COVID-19 Impact on Electives and Clerkships

[rmorelan]

57 minutes ago, LittleDaisy said:

I find it ironic that the likelihood of residents getting the COVID-19 is much higher in hospitals than doing royal college exams with multiple testing centers and multiple dates. 

Ha, well true - although that is the job and that factor cannot be fully removed from it while the exam is more controllable in a sense. Doesn't come up much - or really enough I think the public view but yeah doctors put their health on the line, as well as the health of their family indirectly to do their jobs. That crops up in big picture stuff like this or the more day to day stuff. All of us have treated or exposed to cases of infectious diseases in many forms, and depending on our fields been dealing with needle/surgical cuts etc no matter how careful we are (as some one who has been poked with those needles from sick patients I can tell you it is not fun.) just as two examples. 

 

[Edict]

4 hours ago, Snowmen said:

Reading about the situation in Italy or Spain really makes me feel like this is a period where what we'll need is someone to chat with the patients.

https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/

If you didn't get what i was referring to, nevermind. Just stay home. 

[Haribo7173]

34 minutes ago, HappyAndHopeful said:

Med students here are strictly not allowed to see or be involved in the care of any potential or confirmed covid patients. Thankfully, the staff all seem to be pretty well-aware of this and I haven’t heard of anyone being asked to see a patient with it. 

Yup. It’s been very well handled so far in my experience.

[frenchpress]

Just announced UBC is suspending all clinical activities for clerks until minimum March 29.

[CantConcentrate]

UofT has just cancelled all clinical activities for clerks until March 29.

[HateTheSystem]

Any ideas how schools can ensure completion of core clerkship for third year clerks before elective time in September? 

[omentum]

13 minutes ago, HateTheSystem said:

Any ideas how schools can ensure completion of core clerkship for third year clerks before elective time in September? 

I'm thinking:

- extending the CARMS deadline by a few weeks possibly  
- cutting out a portion of selectives in 4th year 
- possibly shorten the remaining rotations by 1-2 weeks each - but I don't see this happening

No idea how they'll deal with this though  

[frenchpress]

19 minutes ago, HateTheSystem said:

Any ideas how schools can ensure completion of core clerkship for third year clerks before elective time in September? 

I think it’s going to have to vary school to school, and will depend on how long this goes on for. At UBC, for example, our electives are supposed to start in July. If this goes on for a prolonged period of time there may have to be accommodations for a reduction in required weeks per rotations if they want to promote students to year 4 on time. Or perhaps they could delay the start of electives. All speculation at this point.

[omentum]

UofT's official post of cancelling clerkship for 2 weeks: 

https://medicine.utoronto.ca/md-program-pausing-year-3-clerkship

What's the situation at McMaster, Queen's and Ottawa like? 

I'm a bit disappointed if they haven't paused clinical activities for clerks yet...

[mcatthrow101]

UAlberta has decided NOT to remove clerks from clinical activities

*Update* They have decided to remove clerks

[Sauna]

41 minutes ago, omentum said:

UofT's official post of cancelling clerkship for 2 weeks: 

https://medicine.utoronto.ca/md-program-pausing-year-3-clerkship

What's the situation at McMaster, Queen's and Ottawa like? 

I'm a bit disappointed if they haven't paused clinical activities for clerks yet...

Queen's 3rd year clerks will be on vacation for a week followed by an online curriculum for 2 weeks. Different integrated streams will have different sequences (ie some students will still be in clinical activities this week if they're at an integrated site)

 

[omentum]

2 minutes ago, Sauna said:

Queen's 3rd year clerks will be on vacation for a week followed by an online curriculum for 2 weeks. Different integrated streams will have different sequences (ie some students will still be in clinical activities this week if they're at an integrated site)

 

Interesting - that seems like a well thought out initiatve by Queen's. 

Kinda surprised that Ottawa, NOSM and McMaster are still expecting their clerks to perform duties...

[X Æ A-12]

Most McMaster clerks are on 2 weeks of electives before returning to core. These 2 weeks were cancelled for most. --> Most cancellations occured to late for admin to find replacement electives starting March 16th and thus we're forced to do a reading or research elective instead. 

A handful had 4 weeks of electives cancelled. Reading or research electives for the first 2 weeks as above. Hopefully we'll find a clinical elective for the last 2 weeks. 

A handful are on their ObGyn core.

Clinical activities will proceed as usual. Med students not allowed to interact with COVID-19 positive or suspicious for COVID-19 patients. Med students not allowed to partake in care requiring PPE (e.g. contact/droplet/airborne precautions, aerosolizing procedures e.g. bronch/intubation, ORs)

[HappyAndHopeful]

To the residents and staff on the forum, what are your thoughts re: clerks continuing? Have heard a few staff express that we should continue working because we need to learn how the hospital/physicians function in this situation and continue helping where possible (but not with any covid or resp infection patients). Personally I’d like to continue working right now but would also understand if it becomes an issue of limited PPE and/or transmission concern. 

[omentum]

15 minutes ago, HappyAndHopeful said:

To the residents and staff on the forum, what are your thoughts re: clerks continuing? Have heard a few staff express that we should continue working because we need to learn how the hospital/physicians function in this situation and continue helping where possible (but not with any covid or resp infection patients). Personally I’d like to continue working right now but would also understand if it becomes an issue of limited PPE and/or transmission concern. 

Not a resident/staff but tbh, I don't feel medical students should be participating. 

Students are trainees - and they're not getting paid, they're paying money to learn.  

