way of breaking down complicated concepts, Pollak said, and he used his skills to teach medical students and patients alike.

He taught an annual course at the Medical School on kidney disease that people from all over the world flocked to, Pollak said. In 2009, the American Society of Nephrology granted him the Robert G. Narins Award, the highest award for education in nephrology.

Gloria Rose, his wife, said he approached pursuits outside the hospital with the same verve.

She recalled that, while at work, he was looking at the names of their immediate family members, and created the acronym Badgers short for Bud, Ann, Daniel, Gloria, and Emily Rose.

So then he started calling us the Badgers, Gloria said with a laugh. He was just always thinking outside the box, he was very funny in that way.

Rose was also a romantic, Gloria said. One day, he surprised her with flowers and a cake, announcing that it was the 10,000th day since they had met.

He was goofy in a good way, she said. He was very spontaneous.

He loved basketball and tennis, and spent hours at a time bettering his technique.

With everything that he did, it wasn't that he wanted to be the best. He wanted to improve his game. Always, Gloria said. He would go out on the driveway and keep shooting, until he just got it.

With UpToDate, Rose refined medicine, too.

Denise Basow, the CEO of Clinical Effectiveness at Wolters Kluwer, the company that currently runs UpToDate, wrote in a statement that his work changed the medical field over the last three decades.

Once he had the idea for UpToDate, he wouldnt let anything get in the way of pursuing it, Basow wrote. That pursuit has impacted the practice of medicine and the lives of patients for almost 30 years.

Staff writer Camille G. Caldera can be reached at camille.caldera@thecrimson.com. Follow her on Twitter @camille_caldera.

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Harvard Medical School Professor Burton 'Bud' Rose, the 'Steve Jobs of Medicine,' Dies at 77 | News - Harvard Crimson

Likemany of my colleagues, I was very saddened to hear of the passing of Dr BurtonBud Rose on April 24, 2020 at the age of 77 years. There were two importantsides of Dr Rose: First, he was well known in the nephrology community asan extremely modest, brilliant nephrologist who published 2 important textbookson nephrology. Second, and more importantly, he was the founder and editor ofUpToDate.

DrRose was born in Brooklyn NY in 1942.He attended Princeton University,where he majored in history. He then attended New York University School ofMedicine, where he also completed his residency and fellowship.Afterserving in the US Navy as a nephrologist, he moved to Wellesley, Massachusettsand began his academic career, with positions at the University of MassachusettsMedical School in Worcester, Massachusetts, and Brigham and Womens Hospitaland Harvard Medical School in Boston.

Dr Rose seems to have touched everynephrologist of my generation.I first came across his work Pathophysiologyof Renal Disease, when I was a student on the nephrology rotation at BaylorCollege of Medicine in Houston.This book, as well as Clinical Physiologyof Acid-Base and Electrolyte Disorders, provided me with my foundation andinterest in nephrology. Dr Rose was known for his clear style, and especiallyhis ability to express complex nephrologic concepts in a way that a student,resident, and fellow like myself could understand.

When I was a fellow, 2 of his articles werealso of great importance to me.New approach to disturbances in theplasma sodium concentration, published in the American Journal of Medicine (1986;81:1033-1040), still helps me tounderstand pathophysiologic changes that occur with hypernatremia.His Kidney International Nephrology Forum ondiuretics (Diuretics, Kidney International (1991;39:336-352) was also well-readby me and many of my colleagues.It was a great privilege to have afellows lunch with Dr Rose when he visited the University of Pennsylvania in1991. He was extremely approachable and charismatic.During lunch, hedescribed his idea for UpToDate. Several fellows at the dinner were quite enthusiastic,but others thought it was not such a great idea.

In 1992, Dr Rose started his flagshipUpToDate.Like many of my colleagues, I would see him at American Societyof Nephrology annual meeting in his at first very small booth. Nephrology wasthe first component of UpToDate, and I was fortunate to be an author of severaltopic cards.UpToDate was not successful just because it was the firstcomputer access program for medical doctors.There were several thingsthat Dr Rose did to make it special:Topic cards were directed to busypractitioners and provided expert advice; Topic cards were updated regularly,at least annually; UpToDate was established without industry funding or support,which must have been quite hard early on when there were few subscriptions andvery little income; and UpToDate has an international outreach program that hasdonated subscriptions to clinicians and organizations providing care to poor orunderserved populations.

You know the rest: There are now 25specialties covered in depth, with more than 7,100 authors and editors. Some1.9 million doctors and 38,500 institutional sites worldwide use UptoDate.Thereare more than 50 million topic views per month.The median time to obtaininformation needed during a search is a little over a minute.It isestimated that UpToDate changes physician practices one-third of the time. Whatan impact!

I consider Dr Rose to be the most influentialclinical educator in the history of medicine, with an unsurpassed impact onphysician education and patients lives. While we keep alive the memories ofgreat historical figures like Hippocrates, Galen, and Osler, their impactlessens over time as medicine changes. In contrast,Dr Rosesaccomplishments will live on and his impact will become even more substantialwith each passing day and each new click leading a clinician to learn more atUpToDate.

While (thanks to Dr Rose) I may not be able toeffectively teach students about medical conditions like deep venous thrombosisor Hashimotos thyroiditis because they get to UpToDate before me, I can tellthem the history of UpToDate and how a kind, modest, brilliant nephrologist wasresponsible for much of the learning that occurs in medicine today. I hope thatwe will all keep alive the memory of Dr Rose and that someday he will berecognized for his unparalleled contribution to medicine and patient care.

I encourage you to watch the following youtubevideo, in which Dr. Rose discussed the origins of UpToDate https://www.youtube.com/watch?v=k4nQWM6U298

Anthony J. Bleyer, MD, MS, is Professor of Internal Medicineat Wake Forest University School of Medicine in Winston-Salem, North Carolinaand a member of Renal & Urology News editorial advisory board.

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Ode to Burton 'Bud' Rose, MD - Renal and Urology News

Ali Jandal was the student speaker for the medical school graduation at UW-Madison.(Photo: Courtesy of Ali Jandal)

As he approached graduation and a move to the University of Vermont for the start of his career in medicine, Ali Jandal acknowledged that he was afraid.

"How I feel about it changesday by day," said Jandal, who is from La Crosse."I think I've always been a little scared, because viruses are easy to spread and it's really hard to keep yourself safe from them."

In their final weeks of medical school at the University of Wisconsin-Madison, Jandal and his peers had seen the world turned upside down.

Live Updates: The latest on coronavirus in Wisconsin

Daily Digest: What you need to know about coronavirus in Wisconsin

Share Your Story: We want to talk to doctors, nurses and others affected by coronavirus

"I want to argue that the end of our medical school careers is poetic," Jandal said in an addressduring the school's virtual graduation. "And if any class was made for this challenge, it was us."

They were the first to navigate the medical program's new curriculum. They spent the last weeks of school at home, as thedoctors they knewfoughtCOVID-19 on the front lines. They celebrated Match Day the day they learn where they'll work their residencies and graduation from behind computer screens.

Now, they'll put their training to use.Working ininternal medicine, Jandalexpectsto see COVID-19 patients who aren't sick enough to be in an intensive care unit boththose who are getting better and those who mayget worse.

He'll be joined by the Class of 2020's newly-minted nurses, public health professionals and other health care workers as he wadesinto largelyuncharted territory. He knows that work comes with risk.

"I think the scariest part is I haven't actually worked with these people in the hospital yet. I haven't seen the people around me get sick," he said."To go from being a citizen, civilian, to being a front line workeris going to be dramatic and scary."

University of Wisconsin School of Medicine and Public Health Dean Robert Golden participates in the school's first virtual graduation ceremony held during the COVID-19 pandemic.(Photo: Todd Brown, Courtesy of UWMadison)

Wisconsin graduates of medicine, nursing and public healthsaid they're ready to get to work. They've been reading up on everything they can about an unpredictable disease.

The Class of 2020s educational experience has been capped by a global public health and medical crisis unlike any other we have experienced in the past 100 years," Robert Golden, dean of UW-Madison's school of medicine and public health, told medical school graduates.

Brianna Stankey, a senior nursing student at Alverno College, has yet to graduate, butshe's already hard at work.

When her school moved online and her clinical at Froedtert Hospital was canceled, Stankey, 22, started working full time in her training programas a certified nursing assistantat a local hospital, working primarily with cancer patients.

She plans to stay on as a nurse after graduation. Stankey, ofTrempealeau, has applied to work as a "grad nurse," working ona temporary permit that would allow her to work before she passes herlicensing exam. She'll stay in the same cancer unit.

RELATED: 'We need all hands on deck': Wisconsin considering emergency measures to put more nurses in the field

"I'm excited. I feel like there is no better time for me to get into this profession and to be working with these people," Stankey said. "It's hard being a new nurse because I don't know everything ... but it's exciting in the sense that I'm able to jump in and I'm able to help now."

It's also a bit scary, she said, and her life has changed significantly.Instead of kissing her boyfriendas she walks through the door, she runs straight tothe shower.

Work has changed, too. A mask hides the smiles she once loved to share withher patients and co-workers. Her patients arrive for treatments alone. She tries to take more time to sit with them and talk, knowing there's more to nursing than caring for people's physical needs.

"I can't imagine being a patient right now, and being at the hospital alone," she said.

There is an understandable fear in coming to the hospital during a pandemic,John Kopriva, a UW-Madison medical school graduate, said. Hospitals will need to work to reassure patients that they can seek treatment safely.

John Kopriva, center in cap and gown, is graduating from UW-Madisons medical school as an MD. At home with his family in Wauwatosa, they will be watching the graduation speeches on a laptop on the kitchen island while having brunch and celebrating the event. From left to right are his girlfriend Hailey Rowen, mother Angela, graduate John, father John, brother Joe, sister Katherine and brother David.(Photo: Michael Sears / Milwaukee Journal Sentinel)

This is true for the patients Kopriva anticipates seeing in orthopedic surgery at Emory University in Atlanta this summer. He expects he'll be busy with the backlog of elective surgeries postponed early in the outbreak. He knows there's a chance he'll run into COVID-19 as well, especially if there's a localsurge in cases.

