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COVID-19 Impact on Electives and Clerkships


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2 hours ago, frenchpress said:

 

 

It’s a bizzarre reaction given that so many other schools are pulling the clerks. Making accommodations so that students can graduate on time will be a country wide problem - they aren’t going to be able to hold back a year’s worth of medical students. We will all almost certainly complete our degrees on time.

If it does end up resolving in a week or two... then great. We only missed a couple weeks of rotations, which is really not a big deal and can be made up or honestly just accepted as necessary in the face of all this. And we go back to usual.

But if it doesn’t resolve and things get as bad as they are predicting, then having had clerks continue will have been a significant safety risk for patients and students, and could very well have contributed to making things worse.

Yep. Queens decided today to move all graduate courses online as well as undergraduate ones, and they are cancelling spring convocation. They suggest doing research remotely wherever possible, and maintaining distance between people if you need to be in a lab. Summer courses at Queens are cancelled.

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To the premeds following along, if you have multiple acceptances, it's worth looking at how the different schools respond to a pandemic. Do you want to attend the school that puts your safety at risk

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 m

wouldn't be surprised. There are more important things than med students showing their face at their dream schools' dream residency programs right now unfortunately. Edit: not meant to be sa

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8 minutes ago, omentum said:

Better late than never. Disappointed it took McMaster this long.

So just waiting for NOSM to cancel clinical activities 

I'm not entirely clear on what your personal stake here is, but I think your disappointment is misdirected. As a student studying at McMaster, I have found the MD program's communication and commitment to student learning, student safety, and public safety to be reasonable, all things considering. Have I had frustrations with the way the situation has unfolded? Very much so. But I can recognize that this has been largely out of the control of the respective medical schools across the country. If there are schools that are trying their best to keep students in clinical placements with reasonable restrictions, allow me to submit that it is not because they have a vested interest in infecting their student population.

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3 minutes ago, premed647 said:

I'm not entirely clear on what your personal stake here is, but I think your disappointment is misdirected. As a student studying at McMaster, I have found the MD program's communication and commitment to student learning, student safety, and public safety to be reasonable, all things considering. Have I had frustrations with the way the situation has unfolded? Very much so. But I can recognize that this has been largely out of the control of the respective medical schools across the country. If there are schools that are trying their best to keep students in clinical placements with reasonable restrictions, allow me to submit that it is not because they have a vested interest in infecting their student population.

If multiple medical schools in Canada and the US have been cancelling clinical activities for medical students there's a reason - I think McMaster could've come to this decision quicker but better late than never. Students' safety takes precedence.  

 

 

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Just now, omentum said:

If multiple medical schools in Canada and the US have been cancelling clinical activities for medical students there's a reason - I think McMaster could've come to this decision quicker but better late than never. Students' safety takes precedence.  

 

 

McMaster followed within days of the other schools, and with one potential day of clinical exposure today (which is limited since many McMaster clerks were on elective, which were cancelled anyway). Also, this isn't about student safety as much as it is about public safety. Students mainly fall into the 20-30 year age range, and fatality for them is extremely low. You would be better off making an argument in favour of public safety.

 

https://www.vox.com/2020/3/12/21173783/coronavirus-death-age-covid-19-elderly-seniors

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27 minutes ago, premed647 said:

McMaster followed within days of the other schools, and with one potential day of clinical exposure today (which is limited since many McMaster clerks were on elective, which were cancelled anyway). Also, this isn't about student safety as much as it is about public safety. Students mainly fall into the 20-30 year age range, and fatality for them is extremely low. You would be better off making an argument in favour of public safety.

 

https://www.vox.com/2020/3/12/21173783/coronavirus-death-age-covid-19-elderly-seniors

Sure - it's about public safety. But not all students can self-isolate effectively - many live with grandparents, family members who are over 65+ so students should still be considered in the equation. 

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NOSM suspended rotations for all learners (medical, nursing, etc) except 4th year med students who have a few weeks left before clinicals are complete. Students are not assigned to any patient with whom PPE is required (which naturally includes COVID19 patients). The caveat was that if preceptors feel that the student placement cannot continue that they can discuss with the faculty. They also mentioned if any student or resident belong in a high risk group that they can contact the faculty and accommodations be made to ensure graduation is on schedule. 

