THE LOSS OF IN-PERSON INTERVIEWS WARRANTED CREATIVE SOLUTIONS, SUCH AS MAKING INFORMATIONAL VIDEOS ABOUT RESIDENCY PROGRAMS AND NEW ORLEANS AND CREATING QUIET ‘INTERVIEW ROOMS’ ON CAMPUS FOR OUR STUDENTS TO INTERVIEW WITH RELIABLE INTERNET ACCESS.
T HE EFFECTS OF THE COVID-19 PANDEMIC ON THE UNDERGRADUATE MEDICAL EDUCATION EXPERIENCE AT LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS Cathy Lazarus, MD; Hamilton Farris, PhD; Kia Sayers, M4; Nancy Tran, M4; Robin English, MD
ceremonies were cancelled: Match Day, the ritual at which students discover their residency locations, andgraduation. Instead of celebrating their years of hard work surrounded by classmates and family, students opened an email from the National Resident Matching Program (NRMP) in solitude. This represented a great disappointment for students, families, and faculty who deserve commendation for quickly adapting to a new harsh reality. The traditional graduation ceremony was originally scheduled for May 14, 2020. Per LSU SOM NO tradition, the day before graduation is precommencement. Members of our Student Affairs office, in conjunction with our Information Technology staff, quickly created a virtual precommencement event, which was conducted via Zoom and streamed on YouTube for family and friends. As per our tradition, student awards were given, and students were symbolically hooded by student-selected faculty or family members with terminal doctoral degrees. The class president and other class officers worked tirelessly to make the event meaningful for their peers, including delivering ceremonial goody bags to the students’ residences without in-person contact. We have promised the Class of 2020 the best reunion ever, once in-person gathering is possible again.
ABSTRACT
with another school, as close as possible in the same geographic region, to allow only one rotation per student in the given discipline. Accordingly, LSU SOMNO partnered with LSU Shreveport to offer rotations for students in three disciplines. Additionally, residency programs were advised that all interviews were to be conducted virtually. National specialty organizations offered guidance to program directors in their disciplines to make the process more transparent and uniform across the country. 7 This directive required a quick pivot for programs to develop virtual materials and to design ways to connect virtually with prospective applicants. These necessary and proactive measures provoked anxiety in both students and program directors, but the relevant parties adapted, and the virtual interview process took place with similar timing to previous interview seasons. The loss of in-person interviews warranted creative solutions, such as making informational videos about residency programs and New Orleans and creating quiet ‘interview rooms’ on campus for our students to interview with reliable internet access. The medical education community looks on in interest to see the impact this will have on match outcomes and on the residency application process going forward. It has certainly saved applicants and programs a great deal of money. The cancellation of USMLE Step 2 CS for seniors was referenced above, but the administration of USMLE Step 2 CK (Clinical Knowledge) examinations, which are taken after the junior year, was also severely disrupted. Prometric test centers, which administer these examinations, closed nation-wide and were only allowed to re-open on a case by case basis pending the viral activity and restrictions within their geographic regions. This generated widespread cancellations and rescheduling of Step 2 CK, leading to significant anxiety for students in this class. Despite the disruption, andat the timeof this publication, student scores on this examination have not deviated from prior years. Similarly to the class of 2020, traditional Match Day activities for this class have been cancelled. Match Day will be a brief virtual ceremony prior to the distribution of match results. Students who oversee planning of this event are utilizing various social media platforms to increase the opportunities for students to interact with their classmates. Final decisions regarding graduation and precommencement are still pending.
The COVID-19 pandemic affected students at Louisiana State University School of Medicine in New Orleans (LSU SOM NO) as it did at many other medical schools around the world. School administrators, faculty, and students had to adjust their teaching, learning, and assessment strategies in a matter of days to weeks to complete training requirements and ensure continuing education. Four classes of students and the incoming matriculating class of August 2020 faced an array of unique and universal challenges. Guidance from the American Association of Medical Colleges (AAMC) and the Liaison Committee on Medical Education (LCME) shaped the approach taken by course directors, clerkship directors, and faculty within the Offices of Undergraduate Medical Education and Student Affairs to ensure compliance with national recommendations and accreditation standards. Here we describe our efforts and the challenges that lie ahead.