"I think it's something that's going to define the time that I graduated," Kopriva said. "Hopefully when I'm an older attendingand looking back and giving advice to a younger medical student, I can tell them that 'Hey, that was the time when COVID was a problem. Look at all we've done since.' "

For recent graduateswho hope to find work in other areas less touched bythe pandemic response, the search is proving to be tough.

Kelly Hackett, ofWaukesha, graduated from UW-Madison with her master's degree in public health. But she's still struggling to find work formonths amid hiring freezes.

"I keep saying it's like I'm in a fragmented reality where everything around me all the news, social media, friends, family people are constantly talking about public health, whether or not they realize they're talking about public health," said Hackett.

"And yet, I'm looking at not having a job at the end of this, at a time when public health is critical."

Kelly Hackett and her family celebrate her graduation from UW-Madison.(Photo: Courtesy of Kelly Hackett)

She's still applying to jobs and interviewingwithin her expertise, which includes researchingsocial causes of health disparities factors that experts say have allowed the pandemic to affect some communities worse than others.

Ajay Sethi, an associate professor of population health sciences, said he's seen his students adapt and answer the call to help however they can.

"There is this national call to address this pandemic and public health departments everywhere are thinking of how to scale up contact tracing," Sethi said."And our students, even if they have otherinterests, many of them are eager to do that, just to answer that call."

Hackett acknowledgescontact tracing is not off the table.

"If contact tracing is what's needed and it's what is available, at least it's work and it's a way that Ican contribute," she said.

Geoffrey Watters, 50, earned his doctorate in nursing practice from UW-Madison this spring. He's feeling confident about job prospects, but others in his specialty ofpsychiatric nursingare struggling, especially in outpatient care. One of his classmates got a job, only to lose it when her employerfolded.

"There's a lot of uncertainty," Watters, of Milwaukee,said."It seems counter-intuitive that health care workers would be losing their jobs in the middle of a pandemic, but it's happening."

It shows how medical careextends beyondemergency rooms and ICUs, even in a pandemic.Mental health care remainsimportant for patients and health care providers alike, Watters said.

"Everyone is under a lot of stress and especially people who work in health care," he said.

Like so many members of the Class of 2020, there is a disappointment that comes with missing major milestones in theirfinal semesters. As is true forso many, the pandemic has exacted a personal toll.

For Stankey, missing out on the chance to celebrate the end of her senior year wasparticularly painful. Her undergraduate career was not without struggle: She spent most of it working two to three jobs to pay for school. She lost loved ones, including herfather. But she also made lifelong friends, who she's now separated from.

"As things were getting canceled, I was just whiting them out in my planner, like this is just so sad," she said. "I'm not getting that closure, of being done with school."

Jandal's wedding plans were canceled.He and his fiancee, also a new physician, will now marry in a small ceremony before they move to Vermont to start their residencies.

Hackett's father-in-lawdied the day before her graduation. He tested negative forCOVID-19. But thepandemic meant they had been unable to visit in recent weeks.

Still, each acknowledged the need for everyone to do their part to protect thosemost vulnerable to the virus.

"As talented and as smart and as many resources as you have, in a public health emergency, if you still have people who aren't convinced and won't be a part of the effort, the entire effort could fall apart," Jandal said.

Contact Devi Shastri at 414-224-2193 or DAShastri@jrn.com. Follow her on Twitter at @DeviShastri.

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Wisconsin medical students are graduating onto the front lines of coronavirus - Milwaukee Journal Sentinel

The COVID-19 pandemic has placed a tremendous burden on physicians and other health professionals. It is a burden that is cognitive, physical and emotional. One way to address this ongoing burden is through a peer support program, which can positively impact and shape the culture of medicine during the pandemic and moving forward.

Peer support is an organizational approach and an individual approach to being there for each other, Jo Shapiro, MD, FACS, an associate professor of otolaryngology-head and neck surgery at Harvard Medical School in Boston, said in an AMA webinar. When we think about our organizations and when we think about the way we practice medicine, we need to remind ourselves that the culture of medicine is very strong.

Much of the culture is wonderful, like the fact that we're healers and we put our patients first. That is beautiful, and no one will ever take that from us, but there is a dark side to this, said Dr. Shapiro. The culture has in some ways let us down over the years. Its been increasing our workload without actually increasing the support to front-line clinicians, and its minimized the emotional and physical well-being of physicians and other health care providers

Asking the question, How are we expected to sustain our work if we dont address these challenges to our well-being? Dr. Shapiro emphasized the importance of peer support. By implementing peer support in a health system or physician practice, it can help doctors and other health professionals open up about what is causing them stress.

Here are six fundamental elements for how to use peer support to provide guidance during a pandemic and beyond.

Peer support should be proactive, without waiting for peers to show signs of stress. It is important to put the invitation out there in a way that is destigmatizing, said Dr. Shapiro. Were checking in on you and offering peer support because thats what we do.

This is a routine part of what we do now, so the invitation needs to be given in that way, she said. Its not like were just calling people who we know are really not handling things well.

If youve ever been supported by anybody and that person is really giving their full caring attention to you in and of itself, that feels incredibly wonderful, said Dr. Shapiro. That is the basis of peer support. Being able to do that."

Once a peer support conversation has begun, it is important to practice empathic listening. This is because it shows that someone is really hearing what the peer is going through, she said.

Then, based on whatever they say, reflecting with the peer about what theyre feeling, what theyre experiencing and reflecting in terms of normalizing their emotions, because you wont be surprised to hear that most of the things that people say, many of us have experienced, said Dr. Shapiro.

The other part of reflecting is to validate and say, Its totally understandable that given what you just told me you were asked to do or you had to witness, that you would feel that way. That really makes sense.

And then sharing your experience when its relevant, said Dr. Shapiro. Theres this tension between you dont want to overshare because youre really there to support the peer, but sometimes if youve had a similar experience or had some kind of way to connect with the peer, it is perfectly appropriate to share to a degree.

When helping a peer, it is important to practice reframing. This allows the peer to put their emotions in context.

It also helps them to weave their emotions into the positive part of what they do, said Dr. Shapiro. The tricky part of this is you dont want to minimize their emotions, but you do want to help them see all the good that theyre doing.

Reframing is extremely important and while it can be difficult to do at times, it is key to guiding peer support.

Its helpful to encourage learning and teaching so people are learning and growing every day, pandemic or not, said Dr. Shapiro. But especially now where theres so much new information.

Im encouraging people to share what theyve learned and helping their colleagues not just get through this, but actually take better care of patients, she said. That feels good for us anytime something is learned and shared.

Encouraging learning and teaching benefits not only the individual, but the group as well. It allows the team to move through a problem together.

A key part of peer support is helping the peer reconnect to any positive coping mechanisms that they have used in the past so they can use these strategies in their current circumstances. Identifying these can help the peer work through emotions or problems blocking their path.

Interestingly or paradoxically, we often find that the coping mechanisms that the peer uses normally theyve stopped using during this especially stressful time, said Dr. Shapiro. There should be a gentle help for the peer to realize that this is such an important time to care for themselves.

It is also a time for peers to use their support systems, rely on their friends and family, and their colleagues to help them through, she said. We all need support. We all deserve support.

Connecting physicians and other health professionals to appropriate resources as needed is also vital to the success of a peer support program. Sometimes peer support is absolutely not enough, said Dr. Shapiro. We know health care providers, especially physicians, do not usually access mental health or other kinds of support.

One of the wonderful aspects of peer support is offering those resources to any of our peers, she said, adding that it can help to emphasize that sometimes a particular circumstance or environment at the moment is causing them to be especially stressed, and they may want further support

In that case, "you areas a peer supporterhappy to connect them with someone who can help them further, said Dr. Shapiro.

The AMA offers resources to help physiciansmanage their own mental healthand well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of theirphysicians and care teams during COVID-19.

The peer supporter should close with an expression of appreciation for the work the peer does and for sharing their thoughts with you. Because of the pandemic, peer support actually helps us reconnect and gives us back this feeling of solidarity, said Dr. Shapiro. We're in this together, and it's really important for us to remind ourselves that we are.

There's a lot we can do and are doing for each other, she said, adding that this is a very positive way of thinking about how we can support each other.

The AMA is offering afree survey to help health care organizations monitor the impact COVID-19has on their workforce during this pandemic. The survey can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that usethe surveywill receive free-of-charge support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.

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Using the power of peer support to positively impact medicine - American Medical Association

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COVID-19 Therapeutics Accelerator to fund international trial of chloroquine

Clare Ridley, MD, an assistant professor of anesthesiology at Washington University School of Medicine in St. Louis, works in the intensive care unit at Barnes-Jewish Hospital during the COVID-19 pandemic. Researchers at the university are helming a global study of an estimated 30,000 health-care workers to establish whether the antimalaria drug chloroquine might prevent or reduce the severity of COVID-19 infections in such workers.

With $9 million in philanthropic support, an international group of physicians and scientists is establishing a research network to evaluate promising therapies for COVID-19. The group, called the COVID-19 Research Outcomes Worldwide Network (CROWN) Collaborative, is testing whether the antimalaria drug chloroquine can prevent COVID-19 infection or decrease its severity in front-line health-care workers. An estimated 30,000 such workers from across the globe will participate in the clinical trial, which the collaborative is calling the CROWN CORONATION trial.

The collaborative and the trial are funded by the COVID-19 Therapeutics Accelerator, an initiative with contributions from an array of public and philanthropic donors, intended to support research and development to bring effective, accessible COVID-19 treatments to market as quickly as possible.

Washington University School of Medicine in St. Louis is the clinical coordinating center for this ambitious international trial. The investigators comprising the CROWN Collaborative are from prominent research organizations in African, European, North American and South American countries, including Cameroon, Canada, Ireland, Ghana, Peru, South Africa, Switzerland, the United Kingdom, the United States, and Zambia.

