Update - AACOM Message on Medical Student Participation in Clinical Activities

The COVID-19 pandemic continues to rapidly impact all aspects of our private life, as well as our schools, our local communities, the nation, and the world. As our medical schools and teaching hospitals address the steadily mounting challenges—including balancing the demands of clinical care with those of education—collaboration and constant communication across institutions remain essential. '

In our last communication, AACOM called upon on our member institutions to join a very important and urgent effort to create a ‘pause’ in medical student clinical education activities, intended to allow our COM leaders, faculty, and hospital partners opportunity to find a meaningful way forward at this unprecedented time.

The message was jointly issued by AACOM and the COCA, following direct communication between leadership of both entities. AACOM has since continued to work closely with the COCA to address on-time graduation in the context of this message. It should be noted that we are also in close contact with our colleagues at AAMC, so that we have a coordinated response that aids all of our respective students and colleges, and to present a consistent approach as we work with public health officials on the best way we can contribute to the current crisis.

I. Summary Goals of Previous Memorandum

The original rationale and goals of this urgent effort were outlined in our memorandum of March 16 and are summarized below:

1. Local Conditions: Depending upon local conditions and responses that may already be in place, a minimum two-week ’pause’ of medical student participation in any activities that involve patient contact is suggested. Local conditions and resources may determine that a longer or shorter pause is indicated.
2. Student Education: This ‘pause’ will allow medical schools a window of opportunity to develop and implement appropriate programs to fully educate all their students for their return to clinical rotations with 1) up-to-date information on COVID-19; and 2) appropriate steps in place to ensure their and their patients’ safety.
3. Student Health and Safety: This ‘pause’ will contribute to the conservation of personal protective equipment (PPE) across our institutions while the full extent and likely trajectory of COVID-19 becomes better understood, and more widespread testing is implemented. While some localities remain relatively unaffected, it is fully conceivable that in the near future there may be acute shortages of PPE in some localities, and such resources may have to be pooled across institutions.
4. Student Training: During this ‘pause,’ AACOM will organize efforts by our medical education community, including our learners, to compile and disseminate information and resources for alternative clinical learning approaches, including the identification of critically important learner roles in their institutional response to COVID-19 that support patient care but may not necessarily involve direct patient contact.

II. Updates to Previous Memorandum

During a meeting of the AACOM Board of Deans on March 20, 2020, updates were heard from the community regarding various efforts to prepare medical students for a role responding to the pandemic—some requested by hospitals in need, some by students wishing to volunteer, and some arising from COMs that have implemented COVID-19 training for students in preparation for an active role as part of the healthcare team.

In response to concerns raised during the Board of Deans meeting, the first bullet above is further clarified:

• Local conditions and resources may determine the practicality of a pause. While the intention to allow our COM leaders, faculty, and hospital partners opportunity to find a meaningful way forward at this unprecedented time remains unchanged, the needs of the local community, state, or region must determine each COM’s response. Unless a critical healthcare shortage exists, and appropriate training and precautions can be assured, the guidance offered by this message remains the same—medical students should not be involved in any direct patient care activities. There is opportunity for our COMs and their hospital partners to work together to develop plans for how medical students contribute to a response.
• In reference to the fourth bullet above and as shared during the Board of Deans meeting, AACOM continues to work with our community to describe alternative approaches to clinical education and clinical and non-clinical roles for our medical students. Importantly, the pause allows students to contribute to the national effort to ‘flatten the curve’ while gaining additional knowledge and skills to better prepare themselves for this challenging environment. These efforts can and should be conveyed to local, state, and regional officials as meetings occur to address responses to COVID-19.

This is a momentous time for healthcare professionals, and there is a deep desire by students to engage “on the front lines” at this time of crisis. We recognize the important roles that medical students play on healthcare teams, and encourage innovative approaches by school leaders in safely and appropriately engaging their students’ extraordinary dedication, passion, and skills for the benefit of the patients and other healthcare workers.