The health care system is broken. Physician burnout is at an all-time high. Patients don’t trust us. If you ask any medical student today, they will have heard at least one of these statements from their educators, often coupled with the phrase: We don’t know how to solve it, but your generation will find the solution. While meant as encouragement, these statements paint a gruesome future for the health professions we are about to enter. Never before have we seen the U.S. health care system more strained than with the alarming global spread of COVID-19.
As most universities and colleges attempt to navigate a brave new frontier of online education, health professional students are in a unique position, given that there are few virtual substitutes for patient care. To master the skills we will need as future physicians, we model our actions and behaviors on those of our teachers, mentors, and leaders. This opportunity allows us to observe from within the system the responses to this global health crisis.
In the midst of the unforeseen response to COVID-19, we have witnessed mass hysteria, a lack of medical supplies and personal protective equipment, and constantly changing policies. No one is more affected by this than clinicians making their best efforts to implement near-daily changes to institutional protocols in a fear-filled, uncertain environment. What’s worse is that these changes are being implemented in an already deeply inefficient system. As Dr. Atul Gawande describes, levels of burnout, depression, and suicidal ideation in physicians are double or triple that of other professions. Medical students envision a bleak future as they encounter a cumbersome electronic medical record, fee-for-service health care, and bureaucratic structures as problems that our generation is left to fix. The further strain put on this system by the flexibility the present pandemic is requiring reminds us that we have not been set up to deal with this. Medical students don’t know enough about how to solve it, just enough to know to be worried.
The advice given by our mentors, to wash our hands, stay healthy, and to remain compassionate and understanding in this time of uncertainty, while well-meaning, does not address the true anxiety engendered by the COVID-19 pandemic. What we really need, and what our patients are looking for, are examples of leadership–to be given action to take in the face of such adversities and appropriate strategies to turn to when uncertainty becomes overwhelming. The worst action is none at all.
Oddly enough, providers can use this opportunity to rebuild trust with the medical system, the community, and each other. Limited in our capacity to help in direct patient care (yet), medical students can play a vital role in driving that trust by being liaisons to the greater community. By putting together solutions, students can set a precedent for future disasters that threaten the human condition.
Several students have done just that. For example, Jasmine Chigbu, a second-year medical student, responded to the rapid removal of students from college campuses by creating a COVID-19 Resource Database to support students during the pandemic. Medical student bodies around the country are also coordinating efforts to provide child care, do phone screenings for patients, and reschedule canceled appointments. Individual students have also taken action by being a resource for accurate information on social media, advocating for physical distancing, and the public health significance of doing so. This collective response, prompted by our desire to be useful in a time where our education and its near and distant future is in flux, highlights the ways we might help in a time and place where we otherwise feel entirely helpless.
A message from some of our teachers and mentors provided both an encouragement and a challenge: “[We] encourage you to take time to consider your future roles to care for vulnerable people wherever they might live. This is a privilege of our chosen profession … What creative ways can you envision to enhance your learning, as well as the learning of your classmates right now? [We] look forward to hearing stories of educational innovation and creativity as we all go through this time together.”
We do not have to continue to blame external forces for the stresses upon us now. By organizing, mobilizing, and finding solutions to the problems facing us and our adopted community today, we can meet the current challenge to be of help, however we can. Perhaps, in this way, we can stop making pandemics a future generation’s problem to solve, and instead become the leaders we once needed ourselves.
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