I can see why there is some discussion among the group here but personally if a final year medical student complies by safety regulations I personally don't see an issue with them finishing their rotation and being done. Just my own thoughts. 

I'd argue that all schools have the safety of their students in mind... people just seem to disagree on the extent. 

 

- G

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10 hours ago, insomnias said:

To the premeds following along, if you have multiple acceptances, it's worth looking at how the different schools respond to a pandemic. Do you want to attend the school that puts your safety at risk by having you continue with rotations as though nothing's going on, or do you want to attend the one that pulls clerks away from their duties while providing a virtual alternative to ensure that it's still possible to graduate on time?

I think this is such an unfair statement given how extenuating these circumstances are... don't let this somehow affect the positives of many of the medical schools across this country. No one is going in with blinders on. 

- G 

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2 hours ago, crossfit94 said:

Just heard from a friend that University of Manitoba students are still expected to continue with clerkship with the caveat of not seeing anyone with COVID-19 symptoms WITH a recent travel history. Thoughts on this?

My school tried the same thing. Totally impossible to enforce especially in primary care. Patients lie all the time at triage and sometimes you only find out after 10 minutes with the patients that they "forgot" to tell you they have risk factors for COVID-19. Also, community spread for sure has begun. The travel criteria is obsolete.

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On 3/5/2020 at 2:44 PM, divinecomedy said:

UPDATED LIST OF CANCELLATIONS (AS OF 03/14/20): 

Ottawa - cancellations of all electives (CMG and IMG) until June 30th

Montreal - cancellation of all electives (CMG and IMG) until further notice

McGill - cancellation of all electives (CMG and IMG) until further notice

Toronto - cancellation of all electives (CMG and IMG) until June 28th

UBC - cancellation of all electives (CMG and IMG) until July 5th

Dalhousie - cancellation of all confirmed electives and pending applications (IMG only)

Western - cancellation of all electives (CMG and IMG) until further notice

McMaster - cancellation of all electives (IMG only) until August 31st

Queen's - cancellation of all electives (IMG only) until May 1st

Northern Ontario - cancellation of all electives (IMG only) until further notice

Manitoba - not accepting applications from IMG at this time

Saskatchewan - suspension of all learners from emergency department

Alberta - cancellation of all electives (IMG only), all electives outside Alberta have been cancelled (CMG and IMG)

MUN - cancellation of all electives (IMG only) until further notice, CMG electives subject to change

 

UBC: Clerks pulled from clinical activity.

UofA: Clerks pulled from clinical activity.

UofC: Clerks pulled from clinical activity.

USask: No clerks in Emergency Department.

UofM: Clerks continue on clinical activity.

UWO: Clerks pulled from clinical activity.

Mac: Clerks pulled from clinical activity.

UofT: Clerks pulled from clinical activity.

Queens: ???

UOttawa: Clerks pulled from clinical activity.

NOSM3rd year clerks pulled from rural clerkship. 4th year clerks continue on cores and electives.

McGill: Clerks pulled from clinical activity March 16th - 29th inclusive.

LavalClerks continue on clinical activity.

SherbrookeClerks pulled from clinical activity.

UdeMontrealClerks pulled from clinical activity.

DalhousieClerks continue on clinical activity.

MUN: ???

 

 

What a mess!

Manitoba has cancelled IMG/CSA electives until further notice.

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Here is a consensus statement issued by the Council of Residency Directors in Emergency Medicine in the U.S. regarding away rotation requirements and standardized letters -- a glimpse of what to expect in this upcoming match.

 

Consensus Statement Regarding SLOEs and Away Rotations

for the 2020-2021 application cycle, from CORD’s Advising Students Committee in Emergency Medicine (ASC-EM)

With the unpredictable future of COVID 19, we are aware that institutions have begun altering the clinical experience for students, and instituting bans on travel for both their faculty and students. Several institutions have already decided not to accept any visiting students for clerkship rotations, and it is likely that others will prohibit their own students from traveling to complete away rotations. Further, students may be limited in their ability to evaluate and treat respiratory complaints, potentially limiting a comprehensive assessment of their clinical skills.