INTRODUCTION
for students who were in a limbo status, being unable to officially start residency training until July 1. Following guidance issued by the AAMC, stating that any student participation in the care of patients with COVID-19 should be voluntary 2 , we quickly developed a new senior year elective so that students who were interested in contributing to local medical volunteer activities could participate and receive credit. Due to PPE shortages, these activities were limited to research, community testing with supervision, following up with patients with COVID-19 who had been discharged from the hospital or sent home from the emergency department, and serving at our city convention center, which was converted to a treatment site. Most student participation involved analyzing patient charts and data from our hospitals’ intensive care units, contributing valuable skills to the creation of some of the New Orleans early evidence-based ICU protocols for care of these patients. 3 The United States Medical Licensure Examination Step 2 Clinical SkillsExaminations (USMLEStep2CS)hashistorically been required for graduation from our school. In response to the pandemic, the National Board of Medical Examiners (NBME) suspended, and subsequently discontinued, Step 2 CS testing. 4,5 During the initial suspension, several of our students were scheduled for but had not yet taken the examination. The school moved forward with its defined process through the Academic Standards Committee to waive the requirement of Step 2 CS for those graduating students. The state licensure boards took similar action with respect to licensing requirements.
In early March of 2020, cases of patients with COVID-19 surged in the New Orleans metropolitan area. The COVID-19 stay at home order for Louisiana was issued on March 22 nd . 1 This necessitated a comprehensive shift in educational strategies for students in their pre-clerkship and clerkship phases. Faculty leaders in the Offices of Undergraduate Medical Education and Student Affairs utilized guidance from our hospital partners and national organizations, such as the AAMC and LCME, to craft a plan for continuing education while keeping our students safe and compliant with city and state regulations. Hospital partners and national organizations recommended that medical students cease clinical work in the immediate weeks following the stay at home order, primarily because of the shortage of Personal Protective Equipment (PPE). This article outlines the changes initiated by class in addition to the overall changes to the medical school experience. All classes encountered different challenges, including curriculum variations in the pre-clerkship phase, postponement or cancellation of important rituals and ceremonies, and alterations in the residency interview and match selection process.
THE CLASS OF 2021
When the stay at home order was issued in New Orleans, the third-year students were removed from conventional, in-person clinical rotations. Our clerkship and site directors worked closely and swiftly with members from the Offices of Undergraduate Medical Education and Student Affairs to transition clerkship didactic activities to virtual sessions and allow students to participate in telemedicine visits. Approximately 8 weeks after transitioning to all-virtual participation, our hospital partners allowed students to return to in-person clinical duties, seeing patients on a limited basis. The lengths of clerkships were adjusted, and we met with students and clerkship faculty frequently to ensure that core clinical conditions and clerkship requirements were met in accordance with accreditation standards. This was achieved for nearly all of our third- year students by the end of the year, with few exceptions completing requirements in the beginning of their senior year. The disruption came at a critical point in the third-year timeline: at the end of the third year students prepare for away rotations, take USMLE Step 2 examinations, and begin work on residency applications. The AAMC issued guidance, that quickly became normative across the country, recommending that all away senior rotations be cancelled, with the sole exception of students applying to residencies in disciplines not available at their home schools. 6 In such cases, schools were instructed to partner
THE CLASS OF 2020
Faced with graduation only weeks after the onset of the COVID-19 outbreak in the United States, like many schools around the country, the possibility of an early graduation for senior year medical students was considered. Leaders at LSU SOM NO decided against pursuing the option given concerns about licensure, supervision, and safety
Changes for the class 2020 were not limited to clinical and testing responsibilities, however. Two important
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J LA MED SOC | VOL 173 | SUMMER 2021
J LA MED SOC | VOL 173 | SUMMER 2021
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