A. Menon is a fourth-year MD-MPH student, University of Michigan Medical School, Ann Arbor, Michigan.
E.J. Klein is a fourth-year MD-MPH student, University of Michigan Medical School, Ann Arbor, Michigan.
Acad Med. 2020 Aug;95(8):1149-1151. doi: 10.1097/ACM.0000000000003478.
In light of the evolving COVID-19 pandemic, the Association of American Medical Colleges (AAMC) and Liaison Committee on Medical Education (LCME) released a joint statement in March 2020 recommending an immediate suspension of medical student participation in direct patient contact. As graduating medical students who will soon begin residency, the authors fully support this recommendation. Though paid health care workers, like residents, nurses, and environmental services staff, are essential to the management of COVID-19 patients, medical students are not. Students' continued involvement in direct patient care will contribute to SARS-CoV-2 exposures and transmissions and will waste already limited personal protective equipment. By decreasing nonessential personnel in health care settings, including medical students, medical schools will contribute to national and global efforts to "flatten the curve."The authors also assert that medical schools are responsible for ensuring medical student safety. Without the protections provided to paid health care workers, students are uniquely disadvantaged within the medical hierarchy; these inequalities must be addressed before medical students are safely reintegrated into clinical roles. Although graduating medical students and institutional leadership may worry that suspending clinical rotations might prevent students from completing graduation requirements, the authors argue the ethical obligation to "flatten the curve" supersedes usual teaching responsibilities. Therefore, the authors request further guidance from the LCME and AAMC regarding curricular exemptions/alternatives and adjusted graduation timelines. The pool of graduating medical students affected by this pause in direct patient contact represents a powerful reserve, which may soon need to be used as the COVID-19 pandemic continues to challenge the U.S. health care infrastructure.
鉴于 COVID-19 大流行的不断演变,美国医学院协会 (AAMC) 和医学教育联络委员会 (LCME) 于 2020 年 3 月发布了一份联合声明,建议立即暂停医学生参与直接接触患者。作为即将开始住院实习的应届医学毕业生,作者完全支持这一建议。尽管像住院医师、护士和环境卫生服务人员这样的带薪卫生保健工作者对于 COVID-19 患者的管理至关重要,但医学生并非如此。学生继续参与直接的患者护理将导致 SARS-CoV-2 的暴露和传播,并浪费已经有限的个人防护设备。通过减少医疗保健环境中的非必要人员,包括医学生,医学院将为国家和全球努力“拉平曲线”做出贡献。作者还断言,医学院有责任确保医学生的安全。没有向带薪卫生保健工作者提供的保护,学生在医疗等级制度中处于独特的劣势;在将医学生安全重新融入临床角色之前,必须解决这些不平等问题。尽管应届医学毕业生和机构领导层可能担心暂停临床轮转可能会阻止学生完成毕业要求,但作者认为,“拉平曲线”的道德义务优先于通常的教学责任。因此,作者请求 LCME 和 AAMC 就课程豁免/替代方案和调整毕业时间表提供进一步指导。受直接接触患者暂停影响的应届医学毕业生群体代表了一个强大的储备力量,随着 COVID-19 大流行继续挑战美国医疗保健基础设施,这个储备力量可能很快就需要被利用。