The Council of Residency Directors in Emergency Medicine (CORD) Advising Students Committee in Emergency Medicine (ASC-EM) anticipates that the travel restrictions will significantly impact the number of visiting rotations available and the ability of EM bound students to travel to any remaining available rotations.

We anticipate institutional and regional variability in both the spread and response to COVID 19. Many students will likely be unable to complete any away rotations this academic cycle. This will limit students’ collective ability to obtain Standardized Letters of Evaluation (SLOE) outside of their home institutions. For students without a home residency program, these travel limitations may prohibit their ability to obtain any SLOEs.

In this continuously evolving, exceptionally challenging time, we feel that it is important for the educational community to be united and speak with a clear voice. ASC-EM proposes the following recommendations for EM program leadership, medical schools, and EM-bound medical students to consider for the upcoming EM application cycle.

Encourage programs to be flexible with their SLOE requirements Programs have traditionally held non-SLOE letters of recommendation (LoR) in lesser regard. Programs have also traditionally had expectations surrounding the number of SLOEs a student would need to have submitted in order to be considered for an interview (typically 1-2) or rank (typically 2). ASC-EM recommends for application cycle 2020-2021 that residency program leadership consider reducing their typical number of SLOEs needed to review an application to one SLOE (or fewer) to account for students who cannot obtain a SLOE at their home institution. We also recommend programs be willing to accept alternative letters of recommendations to act as surrogates for their typical SLOE requirements as detailed in the paragraphs below. Encourage programs to give weight to alternative (non-SLOE) Letters Examples of alternative LORs include, but are not limited to, orphan SLOEs (a SLOE from a home EM rotation at an institution without an associated residency program), EM sub-specialty SLOEs , or a letter written by an advisor for the instance that a student has been entirely unsuccessful in obtaining an EM rotation. The CORD website contains instructions and a template for writing such SLOEs. Given the increased emphasis that will be placed on non-SLOE letters, letter writers who are not EM physicians should be made aware of the importance of ensuring their letters address knowledge, skills, and behaviors typically seen in the “qualifications for EM” section of SLOEs. Standard template for this can be found on the CORD website. Use of clear language to reflect loss of opportunities: Medical Student Performance Evaluation (MSPE): We anticipate institutional and regional variability in both the spread and response to COVID 19. ASC-EM recommends that institutions include a clear, explicit statement in their MSPE explaining any institutional policy limiting their students’ ability to complete emergency medicine rotations. SLOE: ASC-EM recommends use of a standard verbiage to be added to SLOEs or letters written by advisors for those schools who have students that could not obtain the recommended number of rotations. Encourage students to go on fewer (if any) away rotations Given the possibility of drastically limited EM rotation spots, ASC-EM would like to revise the number of away rotations we have recommended students complete in previous application cycles. In the event that a student is both able to travel from his/her home institution and to secure an available clerkship position at an institution accepting visitors, that student should not perform more than one visiting rotation (for those with a home program), and not more than two, maximum (for those without a home EM rotation). We ask all stakeholders in the EM application process, including but not limited to faculty advisers, clerkships, and students to be cognizant of the number of EM rotations each student chooses to complete.

We understand that these proposed changes may be uncomfortable for programs, who have relied on SLOEs to be the ultimate representation of a student’s abilities, and for students, who are eager to be able to demonstrate their skills in the audition setting. Ultimately, these recommendations are motivated by preserving the health and safety of our EM community and ensuring that our students who traditionally are at the greatest disadvantage in navigating the application process are not excluded entirely from consideration.

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The latest from Queen's:

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Things have evolved rapidly, and today, in alignment with our national counterparts, we have arrived at the decision to suspend clinical learning activities for medical students, nursing students, occupational therapy students and physical therapy students, as of the end of the day, Wednesday March 18, 2020.

Importantly, this suspension does not apply to residents and fellows in the School of Medicine, or registered nurses who are in the Nurse Practitioner program.

 

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