Because of their repeated close contacts with infected patients, front-line health-care workers in all parts of the world have a higher risk of contracting COVID-19 than most members of the general public, said one of the studys principal investigators, Michael S. Avidan, MD, the Dr. Seymour and Rose T. Brown Professor and head of the Department of Anesthesiology at Washington University. In some places, more than 10% of those who have become infected are health-care workers. There is an urgent need to identify drugs that are effective at preventing infection or mitigating its severity.

The study will recruit front-line health-care workers globally, including those from lower- and middle-income countries. Thats important because in many such countries there are relatively few health-care workers per capita, and protecting them from severe COVID-19 infection would provide a substantial public health benefit.

An important way to protect the public at large is to do our best to protect the health-care workers, Avidan said It is very important that there is a global effort to protect health-care workers because when it comes to COVID-19, were all in this together. Finding ways to keep health-care workers from getting seriously ill is one of the most important ways to protect vulnerable people everywhere.

This new trial will be important because of its immense size and global reach, as well as its use of three different but well-established chloroquine dose schedules in healthy people. Health-care workers in the trial will be divided randomly into four groups. Three of the groups will receive chloroquine at various doses. The fourth group will receive an inactive placebo. The researchers want to learn whether the drug can prevent health-care workers from developing COVID-19 disease or decrease the severity of illness for those who do become infected.

The researchers also want to determine the lowest dose required to provide a benefit. Health-care workers in the study will receive lower doses of chloroquine than have been given in most other trials that have focused on treating patients already sick with COVID-19. That is important because lower doses of chloroquine should have fewer side effects. Plus, with a limited supply of chloroquine globally, if a lower dose turns out to be just as effective as a higher dose, many more people could benefit from the drug.

When people have to travel to parts of the world where malaria is a problem, they often take low doses of chloroquine to help prevent infection, said Avidan, also a professor of psychiatry and of surgery. We want to learn whether this drug might work in a similar fashion in the case of COVID-19, or at the very least, whether low-dose chloroquine might help prevent the severe and life-threatening complications associated with the illness.

Charge nurse Caroline Becker adjusts her face shield before entering a patients room at Barnes-Jewish Hospital.

The study will last five months. Health-care workers who participate will take chloroquine or a placebo for the first three months and will be monitored for another two months. Those previously infected with COVID-19 or those who have underlying medical problems that might make it unsafe to take chloroquine, such as heart ailments, will not be eligible to participate.

Data from the trial sites will be compiled at University College London. Laurence Lovat, MD, PhD, a professor of gastroenterology and biophotonics, is the study leader in the United Kingdom.

Our hypothesis is that chloroquine may decrease the COVID-19 burden by decreasing entry of the novel coronavirus into host cells and by inhibiting viral replication, Lovat said. Furthermore, with its anti-inflammatory properties, chloroquine might dampen the exaggerated and unregulated immune response in the host, which often is responsible for the unpredictable and severe complications of COVID-19.

The CROWN CORONATION trials other principal investigators are Ramani Moonesinghe, MD, a professor of perioperative medicine at University College London, and Helen Rees, MD, executive director of the Wits Reproductive Health and HIV Institute in Johannesburg.

In the African region, the health-care workforce is under-resourced and overstretched, and the impact of the COVID-19 pandemic will make this situation worse, Rees said. If an inexpensive drug such as chloroquine could help protect our health workers, it would provide important insurance for many countries whose health-care systems could collapse if large numbers of health-care workers were to become infected and could not care for others who were sick with COVID-19.

The investigative team at Washington University includes Avidan, Mary Politi, PhD, a professor of surgery in the Division of Public Health Sciences; Erik Dubberke, MD, and Elvin Geng, MD, both professors of medicine in the Division of Infectious Diseases; and Graham Colditz, MD, DrPh, the Niess-Gain Professor of Surgery and director of the Division of Public Health Sciences; George Kyei, MD, PhD, an assistant professor of medicine in the Division of Infectious Diseases; Victor Davila-Roman, MD, a professor of medicine, of anesthesiology and of radiology and associate director of the Center for Global Health in the Institute for Public Health.

There is quite a bit of interest in chloroquine for both the prevention and treatment of COVID-19 infection, Avidan said. It has shown promise treating patients with COVID-19, but the only way to determine accurately whether this drug actually works is to conduct rigorous, large-scale, randomized trials in multiple locations.

Politi, a leader in health decision-making, said she is particularly enthusiastic about the design of the study.

The trial will be focused on health-care workers and their safety so that they can continue to care for patients around the world, she said. In addition to helping us study whether chloroquine works, and at what dose, all participants will receive education about COVID-19 and will be screened for evidence of infection. The trial has an adaptive design to learn from early study results. After a certain time period, if at least two of the chloroquine doses are demonstrating a benefit, we could stop assigning people to take placebo.

COVID-19 Therapeutics Accelerator donors include the Bill & Melinda Gates Foundation, Wellcome, Mastercard, U.K. Department for International Development, Chan Zuckerberg Initiative, Michael & Susan Dell Foundation, Avast, Zhang Yiming, Alwaleed Philanthropies, EQT and Madonna.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Global study to test malaria drug to protect health workers from COVID-19 - Washington University School of Medicine in St. Louis

May 18, 2020

Sarah Peyre

Sarah E. Peyre, associate dean for innovative education at the University of Rochester Medical Center and executive director of its Institute for Innovative Education, has been appointed dean of the Warner Graduate School of Education and Human Development. University Provost Rob Clark announced Peyres appointment, which will begin on July 1 with a five-year term.

This is a great appointment for Warner, said Clark. Out of an exceptionally strong pool of candidates, Sarah distinguished herself with her experience working in complex and fast-paced environments and with her commitment to both research and practice. She knows the University well, and will strengthen productive relationships across campus and in the Rochester community. I am thrilled to welcome her to the Deans Council. I would also like to thank Brian Brent for his service as acting dean. When Warner needed him, he stepped in to lead the school with resourcefulness and commitment.

A search committee led by Wendi Heinzelman, professor and dean of the Hajim School of Engineering & Applied Sciences, and including faculty members and leaders in education and human development, conducted a national search to identify the schools new dean and successor to Brian Brent, Earl B. Taylor Professor and senior associate dean for graduate studies, who has served as acting dean since October. The Warner School dean is a senior academic leader at the University who shapes the vision and objectives for the school, generates resources in support of those priorities, and effectively manages its operations. The dean develops the schools strategic plan that ensures its financial sustainability, builds community both within and beyond the school, fosters interdisciplinary collaborations, and maximizes its impact on the fields of education and human development.

University President Sarah Mangelsdorf commented, I have been impressed with Sarahs contributions to our Medical Center, and Im delighted that she will be now be bringing her energy and strategic vision to the important work of the Warner School.

Peyre joined the University in 2011 and also holds faculty appointments as professor of surgery, nursing, medical humanities, and bioethics. She is a national expert in the field of simulation and the development of educational innovations that support collaborative health-care models. Her work in interprofessional education includes curriculum development on disparities in health care, leadership, and technology. Her educational research has been funded by the National Institutes of Health, Josiah Macy Foundation, Burroughs Welcome Foundation, and others.

As executive director of the Institute for Innovative Education (IIE), she leads advances in health professions education through simulation, adaptive technology, team science, and novel approaches to information and education delivery. The IIE is a centralized matrix of services that includes the Miner Library and the Center for Experiential Learning, and is supported by IT and educational specialists with expertise in instructional design, simulation, and program development. The IIE supports the educational mission of the School of Medicine and Dentistry, School of Nursing, Eastman Institute of Oral Health, Strong Hospital, and the Faculty Practice Group.

Peyre serves on several committees that help advance the educational mission of the Medical Center. In 2014, she was awarded a Macy Faculty Scholar position, supporting her efforts to develop and implement an interprofessional education program addressing the communication needs at the intersection of electronic health records and patient- and family-centered care.

I am thrilled to be joining the Warner community, said Peyre. I have long admired the passion and dedication of the faculty, the robust and meaningful partnerships with the Rochester community and beyond, and the schools commitment to advancing the fields of education and human development. Together, we can help lead the way through these challenging times that are being experienced throughout the spectrum of education in our society.

Prior to joining the University, Peyre served as the director of education and research for the STRATUS Center for Medical Simulation at the Brigham and Womens Hospital, and as assistant professor of surgery at Harvard Medical School.

She received her bachelors degree in sociology from the University of California at Berkeley, and her masters degree in medical education and doctorate in educational psychology from the Rossier School of Education at the University of Southern California.

Tags: appointment, dean, Warner School of Education

Category: University News

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Sarah Peyre named dean of Warner School - University of Rochester

by: News Release & Posted By Staff | newsweb@everythinglubbock.com

(Photo provided by Texas Tech University)

LUBBOCK, Texas (NEWS RELEASE) The following is a news release from Texas Tech University:

The U.S. News and World Report ranked the Texas Tech University Health Sciences Center (TTUHSC) School of Medicine as the most affordable medical school in the country for out-of-state and in-state tuition and fees.

U.S. News surveyed 188 medical schools for the 2019 survey of research, primary care programs and affordability. Among the 72 ranked public medical schools that provided data for the survey, the average annual cost of out-of-state tuition and fees in 2019-2020 was $60,293. But the average cost was much lower at TTUHSC with tuition fees at $31,908. According to the Association of American Medical Colleges, an average of 78% of U.S. medical school applications were sent by students with an out-of-state residential status in 2019-2020.

According to U.S. News, the average student loan debt for those who completed medical doctorate degrees nearly doubled in the 17 years from the 1999-2000 academic year to the 2015-2016 academic year. The average cost of in-state tuition and fees in the 2019-2020 academic year was $36,735, according to data submitted by 74 ranked public medical schools to U.S. News in an annual survey.

Among the 10 most affordable public medical schools for in-state students, TTUHSC tops the list with the least expensive in-state tuition and fees, totaling $18,808 in 2019-2020.