The restrictions imposed already prevent clerks from doing many activities (especially if you're on a rotation where your bread and butter is fever, cough). On top of that, we're just another body for the virus to spread to/from.    

 

[omentum]

23 minutes ago, swoman said:

Most McMaster clerks are on 2 weeks of electives before returning to core. These 2 weeks were cancelled for most. --> Most cancellations occured to late for admin to find replacement electives starting March 16th and thus we're forced to do a reading or research elective instead. 

A handful had 4 weeks of electives cancelled. Reading or research electives for the first 2 weeks as above. Hopefully we'll find a clinical elective for the last 2 weeks. 

A handful are on their ObGyn core.

Clinical activities will proceed as usual. Med students not allowed to interact with COVID-19 positive or suspicious for COVID-19 patients. Med students not allowed to partake in care requiring PPE (e.g. contact/droplet/airborne precautions, aerosolizing procedures e.g. bronch/intubation, ORs)

Interesting, so they cancelled electives for students but not cores? :/

That's kind of puzzling to me 

[X Æ A-12]

1 minute ago, omentum said:

Interesting, so they cancelled electives for students but not cores? :/

That's kind of puzzling to me 

McMaster did not cancel any electives for outside students. McMaster students' electives were cancelled by other host institutions. Thus, we are forced to undertake home electives, likely not even in the specialty you were hoping for.  

[X Æ A-12]

4 minutes ago, omentum said:

Not a resident/staff but tbh, I don't feel medical students should be participating. 

Students are trainees - and they're not getting paid, they're paying money to learn.  

The restrictions imposed already prevent clerks from doing many activities (especially if you're on a rotation where your bread and butter is fever, cough). On top of that, we're just another body for the virus to spread to/from.    

 

The hospital industry complex will collapse without a fresh new batch of interns to exploit q yearly on July 1st. We are just another cog in the wheel and will be pushed through the program to ensure we graduate on time to provide cheap cheap labour to the hospitals. 

[rmorelan]

Just now, swoman said:

The hospital industry complex will collapse without a fresh new batch of interns to exploit q yearly on July 1st. We are just another cog in the wheel and will be pushed through the program to ensure we graduate on time to provide cheap cheap labour to the hospitals. 

ha rather grim assessment  There maybe some truth to part of it although the majority of hospitals etc aren't academic and don't use residents (we do have a rather focused look at health care in our training as we are only at very specific sites). 

It is always fun to see hospitals operate on those days where are are no residents - there are few times like that each year already. They wouldn't want to do it for an extended period of time but the universe doesn't come to an end either. 

 

 

 

[ellorie]

I think it makes sense to pull the clerks.  We need to conserve PPE for providers who can do more independently.  Also, realistically, if they are in the hospitals, some will get sick, which creates more vectors who can spread the virus.  I think the exchange of the work they can do for potential increased transmission, increased people needing hospitalized/ICU, and increased PPE use isn't worth it unfortunately.

Even if this continues, there will come a time when we know more about it and are more organized to handle it.  Then we can re-introduce the clerks once we know how to make it safer.  Right now everything is going to be in chaos.

[omentum]

1 hour ago, swoman said:

The hospital industry complex will collapse without a fresh new batch of interns to exploit q yearly on July 1st. We are just another cog in the wheel and will be pushed through the program to ensure we graduate on time to provide cheap cheap labour to the hospitals. 

Yup. At least residents get paid (even if the hourly wage is not fair)

At least in surgery, clerks were essentially free labour (even Internal to an extent)

[omentum]

1 hour ago, swoman said:

McMaster did not cancel any electives for outside students. McMaster students' electives were cancelled by other host institutions. Thus, we are forced to undertake home electives, likely not even in the specialty you were hoping for.  

Wow. Seems kind of risky for students - especially considering other schools in Ontario are shutting clerks down temporarily for their safety 

 

[JohnGrisham]

4 hours ago, ellorie said:

I think it makes sense to pull the clerks.  We need to conserve PPE for providers who can do more independently.  Also, realistically, if they are in the hospitals, some will get sick, which creates more vectors who can spread the virus.  I think the exchange of the work they can do for potential increased transmission, increased people needing hospitalized/ICU, and increased PPE use isn't worth it unfortunately.

Even if this continues, there will come a time when we know more about it and are more organized to handle it.  Then we can re-introduce the clerks once we know how to make it safer.  Right now everything is going to be in chaos.

Exactly, I would rather see the current 4th years/incoming R1s pulled - and be fresh to be re-introduced into the mix in 6-8weeks if things get hectic. Be at home, studying and prepping for R1. 

No use exposing them, and wasting PPE right now, while we are still fully staffed and have PPE. Once we are running low on staff, and don't have "ideal scenarios" with PPE, then its all bets off and we have a solid 3000 fresh R1s that come into the mix, presumably healthy and able to be given a bit more independence to manage all the non-Covid issues that are still going on. Less than ideal obviously, but if it gets to the point of TRUE emergency triage, a fresh R1 managing your DKA, ETOH tapers, casting/suturing up all the regular lacs that come in etc is better than those people being turned away.  Some entering R1s are already fairly strong/pragmatic, and likely would be able to hit higher than their current training anyways, especially with extra latitude and motivation of life/limb.

[HappyAndHopeful]

Ottawa clerks are now pulled as well. 

[Snowmen]

Sherbrooke clerks have been pulled for tomorrow while they supposedly reassess, which means we'll be pulled for longer the way things went today.