Should Medical Students Keep Their Clinical Activities During the Covid-19 Pandemic?

Abstract

In three months, covid-19 evolved from an outbreak of severe pneumonia in Wuhan, China, to a global pandemic with hundreds of thousands of confirmed cases and many thousands of deaths. 1 While China has all but stopped it, the pandemic continues to grow exponentially in most countries. Thanks to its exponential growth, covid-19 has been overwhelming healthcare systems and imposing a series of dilemmas throughout the world. One dilemma is the involvement of medical students in the response to covid-19. On the one hand, higher education students have seen their in-person activities replaced by remote activities. On the other hand, healthcare professionals have been summoned to maximize their clinical activities, which involve increased exposure to covid-19, among other contagious diseases. What then should be done about the medical students' clinical activities? Some say we should stop their clinical activities, while others say we must increase the activities or even fast-track the student' s graduation. WHETHER TO SUSPEND CLINICAL CLERKSHIP Clinical clerkship occupies the last one to two years of medical school and consists of practical activities in various clinical settings. The medical student' s clinical competence increases considerably during this phase, thanks to contact with real patients under direct supervision of qualified medical doctors. Depending on the context, contact with real patients involves exposition to contagious diseases, such as tuberculosis 2 or SARS 3. With the progressive focus of healthcare services towards handling the pandemics, keeping the clinical clerkship going on involves putting medical students in contact with covid-19 patients. We disagree with three arguments that have been put forward for keeping clinical clerkship or even deliberately directing it towards covid-19. The first and most prevalent argument is the need to increase the workforce in health services. This argument comes up against the fact that students are not part of the workforce: their clinical activities are selected based on the educational potential, not on the assistance demand. Besides, direct supervision means students deviate preceptors from performing their own clinical activities. 4 An effective increase in the workforce would require students to perform activities they are already qualified for, and without direct supervision, thus beating the whole purpose of medical education. The second argument is that the presence of students would increase the quality of the health services. While this is a well-known phenomenon, 4 temporarily removing medical students from the health services should not revert it. Furthermore, the covid-19 pandemic is depleting personal protective equipment (PPE) everywhere, and the continuing presence of medical students would multiply the demand for PPE. An early shortage of PPE would then result in preventable exposure of healthcare professionals and medical students alike to contagion by covid-19. Lastly, the third argument is that public health crises would comprise uniq...

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