We are proud to claim being the most affordable medical school but we dont compromise on quality education. A number of key metrics make our School of Medicine extremely competitive at a national level, Steven L. Berk, M.D., TTUHSC executive vice president and School of Medicine dean said.

Along with affordability, Berk said students attend the TTUHSC School of Medicine because of excellent educational advantages that include:

We offer an excellent curriculum and learning environment, Berk said. Our medicalstudents obtain the best residencies across the country at graduation, and today, with theCOVID-19 pandemic, our students are working hard to support our physicians and staffproviding care to hundreds of patients across West Texas.

(News release from Texas Tech University)

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TTUHSC named most affordable medical school in the country - KLBK | KAMC | EverythingLubbock.com

While preparing for the MCAT exam, 2018 college graduate Lauren Pinchbeck has been working 40-hour weeks as a medical scribe to squirrel away money to apply to medical school. Her former job in a Phoenix, Arizona, hospital made it tough to squeeze in study time, and she didnt score as well as she wanted the first time she took the test.

I need to take the MCAT again, and I'm really hoping they wont cancel more test dates, she says. I cant go spending all the money I've saved for applications unless Im sure I have a high chance of getting in. Even as an undergrad at Virginia Commonwealth University, Pinchbeck worked full-time. I have to finance everything myself, she explains. My dads unemployed, and there are three other kids back home.

Applying to medical school is always time-consuming and stress-inducing in addition to the MCAT exam, there are essays to write, recommendations to accumulate, interviews to ace, and more but the COVID-19 pandemic has thrown many new obstacles into the paths of thousands of aspiring doctors. And medical schools face their own issues as they try to build classes that will serve their missions and the nations need for talented future physicians.

There are so many unknowns now, says Geoffrey Young, PhD, AAMC senior director for student affairs and programs. This causes significant anxiety for students who need information from schools, which all have their own policies. And it causes concerns for admissions deans who will be reviewing applications that wont be as complete as in previous years.

Admissions officials arent terribly concerned about 2020 applicants who already went through most of the process before the pandemic hit, but instead are worried about the many essential steps in the 2021 application cycle.

That means academic medicine leaders are scouring options to move the process forward as quickly, fairly, and effectively as possible.

On April 20, after conferring with admissions deans, college prehealth advisors, and other stakeholders, the AAMCs American Medical College Application Service (AMCAS) announced that it would postpone the date that schools can access applicants files which include GPAs, MCAT scores, essays, and other key indicators from June 26 to July 10. Thats to give students more time to complete their applications before the AMCAS release date.

Due to the pandemic, this cycle is going to be like no cycle weve ever experienced before. We may not even know what some of the stages will look like until we get there.

Geoffrey Young, PhDAAMC Senior Director for Student Affairs and Programs

Individual schools are also contemplating and making COVID-19-related changes daily, and dozens of schools have posted policy changes on the AAMCs Medical School Admission Requirements page.

So far, a recent AAMC survey shows that 78% of respondents say they will accept pass/fail grades for prerequisite coursework taken between January and August this year, and 76% say they will accept online lab courses for spring 2020 and any subsequent semesters affected by the global pandemic. Other schools are also considering these options. In addition, many are considering extending application deadlines, and more than 30% of responding schools have done so. Yale, for example, has moved its secondary application meant to supplement the AMCAS package back a full month, from Nov. 15 to Dec. 15.

And more changes likely lie ahead for both students and schools.

Due to the pandemic, this cycle is going to be like no cycle weve ever experienced before. We may not even know what some of the stages will look like until we get there, says Young.

Still, he adds, the admissions community is really trying to listen to and provide support to applicants and prehealth advisors. They are doubling down on their use of holistic review to ensure they have a thorough picture of applicants.Collectively, they are really coming together to try to get through this together.

Even in ordinary times, the MCAT exam the rigorous multiple-choice test that helps schools evaluate applicants problem-solving skills, scientific knowledge, and more often tops lists of concerns about admissions.

In an attempt to protect examinees and halt the spread of the novel coronavirus, MCAT exams were suspended from March 27 through May 21. To compensate, the AAMC has announced three new testing dates June 28, September 27, and September 28. Registration for the new test dates will open on May 7. There will be a total of 21 dates between now and the end of September.

To further accommodate more test-takers, all 2020 sessions will offer three sittings per day: an early morning, an afternoon, and an evening option. To pull that off, the exam will be trimmed for the remainder of the calendar year from 7 hours to 5 hours and 45 minutes. The cuts will come from parts of the exam that dont impact scores, such as some questions that are being given a test run and an end-of-day survey. The plan is to return to the regular format in January.

In addition, MCAT officials are reducing the results-reporting timeframe from one month to two weeks for the June 19 through August 1 dates to allow examinees to include MCAT scores in their package earlier in the application cycle.

Given the unclear course of the pandemic, its impossible to predict whether all upcoming exams will be available, notes Valerie Parkas, MD, senior associate dean of admissions and recruitment for the Icahn School of Medicine at Mount Sinai. Each school needs to figure out how they want to handle the MCAT, she says. If they used to accept scores only up until September, maybe they will take them in October or even January, she notes. Here, one change weve made is that we will allow older scores than we had previously.

This is a rapidly evolving situation, and we thank examinees for their patience. We want to work to ensure the use of safe practices in the test centers.

Karen Mitchell, PhDAAMC Senior Director of Admissions Testing

Elsewhere, schools are considering whether they would screen applicants or even interview them without MCAT scores for now and then require the scores later in the process.

The MCAT serves as a bit of an equalizer, admissions leaders say. It allows us to compare applicants from different schools and who have taken different courses, explains Iris Gibbs, MD, associate dean of admissions for Stanford University School of Medicine, which signed a pandemic-related admissions statement together with all other California medical schools. Of course, we alwaysview the MCAT in the context of a holistic review of the entire application, she says.

Meanwhile, MCAT officials are focused on balancing speed and safety.

This is a rapidly evolving situation, and we thank examinees for their patience. We want to work to ensure the use of safe practices in the test centers, says Karen Mitchell, PhD, AAMC senior director of admissions testing. Once centers open up, they will practice social distancing measures and rigorous cleaning protocols, and they will allow test-takers to wear gloves and masks.

What about an online exam? Mitchell says that while her team has been evaluating various options to deal with the outbreak, online testing raises possible concerns, including that some students may face obstacles to an online offering, such as not having the right display resolution, reliable internet coverage, or a quiet spot to take the test. Fairness must be central to any solutions, she says.

Certainly, the MCAT exam is only one portion of the application process, experts note. Most schools take a holistic approach, looking at GPA, letters of recommendation, volunteer activities, and a broad range of other information, such as the context in which you were learning, says Steven Gay, MD, assistant dean for admissions at the University of Michigan Medical School.

Students, therefore, have many concerns about this multifaceted process. Below are some key issues.

As undergraduate institutions shuttered campuses and moved courses online, many switched to pass/fail grades or at least offered the option.

Although these changes were meant to serve students, they have also generated some stress. Kaitlyn Tindall, a junior at Ohio State University, notes that she didnt feel comfortable opting for pass/fail. Depending on the class, a passing grade can sometimes be anywhere from an A to a D, she notes. I dont know how medical schools will view transcripts, so I didnt want to take any chances.

Medical schools are taking a range of approaches to pass/fail, with some saying they prefer letter grades in prerequisite courses and others explicitly declaring no negative consequences for anyone who chooses the option this spring.

Meanwhile, says Young, the AAMC is developing resources to help medical schools and prehealth advisors understand how to work with changes caused by online courses and pass/fail grading. Above all, he says, we are encouraging schools to be flexible and transparent with students who are trying to figure out how to apply at an unprecedented time.

Some students worry about their ability to solicit all-important recommendation letters from professors, mentors, and prehealth advisors given the current circumstances.

I was hoping to have enough time to show professors that I could make a good medical school candidate, but we only really got to meet for the first half of the semester, says Tindall. Some of my classes have something like 500 people in them, so although a professor might recognize my face if I went to office hours, Im not sure that he would recognize my name in an email.

Another concern is whether students can garner gold-standard committee letters a composite document capturing an applicants overall preparation given that campuses have shut down.

In response, several schools have loosened their rules around recommendation letters. We will take a packet of letters rather than a committee letter, for example, and it wont hurt applicants, says Christina Grabowski, PhD, associate dean for admissions and enrollment management at the University of Alabama School of Medicine. We completely understand that the recommendation process has really been disrupted.

The COVID-19 outbreak has also severely limited applicants ability to access health care and research-related experiences.

Opportunities to get clinical experience, to volunteer in hospitals, and even to work in communities have been greatly reduced, says Gibbs. We are completely understanding about those opportunities not being available, and if a student is ready to apply in other areas, we will still take that person's application quite seriously.

But experts note that recent experiences might have made a significant difference for some candidates. For most students, applying isnt about the last three months, notes Grabowski. My fear is for students who are really counting on this time to make their applications more competitive. Unfortunately, those students may feel like they shouldnt apply now.

In fact, she adds, Im interested to see whether our application volumes will go down because of students who decide, Im just not ready, and Im going to wait another year to apply.

In a March 19 statement, the AAMC strongly encouraged medical schools and teaching hospitals to conduct all interviews virtually to help promote public health. While students may understand the need to move online, some consider it a setback.

I would be disappointed to do an interview on camera. I like to be able to get a sense of someones demeanor and to read them during the interaction, says John Thurber, a University of Alabama student working on his masters degree in biomedical and health sciences. Id be frustrated because I think I could crush an in-person interview.

Others, though, would welcome the shift. Taking off work and having to pay for flights, a place to stay, and food would put me in a bad place financially, says Pinchbeck. Sure, it would be great to see the campus, but Id rather do virtual interviews.

Schools have their own issues to consider. Grabowski offers one scenario: Say theres a dip in the pandemic when her school launches in-person interviews in August but then they have to switch to online interviews during a resurgence. That means we would be giving different students different interview experiences, which isnt completely equitable, she says.

