Tuesday, May 26, 2020

Third-year students to return to clinical rotations

Medical students round with attending and resident physicians at University Hospital in 2019.
After 10 weeks on virtual clerkship rotations because of COVID-19, third-year medical students at the University of South Alabama College of Medicine will return to USA Health hospitals and clinics starting June 1.

T.J. Hundley, M.D., associate dean for medical education, said that the students will follow all screening and PPE requirements set forth for USA Health employees to reduce the spread of infection, and will not be allowed to treat COVID-19 patients.

“The faculty and residents are excited about getting our students back into the clinical environment where they can see patients, interact with them and learn those critical skills that complement the medical knowledge they’ve been gaining while they’ve been outside the clinical environment,” Hundley said.

Classes at the USA College of Medicine transitioned to an online learning format in March in response to the COVID-19 pandemic. Faculty members used Zoom video conferencing to post team-based learning exercises, including lectures and interactive case studies, allowing students to interact with faculty and ask questions.

The shift was significant for third-year clerkships, which form the foundation of the third year of medical school. Rotating through clerkships in family medicine, internal medicine, neurology, OB-GYN, pediatrics, psychiatry and surgery, students begin to apply the knowledge they gained during their preclinical years to real patients under the direction of resident and attending physicians.

Third-year medical student Jordan Smith said she is relieved and grateful to be returning for the final two weeks of her internal medicine rotation. “Internal medicine is known for being the clerkship in which you see the same patient every day for up to four weeks,” Smith said. “You can really develop a deeper relationship with your patients and their families.”

Third-year medical student Ravi Rajendra was preparing to begin his orthopaedics elective when the college transitioned to virtual learning. “My dream is to become a pediatric orthopaedic surgeon, so initially I was sad that my orthopaedics elective would not proceed due to COVID-19,” he said.

Rajendra was still able to round virtually with faculty and residents in his pediatric rotation. “Although I am not physically at the hospital, I have been able to learn about newborn care and, to my delight, about certain pediatric orthopaedic conditions that can affect the newborn,” he said.

Lynn Batten, M.D., associate professor of pediatrics, said that some – but not all – lessons can be taught virtually. Faculty can present cases and ask students to develop their clinical reasoning skills by formulating a differential diagnosis and considering what tests to order and why.

“The things they’re missing in the virtual environment are the patient interactions – actually putting a stethoscope on someone and deciding if there’s a murmur and what it is,” she said. “They’re missing the humanistic side of medicine – touching a mom’s shoulder and reassuring her that her child is going to be fine, or calming down a scared toddler by juggling his shoes to make him laugh. We hope to provide those experiences for them when they come back.”

Hundley said that students will return to the clerkship rotations they left, ensuring that they don’t miss out on important skills.

Also, returning in June will keep the class from having to make up hours in July, thus keeping the fourth year mostly on schedule, said Smith, who will apply to urology programs in the fall. “Not having to make up clinical time will allow us to study diligently and ace board exams, complete and excel in acting internships for letters of recommendation, and also ensure that the Medical Student Performance Evaluation will be completed by the time we begin to apply for residency. It cannot be understated how important this is.”