The question then becomes if we should offer virtual interviews the whole season, or if it isnt really necessary to jump to that level from the get-go. Both options have disadvantages, but we want to try to mitigate the downsides as best we can.

Admissions officers say theyre committed to focusing on how the COVID-19 pandemic has taken a toll on the applications and the lives of medical school applicants.

Weve always had a question on our application asking students to describe any adversity that might have impacted their journey, notes Parkas. Now, though, we have explicitly indicated that applicants should let us know about anything they feel was impacted by the pandemic.

In addition, leaders recognize that some students are harder hit than others. We need to look through the lens of equity as we think about how this has impacted communities of color more, urban communities more, Parkas says.

In some cases, experts note, students are back home studying in increasingly impoverished conditions, in locations with poor Wi-Fi connections, or while acting as caregivers for younger siblings. I need to keep all this in mind as I try to understand what students have gone through during these last few months, says Gay. If I ignore this, I do so to the detriment of the applicant and my school.

Whats more, schools need to recognize that current concerns will not evaporate with this round of applications, Parkas notes.

Weve lost thousands of people during this pandemic, she says. Those people were parents and grandparents and parts of an applicants community. We have to remember that these effects will linger into many upcoming application cycles, too.

Excerpt from:

Shortened MCAT exams, extended AMCAS deadlines: How the pandemic has upended medical school admissions - AAMC

In a bold response to the COVID-19 pandemic, Rowan Universitys two medical schools are enabling their fourth-year students to graduate early and join the health care workforce weeks ahead of schedule.

Both Cooper Medical School of Rowan University (CMSRU) and Rowan University School of Osteopathic Medicine normally graduate students in mid-May, and the newly minted physicians start their hospital residencies on July 1. Under the new policy, qualified students will be able to complete medical school as early as mid-April and either start their residency shortly thereafter if the graduate medical education program accepts them to start early, or join the workforce in another capacity as an employee or volunteer.

Our medical students are passionate about helping others. They dont want to wait on the sidelines during this unprecedented public health crisis, said Annette C. Reboli, M.D., CMSRU dean.

Early graduation will allow the new doctors to help address staff shortages as health care professionals care for COVID-19 patients or are unable to work.

The new physicians can mainly care for those with other needs, as more of the medical workforce tends to the surge of COVID-19 patients, Reboli explained.

By graduating early, our students can make a huge difference in hospitals ability to care for patients and save lives, said Thomas Cavalieri, D.O., RowanSOM dean.

At CMSRU, nearly one third of the schools 79 fourth-year students reported they would like to graduate ahead of schedule. Cavalieri expects a similarly high level of interest among RowanSOMs 180-member graduating class.

While the initiative is voluntary, requirements include:

Both schools will work with students who choose the early graduation option to ensure as smooth a transition as possible, said Reboli.

Many of the graduates will join health systems in New Jersey, which has the second-highest number of COVID-19 cases nationwide, noted Cavalieri.

At RowanSOM, half of this years graduating class has accepted residencies in the states health systems, including Jefferson Health New Jersey, Cooper University Health Care, and Inspira Health. CMSRU will send 32 percent of its 2020 graduates to New Jersey institutions, with a large portion going to Cooper, the schools teaching affiliate.

By graduating sooner, our students will help allay the tremendous physician shortages expected in our state, Cavalieri said.

Some students will go to parts of the country where COVID-19 rates are low right now. While those hospitals may not need new physicians to start early, situations can change quickly as new coronavirus hot spots emerge. CMSRU and RowanSOM students can opt into the early graduation program as needs shift.

Both schools are planning early graduation ceremonies held virtually in the coming weeks. Details will be announced soon.

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Rowan University's two medical schools will offer early graduation to aid fight against coronavirus - Rowan Today

Philadelphia is home to the ninth oldest medical college in the United States and the fascinating archives that come with it.

Founded in 1825, Thomas Jefferson University has maintained a wealth of records. Most impressively, theyre all digitized. Staff have worked since 2005 to upload materials to an accessible and searchable online repository.

Thats the most exciting part, is to discover it for yourself, university archivist F. Michael Angelo told Billy Penn. We saved almost everything. Its a really rich collection, very detailed, very complete.

That means in quarantine, you can peruse centuries of health records totally free.

You wouldnt be alone. I suspect were getting new audiences now, Angelo said. Weve been getting more emails and phone calls asking questions, especially about genealogy.

The archives contain leads into stories about all number of topics, from war history to womens rights to scandals over racist body snatching. The most popular item? Look no further than an 1840 text on the anatomy of the breast.

Read on for a few highlights to get you started.

If youre interested in what its like to perform emergency medical procedures under extreme duress, look to the Civil War.

There are dozens of records on military surgery from the 1850s and 60s, when Jefferson doctors were overwhelmed with wartime injuries. The documents cover surgical technicalities, descriptions of emotional strife, and notes about the importance of medical professionals on the battlefield.

In the 1861 book A Manual of Military Surgery, Jefferson surgeon Samuel Gross wrote:

No men of any sober reflection would enlist in the service of their country, if they were not positively certain that competent physicians and surgeons would accompany them in their marches and on the field of battle, ready to attend to their diseases and accidents.

A dark spot on Jeffersons history is its sexist legacy. The Philly medical school was among the last in the country to start accepting women as students, according to Angelo, the archivist. But at least the experiences of these female pioneers were well recorded.

They did a really nice job interviewing some of those in the very first class of women, from 1961 to 1967, Angelo said.

There are about a dozen recorded interviews with women who graduated in Jeffersons first few integrated classes with audio files and written transcriptions available online.

Nancy Szwec Czarnecki tells her story as the first woman ever to graduate from Jeffersons medical school. Theres also Bonnie Lee Ashby, who later moved onto an infectious disease fellowship at Lankenau.

Anita Robinson first attended grad school at Penn but then realized she wanted to practice medicine first hand instead of research it. Shes still working in Philadelphia as a specialist in adolescent medicine.

Over the past 200 years, Thomas Jefferson University has graduated more than 46,000 medical students. By Angelos estimation, if your fam has been in Philly awhile, youre likely to find someone you know in their diploma records.

Somebody in Philadelphia who has an interesting last name probably can look in the directory and find forebears with the same last name, Angelo said. The odds are pretty good.

Here are the steps to find someone:

If youre lucky, you could find past work of someone related to you or your friends, and perhaps even find their signature in one of the university ledger books.

For those who like to confront their own mortality, searching the Jefferson archives for the word dissection will yield a whopping 1,177 results.

If you choose to click, many of them reveal pics of white men with handlebar mustaches, crowded around medical tables. Sometimes its dozens of people watching, sometimes just a few. Some of the bodies theyre observing have been resorted to skeletons, while some look mostly normal.

In the 19th century, it was tough to find cadavers on which to practice, and the college was at one point entangled in a scandal over body snatchers who raided Black cemeteries and sold disinterred bodies for $8 apiece.

Especially considering the provenance of whats on the table, the pictures are super interesting. They also reveal the evolution of popular facial hair choices of Phillys medical types over the years.

Keep your inner preteen boy from giggling if you must, but its true. The most popular item in the archives has to do with female anatomy.

According to Jefferson archivist Angelo, Anatomy of the Breast by Sir Astley Cooper has been downloaded more than 20,000 times and surpasses any other archive document in number of views.

I have to wonder how many of those downloads are because it has the word breast in it, Angelo said. Still, its a really cool item.

Though the thing was written in the 19th century, its still super accurate among the most accurate drawings of breast anatomy in the history of medicine, Angelo said. So its popular among medical students and researchers and yes, prob some internet trolls, too.

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Inside the Jefferson medical archives, where the most popular item is 1840's 'Anatomy of the Breast' - Billy Penn

Caddo Sheriff Steve Prator and Shreveport Police Chief Ben Raymond explain Gov. John Bel Edwards' stay-at-home order. Shreveport Times

Young medical school graduates around the world are joining the front line fight of the COVID-19 pandemic.

The same is true for recent LSU Health Shreveport School of Medicine graduateDr. Gabriel Sampognaro, who is making an early transition from medical school to serve alongside other LSU Health doctors during the coronavirus outbreak.

Though orthopedic medicine is Sampognaros area of practice, his assignment during the pandemic, places him in an LSU Health emergency room.

Dr. Gabriel Sampognaro(Photo: Submitted Photo)

With everything going on with the coronavirus, basically the school halted our rotations, Sampognaro said. We were unable to go to school. Everything at that point, things were changing by the minute. What was Tuesday at 8 p.m. was not the same by Wednesday morning. It got to the point where it looked like we were not going to be able to finish our rotations.

"In your fourth year, most people have finished their rotations anyway and met all of their requirements. I was finished and had a few electives left but it wasnt a required rotation so, I just choose to forgo that rotation basically. People who had not met all of the qualifications yethad the opportunity to finish them online.

Had it not been for the coronavirus outbreakApril 30 would have been Sampognaros graduation day, but that date was moved up to April 13.

People, especially students who matched at LSU Shreveport for residency, who went to LSU Shreveport for medical school, were able to start applying for their (medical) license early in order to help out with the coronavirus, Sampognaro said, adding, he expects to receive his license sometime in early May.

To provide our community with important public safety information, our newsroom is making stories related to the coronavirus free to read. To support important local journalism like this, please consider becoming a digital subscriber.

Once he receives his license to practice medicine, Sampognaro will receive emergency room training to prepare for the time hell help out at LSU Health in a new area of medicine and a new and different time in the medical field.

We were offered start dates of May 1 and June 1, Sampognaro said. I will work in the emergency room up until July 1 and then after that will start my orthopedic residency.

A big part of a medical school graduate's life is the longstanding Match Day tradition and celebrations. But how does one celebrate during the COVID-19 pandemic?

COVID-19 changed the way Americans carry out their daily routines. It also changed the way Americans honor longstanding traditions such as Match Day, a day when the National Resident Matching Program or NRMP, releases results to applicants seeking residency and fellowship training positions in the United States.

Sampognaro, like others around the world, made the most of his big day in his own special way.

"At that point we were able to congregate in groups of 10and not under full quarantine at that point, Sampognaro said. So, my wife, myself, my buddy from school and his wife, got together and had our own miniature Match Day at my house. Our wives printed out our letters and we opened them and read them; that was kind of special.

Graduating medical school is huge deal, especially for parents.

More: LSU Health Shreveport postponing its graduation until time when it's safe for large groups

Obviously, they are very proud of me, but you know were in quarantine and we cant go to see them. Especially my dad, hes 65 years old and my moms in her mid-50s, Sampognaro said. So, I definitely dont want to be around them. Weve talked a lot on the phone and well celebrate when we can all get together.

Navigating the new normal brought on by the coronavirus pandemic is difficult for everybody, but especially difficult for the heroes who serve on the front lines, the essential, working Americans.

Its a little different, weve never dealt with a global pandemic, Sampognaro said. I dont believe my parents were ever forced to stay inside with a quarantine. This pandemic is very serious, and some people are not taking as seriously as they should. But youve got to look at the extreme measures that have been taken with shutting down restaurants and businesses and see what it could have been had we not, and if people dont follow the rules weve been given.

Sampognaro has not been around the hospital much, except to get finger printed and to have a few documents notarized.

More: LSU Health Shreveport among first in US to offer nitric oxide clinical trials for COVID-19

Sampognaro said. It definitely wont be a normal day of walking into the hospital, thats for sure. Ill be joining the front line workers. I believe ER shifts are normally 12-hour shifts. I havent been told yet, but I believe I will be working 12-hour shifts in the emergency room. Its really cool, how all the different aspects of LSU medicine in all the different fields, have come together and are working to fight the virus. The orthopedics team at LSU has started doing some ICU training. At the (core) we are doctors and have the ability to learn what we need to learn. Everybody has come together for extra training to help fight this virus.

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Early LSU Health grad to serve locally on front lines of COVID-19 - Shreveport Times

In a time of year when most medical schools are finalizing their classes and students are making choices on where they will begin their medical careers, the COVID-19 global pandemic has added a curveball to the admissions process.

For the 2020 application cycle, schools with rolling admissions have filled most of their spots. From the student vantage point, the American Medical College Application Service sets a deadline for students to narrow their acceptances down to a single medical school by the end of April.

Yet the COVID-19 pandemics limiting of physical contact has changed the final recruitment weeks for both students and institutions weighing options. For instance, second-look daysa chance for admitted students to visit schools in the spring and compare their finalistshave largely been moved online.

A Second Look Day is primarily a celebration to get the students very excited for medical school, said Benjamin R. Chan, MD, associate dean for admissions at the University of Utah School of Medicine, one of 37 member schools of theAMAs Accelerating Change in Medical Education Consortium. For a significant number of students who have multiple offers, its a chance to shop around. Those being canceled nationwide forced us to adopt a virtual second-look day. I dont know that it can fully replace what a live event looks like.

In terms of making that final decision, Dr. Chan said students shouldnt change their mind about a medical school based on the pandemic.

At times of crisis, it makes sense to go with your gut instinct. If you originally liked a med school [before the pandemic], its still going to be the same medical school, even if we are all going to be a little different after this, Dr. Chan said. Dont make decisions strictly based on the crisis. The same instincts of the decision being a combination of programming strengths, connection to the local community, finances, where you see yourself, those still stand.

Medical schools that are still extending offers to new candidates continue to conduct interviews with 2020 applicants.

John D. Schriner, PhD, is associate dean for admissions and student affairs at Ohio University Heritage College of Osteopathic Medicine (OU), also a member of the AMA consortium. OU plans to complete interviewing prospective students in the coming weeks. To do that, the school has moved interviews online, conducting them in part on Zoom and in part on GoToMeeting.

We have still been able to get what we want out of the process [while conducting interviews online], Schriner said. I dont feel like were compromised, but it was just a bit different. This is kind of the new reality for everyone, and we have just established our new process.

For prospective students who are readying for remote interviews, Schriner advised to treat the experience like any other interview.

Prepare as if it were in person, which means dress for success, he said. If you can find a comfortable space that is going to be quiet, go to it. Make sure that you minimize any distractions that could take away from the focus of your interview. You still want to maintain virtual eye contact and good posture and continue to make sure that youre a really active listener.

For those planning on applying as part of the 2021 application cycle, the spring prior to applying to medical school is a common time to take the Medical College Admission Test (MCAT), one of the primary criteria used to evaluate prospective applicants.

According to an FAQ prepared by the Association of American Medical Colleges, administrations of the exam have been canceled globally through May 21. For those who had already registered for the test, all rescheduling fees will be automatically waived.

Applications are typically submitted in the early fall of the year prior to admissions. MCAT scores are part of that, and many schools require applicants to have taken the exam before October of their application year. The AAMC is working with the schools as they begin to prepare for later test score availability for the upcoming application cycle.

Other areas of a medical school applications that could be affected by the pandemic include students ability to work as volunteers or shadow physicians, which are limited by mandates on social distancing and a shortage of personal protective equipment. There also will likely be some leeway given on how medical schools view transcripts. Most medical schools do not accept undergrad pass-fail credits, but with undergraduate schools going to remote learning, that has become a common practice.

Everyone is in the same boat, Dr. Chan said. This pandemic is an international crisis. We are all going to through it together. So future students, your application is going to be impacted like everyone elses. No one can go out and do any of those premed activities right now. That might be the case for the next few months or longer, so it doesnt make sense for people to feel like they are at some sort of competitive disadvantage.

Medicine can be a career that is both challenging and highly rewarding, but figuring out a medical schools prerequisites and navigating the application process can be a challenge into itself. TheAMA premed glossary guidehas the answers to frequently asked questions about medical school, the application process, the MCAT and more.

Have peace of mind andget everything you need to start med school off strongwith the AMA.

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How COVID-19 is affecting medical school admissions - American Medical Association

Third-year Oakland University William Beaumont School of Medicine medical student Niki Khajeh recalls exactly when she knew that the novel coronavirus COVID-19 would be devastating.

It was in one of the break rooms at Beaumont Hospital where Khajeh was on an OB-GYN rotation when she witnessed a physician on the verge of tears, and the doctors face lined with marks from wearing a mask for so long.

That was early March, well before the number of COVID-19 cases surpassed the 21,000-mark (according to state numbers as of April 9).

It just kind of made me realize that Oh, this isnt even the worst of it...its going to get worse than this and it was kind of frightening to watch, Khajeh said.

Khajeh is among many with a connection to OUWB to have spent time on the frontline in the battle against COVID-19.

Some current medical students like Khajeh, for example were on the frontline in what we now know as the beginning of the outbreak in the U.S. For safety reasons, medical students were removed from clinical settings weeks ago (though many have found other ways to help the community).

Concurrently, OUWB alumni and faculty members remain in the heat of the battle. Many are taking to social media or simply sharing their stories to provide greater understanding of what its like, often using terms like tense and stressful.

Among them is Ryan Fringer, M.D., associate dean for Graduate Medical Education, OUWB, and director of Graduate Medical Education for Beaumont Health Royal Oak, Troy and Grosse Pointe.

He said it really is quite staggering to see how this illness is impacting our patient population.

No one has seen anything like this and I think that we have to understand that just being in a situation that is a first-time situation for all of us is going to be extraordinarily difficult, he said.

But we will get through this, said Fringer. This will not go on at this level of acuity forever...we have to keep that in mind.

An intense time

Fringer

Fringer said patients diagnosed with COVID-19 can generally be described as extraordinarily sick...especially those with underlying chronic illnesses.

From the medicine side of things what needs to be done, what we need to monitor, what needs to be ordered things have almost become formulaic, he said.

The difficult conversations many involving end-of-life decisions and held via phone with family members represent the toughest part of the job, he said.

Its the softer side, or the art, of what we do that is really taking up most of the time and emotional energy of the residents and staff, said Fringer.

Thats something to which Alex DeMare, M.D., OUWB Class of 2015, can attest.

DeMare is a fifth-year general surgery resident at Beaumont Hospital, Royal Oak. To help with the influx of COVID-19 patients, hes been working as part of an ICU team.

Typically, most of our surgical patients dont have terminal illnesses they cant recover from, he said. Were getting used to seeing a lot of people die, which is tough.

Jay Brahmbhatt, M.D., OUWB Class of 2017, shared a story of just how tough it can be in a piece called Hold on to humanity while we still can that he wrote for KevinMD.com.

Brahmbhatt currently is an internal medicine resident for University of Washington Affiliated Hospitals in Seattle one of the regions in the U.S. hardest hit by COVID-19.

He detailed how, while working in an ICU, he was asked to evaluate an 80-year-old Vietnamese woman, admitted to the acute care service with her husband with COVID-19 and boarded in the same room.

Brahmbhatt

I laid out the scenarios: intubation versus no intubation, resuscitation versus no resuscitation, transfer to the ICU versus remaining on the acute care service. Yes, she could continue care in the same room as her husband, though the hypoxemia would worsen and lead to death. Alternatively, she could be transferred to the ICU, a different room, unconscious, and intubated. I expressed my doubt that she would be extubated or see her husband again.

I was eventually able to pose the question in a way to best elicit his preference. He finally told me, if he were forced to choose, he would rather his wife stay in the same room as him. His wife woke up to hear that statement.

"The circularity of my discussion ceased; the tone became straightforward, pointed. She looked at me, suddenly her eyes bright with clarity. I asked her if she wanted a breathing tube to treat her illness; she nodded no. I asked if she wanted to stay with her husband, she nodded yes. She asked me if she could see her son. I told her I was not sure if it was allowed, I apologized. She thanked me anyways. The recompense was in navigating the decision.

Other OUWB alumni have shared details on what its like to be in the hospital setting today.

Andrew Koo, M.D., OUWB Class of 2016 and also a resident a Beaumont Hospital, Royal Oak, shared details on some of the changes hes witnessed within the hospital setting.

Its odd to be in the (hospital) setting when theres no visitors, everybodys wearing masks, every entrance is a sort of screening site...its just a very odd time to be a doctor, said Koo. Its also a very intense time...a lot of people are scared of whats going on.

Amanda Xi, M.D., OUWB Class of 2015, echoed similar sentiments in an Instagram post. Xi is currently in a one-year critical care fellowship at Massachusetts General Hospital in Boston.

I am at a loss for words, she wrote. I am worried about my family and friends. I am worried about how the future will look things have been changing rapidly hour to hour.

Jamilah Alhasidi, M.D., OUWB Class of 2019, and a family medicine resident at Beaumont Hospital, Troy, also took to Instagram to share her thoughts on what she called a tough month.

But I am grateful for the opportunity to be able to give back however I can, she wrote. This is the job. I may not have signed up for a pandemic, but nobody did. I did sign up to help those who need it most and I will continue to do so.

Rising to the challenge

Despite the difficulties brought on by COVID-19, Fringer, along with several others with connection to the OUWB family, say they have been generally impressed by the way health care workers have answered the call in such a time of need.

Fringer, who oversees the residency program at Beaumont Hospital, Royal Oak, has seen it firsthand through residents like DeMare who have been repurposed and reassigned from various specialties to care for COVID-19 patients.

Were essentially putting them on multi-disciplinary teams, Fringer said. And were finding these residents from all specialties are really rising to the challenge...(residents) are not only capable, but theyre interested, motivated, and volunteering to help out in different ways.

DeMare said hes seen his fellow residents step up countless times.

Whenever were asked to do something, the answer has always been Yes...yes, I can, he said. Everyone has stepped up across the board and throughout the whole hospital.

Koo said hes been particularly struck by what he calls a rally by health care workers.

Despite a lot of fear that everyone has revolving this disease, I have really seen people rally to this idea that we have this job to do, Koo said. Ive watched a lot of people who have been able to come to work, put their fear aside, and say How do I do my best today?

Gabriel Dominguez, M.D., OUWB Class of 2016, is an emergency medicine resident in central Florida (he did not want to identify the health system where hes working).

This thing is evolving really fast and its a huge privilege as an ER doctor to be there helping these patients, he said. Every day we discover new things, and its impressive to see how the medical community comes together to help each other out.

Dominguez said its not just the physicians hes working with in Florida, either.

Im in contact with my friends and colleagues from medical school at OUWB and we help each other out, he said. We still have that camaraderie, and its really amazing to be honest with you.

For more information, contact Andrew Dietderich, marketing writer, OUWB, atadietderich@oakland.edu.

Follow OUWB onFacebook,Twitter, andInstagram.

NOTICE: Except where otherwise noted, all articles are published under aCreative Commons Attribution 3.0 license. You are free to copy, distribute, adapt, transmit, or make commercial use of this work as long as you attribute Oakland University William Beaumont School of Medicine as the original creator and include a link to this article.

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OUWB on the frontline: Medical school students, alumni, and faculty battle COVID-19 - News at OU

Anthony Schramm graduated from Stony Brook University's medical school Wednesday in a Zoom call, along with 121 other graduates. Binghamton Press & Sun-Bulletin

AnthonySchramm celebrated his graduation from medical school Wednesday at his mother's house in Vestal.

Schramm's mother, Becky Schramm, and his sister, Stephanie Moochler, of Endicott, blew up balloons, shared his favorite meal chicken and dumplings and outside, members of their extended family drove by the house slowly, honking the car horn to congratulate him.

This was one of the last times they'd be together, and in light of the coronavirus spread, the moment had arrived months early.

On Friday, 26-year-old Schramm leaves for his first assignment: assisting physician at Stony Brook University Hospital onLong Island,on the front lines in the fight against COVID-19.

Anthony Schramm, of Vestal, graduated early from medical school and will spend the next 6-8 weeks at Stony Brook Hospital helping fight the coronavirus.(Photo: Photo provided)

"Im very happy to be going back to the hospital to help out," the 2012 Vestal High School graduate said Thursday. "Ive been feeling very useless just sitting at home during quarantine."

Schramm recited the Hippocratic Oath along with 121 other graduatesof Stony Brook University's Renaissance School of Medicine Wednesday, more than a month before their scheduled commencement, in a Zoom call telecast on Facebook.

In doing so, the school joined others across the United States who've pushed up graduation dates in light of the pandemic. Gov.Andrew Cuomo also passed an executive order allowingqualified medical studentsto graduate early in New York.

Coronavirus story time: Teacher, student take to Facebook to share stories live

Virtual 5K: Heart Walk, local running events keep families active while stuck at home

Schramm is scheduled to begin anesthesiology trainingat Columbia University Medical Center in New York City in July, but along with 48 fellow graduates, he's volunteered to report to Stony Brook Hospital first, and spend up to eight weeks helping fight the spread of the coronavirus.

Anthony Schramm, of Vestal, will start anesthesiology research at Columbia Medical in July.(Photo: Photo provided)

He says it was an easy decision to return to the hospitalwhere he's spent the last four years studying as a medical student.

For Moochler, it's hard not to be concerned, knowing how many more confirmed cases of COVID-19 there are in Suffolk County, where the hospital is located there have been about 17,000 confirmed cases of COVID-19 compared to about 100 confirmed cases in Broome County.

"I just know that they need him, he will save lives and I know that was what he was meant to do in his life," Moochler said. "That's enough assurance for us to just know hes going to be OK."

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Schramm's first shift is Sunday. He doesn't yet know what time his shift starts, or what unit he'll be on either emergency or intensive carebut he knows he's ready to help any way he can.

"I think it just kind of comes down to why I wanted to pursue medicine in the first place," he said. "Being a physician is such a privileged position where we get to treat people in the worst of times."

Follow Katie Sullivan Borrelli on Twitter @ByKatieBorrelli. Support our journalism and become a digital subscriber today. Click here for our special offers.

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After early graduation, Vestal native and new doctor is off to fight on COVID-19 front lines - Pressconnects

As the United States is gearing up nationwide for the surge in patients from the COVID-19 pandemic, a major question on everyone's mind is, Will we have enough doctors, nurses, pharmacists, and other health care providers? Meanwhile, medical and other health profession schools have sent students home to keep them out of harm's way; to save precious personal protective equipment; and to decrease the number of persons who might function as vectors, especially those who are young and healthy.

Academic medicine nationally might take another approach. We could quickly prepare our graduating students for meaningful work at their home medical schools in anticipation of a time in the next few months when many health care providers will become ill. For the first time since World War II, we are having major societal disruptionbut there is one major difference. Then, it was all hands on deck; now, we have more than 30000 almost-qualified future interns mostly under stay-at-home orders.

Further, delays in transition to residency for this year's students due to chaos, credentialing, and other barriers might generate more problems for graduating students and short-staffed health care systems. We should urgently prepare these all-but-graduated students to help us address the looming workforce shortage as junior physicians during the next few weeks. However, they also should get credit for the experience they will gain and the service they will provide.

The last big advantage of this plan is that the new junior interns would be working on home turf rather than adjusting to a different hospital or place, as happens for many interns who move across states, or across the country, to start in different health systems. Starting at their home institutions would vastly decrease credentialing and barriers to electronic health record access.

We would have to rapidly address financial and logistic issues. Potential guarantees for loan repayment and tuition refunds would be key to success. Health profession schools would have to signal which students have the competency to begin working with more independence and agree to supervision requirements similar to those for residents. Supervision might be expanded to appropriate recently retired physicians or those whose health risks due to COVID-19 make them unable to work on the front lines. Health systems would need to authorize access so that competent students could write orders and access electronic medical records from home. Graduate medical education (GME) leaders would need to discuss potentially giving participating students credit toward residency completion.

These are bold but relatively straightforward requests, which I am certain academic medicine could tackle nationally in concert with GME leadership. Breaking down bureaucratic barriers must be a prioritya national effort could save many thousands of lives, not to mention being a substantial uplift for exhausted health care providers. Despite the logistic challenges, definitive and organized collective action now may give the United States an edge that we desperately need in this fight.

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Fighting COVID-19: Enabling Graduating Students to Start Internship Early at Their Own Medical School - Annals of Internal Medicine

METHUEN Schyla Wante stood in her living room and marked a major life accomplishment: graduating from UMass medical schoolin a virtual ceremony.

"Our graduation was supposed to be May 31. We graduated exactly two months early," said Wante, 27, a Methuen native.

While she had planned to take some down time and travel to Nice and Croatia with friends, Wante is beingdeployed to the front lines of the COVID-19 coronavirus pandemic.

"The need is there. We are hoping to take the burden off the health care system and take the burden off people who are being overworked," said Wante, a 2011 graduate of Central Catholic High School in Lawrence.

Gov. Charlie Baker allowed Massachusetts medical students to graduate early so they can help tens of thousands people across the state infected with COVID-19.

Wante previously thought she'd work in an emergency department. Now that training is fast-tracked, she expects to be placed in one of five hospitals affiliated with the University of Massachusetts.

"I never expected to graduate under these type of circumstances," Wante said.

She said the situation is "nerve-racking," but she also has some "nervous excitement" about stepping into the medical world so suddenly.

"I really want to do anything I can to help," she said.

Schyla is the daughter of Laura and Mark Wante and has a younger sister, Jennifer, 24.

Her sister was diagnosed with diabetes at a "really young age," which was a driving factor in Schyla's interest in medicine, she said.

She previously volunteered in hospice care and as medical scribe at Lawrence General Hospital from 2015 to 2016.

She also has a strong interest in global health issues and education. In February, along with other medical students, she traveled to Peru to treat tuberculosis and longstanding HIV positive patients.

While away she was keeping an eye on COVID-19 and the path the virus was taking across the globe. She never expected it to come to this, she said.

It's a very "solemn time" in medicine right now, she said. "But I do feel this a responsibility we have," she said.

Follow staff reporter Jill Harmacinski on Twitter @EagleTribJill.

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

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After early graduation, med student joins the battle - Eagle-Tribune

HARTFORD, Conn. (WTNH) Governor Ned Lamont signed an executive order Tuesday allowing recent medical school and other medical profession graduates who are not yet licensed to participate in the states COVID-19 response for the duration of the public health and civil preparedness emergency.

This is necessary during the emergency period because the ability to take the required exams or other steps to receive a license have been suspended, Lamont said.

I've issued an Executive Order tonight permitting recent medical school and other medical profession graduates to begin practicing now.

During this emergency Connecticut needs every bit of assistance we can get.

Thank you to every health care worker for the jobs you are doing.

Days ago, New York Governor Andrew Cuomo signed a similar order that allowed those slated to graduate to practice.

Tuesday, Gov. Lamont also implemented new Safe Workplace Rules for businesses during the coronavirus outbreak.

In a post on Twitter, Gov. Lamont said the rules direct every workplace in Connecticut thats deemed essential to implement additional protective measures.

They include the rule to have every employee that CAN work from home TO work from home, gives guidance for employees who have recently traveled internationally where COVID-19 is present, eliminates all non-essential workplace travel, and gives guidance prohibition of non-essential visitors.

Governor LamontsExecutive Order No. 7Venacts the following provisions:

Safe workplaces in essential businesses: Requires the Department of Economic and Community Development to work in consultation with the Department of Public Health on the development of legally binding statewide rules prescribing additional protective measures that every workplace in Connecticut deemed essential and any other business or nonprofit allowed to remain open must follow. Such rules will be mandatory throughout the state.

oImmediately upon Governor Lamonts signing of this executive order, the Department of Economic and Community Development published theSafe Workplaces Rules for Essential Employers on its website, outlining guidance for these businesses. These rules go into effect immediately.

The rules go into effect immediately.

The Executive Order that I signed this afternoon implements new Safe Workplace Rules, which direct every workplace in Connecticut that's deemed essential to implement additional protective measures. They go into effect immediately.

Check them out here: https://t.co/zZjh3qDWQP pic.twitter.com/5WtQBCNFJO

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Governor Lamonts executive order permits recent medical school grads to begin practicing during pandemic, implements new workplace safety rules -...

A group of Creighton University medical students heeded the principal rule of their calling: First, do no harm.

When the plug got pulled on medical student rotations in hospitals and clinics last month, the students had to stay home.

Personal protective equipment was too limited to spare for students doing so in a time of crisis and potential shortage would be unconscionable, said the medical school dean, Dr. Robert Dunlay.

Plus, introducing more potentially virus-carrying humans into patient rooms could be too risky for all involved.

Dunlay said most medical schools across the U.S. have pulled medical students from hospital and clinic rotations, though in hard-hit places where fourth-year students have high-demand skills, they are still present. The students who do miss clinic will have to make up the lost time, and Dunlay said he hopes that Creightons students can be back in clinical settings as early as June.

Creighton medical students understood the reasoning, but some were unhappy about being benched when rotations ended March 17. No one, least of all a young, idealistic would-be doctor, wants to sit on her hands in a time of crisis.

So they sprang into action. Second-year student Grace Pratt, a 23-year-old from suburban St. Paul, Minnesota, and third-year student Adrienne Pyle, a 25-year-old from Des Moines, devised ways that they could help from afar: medical supply drives.

Last week, they blitzed local businesses and made a public ask for the desperately needed PPE. In two days, they collected 29,000 surgical gloves, N95 and other face masks, and alcohol wipes. Those went to homeless shelters, community health clinics and the students teaching hospital, Creighton University Medical Center-Bergan Mercy.

Now they are collecting scrubs: New or gently used, preferably in shades of green or blue (patterns are OK). Collection sites are Wohlners (in the anteroom between the covered parking garage and store entrance at 33rd and Dodge Streets) and First Covenant Church at 201 N. 90th St.

Students will go fetch donated scrubs, too, if donors make the request by email at creightoncares2020@gmail.com. The drive runs through the end of April.

Goodwill will give some 350 sets of scrubs collected from the nonprofits retail stores. Max I. Walker will provide dry cleaning.

All supplies are in desperate need. The scrubs give health care workers a clean change of clothes for the drive home.

Creightons campus, like other college campuses, is shut down. Med students cant gather. Classes are held online. The students lives, too, have been interrupted by the novel coronavirus.

But this is giving them quite the education.

Pratt wants to specialize in emergency medicine despite the fact that this kind of front-line work just got more dangerous. She said she is learning about how different hospitals and systems handle something so massive and how changes being made now to keep workers safer will probably be enshrined in a hoped-for safer future.

Pyle, who wants to study obstetrics and gynecology, said students are learning from how their own professors grapple with the upside-down present and unknown future. If anything, she said, this experience will sharpen students abilities to deal with change and emergencies. Pyle said shes seeing a lot of really great leaders handle unusual situations with grace.

Its teaching us how we who will be the future people in charge of the next pandemic or next medical emergency how we are to handle that and how we can be effective leaders, she said. Its been very enriching to be able to learn how to adapt and be flexible and make the best of every situation.

Pyle is a vice president of her class. Pratt is not in student government but described herself as someone who wanted to get the ball rolling and start helping.

The two are in different graduating classes and were well-acquainted. But the pandemic placed them in the same helper roles together, said Pratt, texting back and forth like crazy.

Community helping efforts were, in part, an outgrowth of an in-house system of help that sprang up as the pandemic began. A Creighton University School of Medicine mutual aid society allows students to help one another with everything from child care to rides to the grocery store to medicine drop-offs.

The act of helping is a form of medicine.

Its really awesome, honestly, to be able to contribute in some way, Pratt said. It does feel like youre benched when theres nothing youre able to do. Were so close to being able to help, but were not quite there.

Dunlay said Creighton emphasizes to prospective and current medical students that their training is to form them for a life of service to others. This is especially true now. He said the pandemic response offers important lessons.

What we really want them to see is resiliency, he said. Were in a business where you cant give up. Youve got to keep looking for new solutions to tough problems. And frankly, people look to physicians for leadership. We expect them to step up and offer innovative leadership during times of great stress.

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Grace: Creighton med students can't be in the hospital, but they're still finding ways to help - Omaha World-Herald

There has been a lot of public debate over the last few weeks over the role scientists are playing during the coronavirus crisis. In the space of just a few weeks, the likes of Chris Whitty, chief medical officer for England, and Patrick Vallance, the governments chief scientific adviser, have become household names.

As Covid-19 spreads around the world, scientists are taking a prominent role in advancing public knowledge about the virus by advising world leaders, providing expert comment in the media and urgently researching new ways of tackling the pandemic. We are lucky here in the UK: the scientists we have at the moment are as good as it gets. Whitty is a professor of epidemiology this is what he does.

But as this crisis deepens the role of researchers will become even more fundamental as many are now being called upon to join the NHS frontline. Thankfully, we understand within the community that research can go on hold. Whats more, much of it has to because of social distancing.

We have taken the decision to release all our clinical staff from academic and research responsibilities at UCL, where I am head of the medical school, as part of a national effort to staff hospitals. These are medically trained staff, who work across the faculties of population health, medical, life, brain and engineering sciences. I expect we will see the same measures enacted soon nationwide. The medical community needs to do everything possible in response to this epidemic.

In nearly 35 years as a doctor, the coronavirus pandemic is like nothing I have witnessed a global crisis, which will likely overload the health service in every country if it hasnt already done so. By this, I mean, health services will be overwhelmed by the demand put on them by the number of patients requiring treatment. I fear we have to see doctors and nurses working double, or even triple shifts. Many, themselves, will of course get sick, and will have to self-isolate, further compounding the problem.

My work at UCL requires me to look after the largest group of biomedical scientists in Europe. Two weeks ago, I started a regular, albeit occasional, clinical service as a consultant respiratory physician at Londons University College hospital alongside this. I always enjoy leaving the desk work behind and returning to my roots as a clinician. As things progress, I am in no doubt that I will spend more and more time on the frontline.

My first week working in the wards was unremarkable. But by week two last week everything had changed. The ward became eerily quiet. Very few patients were referred to the respiratory team as we prepared for the expected influx of patients infected with the Covid-19 virus. Patients were moved to different wards or different hospitals, personal protective equipment arrived and the infectious diseases team grew overnight.

Then, the patients with Covid-19 started to arrive. As expected some were well, some poorly and new unexpected challenges emerged. Can a patient who is a contact of a patient with Covid-19 have an MRI scan? How can we get a patient home if their carer(s) are unwilling to look after them?

We live in unprecedented times, at least for my generation of 50-something doctors. We are three-four weeks behind Italy and the full force of the pandemic is about to break in the UK which it is thought will not peak until mid-June. The horrific images that we see from Italy are likely to play out here. Of course I might get ill myself, but this is a challenge faced by everybody. Ideally, I hope I will be fine, but if I get it, I get it. I will self-isolate and hope I am fine.

The demand for beds and intensive care facilities, the difficult decisions with limited resources and the pressure on staff, will all build over the coming weeks and months. I have heard that many colleagues have offered to volunteer and have received numerous positive messages from our hospital colleagues. The government has said it will provide training for anyone who feels it is necessary.

Our senior students will also be given the opportunity to help and dozens of other highly skilled scientists working in our labs with relevant transferable skills will also be freed up. But UCL is not mandating this, it will be down to individual choice.

Whatever may happen over the coming weeks and months, I have never been so pleased that we have a joined-up public health structure, a top down NHS, dedicated and loyal staff from across the clinical field and the brightest and best-informed people advising the government on the way forward. Everyone is now stepping up in this new healthcare environment: health professionals doing what they do best. We are professionals, this is what we do. This is our moment. We have to step up and deliver.

Prof David Lomas is vice provost (health), UCL and head of UCL medical school

More:

I'm the head of a medical school. But doctors like me are going back to the frontline - The Guardian