I remember walking home from the hospital the day medical student rotations were suspended. It felt like being woken up in the middle of a vivid dream. I was so immersed in clinical learning that although I was aware of the virus’ spread, its direct effect on me was unexpected. I felt disoriented. My typical agenda when I arrived home was to prepare for the next day. However, there wasn’t going to be a next day. At least not for another month or two. I needed a new plan. I reached for my phone and called a classmate. I desperately wanted to know, “What now?”
Amazingly, similar conversations occurred throughout the country. Medical student response teams at various institutions rallied in swift and inspiring fashion to transform health care. At the University of Michigan Medical School, more than 20 student-led initiatives were developed.
For the next few weeks, I rarely left my house. Surprisingly, it wasn’t because of a conscious effort to socially distance. I was immersed in a project to transform prenatal care, and while some described sentiments of isolation, I felt more connected than ever before. Shifting between Zoom meetings and phone calls, I found the my relationships with my classmates, faculty, and the community grew and matured.
In medical school, opportunities to see classmates are labile. During the first year, we spend long hours together in study groups, but during our clinical rotations, we are dispersed to a variety of sites. We share a communal experience, but we rarely have the chance to enjoy the frequent interactions we experienced at the start of medical school. Service-learning projects in response to COVID-19 rekindled many of these friendships. I had the chance to see my classmates at their very best as leaders, artists, engineers, and writers. I recall during one Zoom meeting troubleshooting how to ensure non-English speaking patients would be able to receive information regarding changes to prenatal care. In just a couple days, students who spoke seven different languages volunteered to call non-English speaking patients who otherwise might have been left in the dark.
Faculty also had the chance to see us students in a different setting. Clinically, we are at the very beginning of our training, and it is often hard to show initiative and leadership. The COVID-19 service-learning projects allowed us to showcase the diverse set of talents we brought with us to medical school. Similarly, faculty have the chance to show us a different side of themselves as they engaged with the community and hospital leadership.
The conversations I had with patients were particularly meaningful. COVID-19 has claimed more than 70,000 American lives thus far, and earlier this month, 6.6 million people filed new claims for unemployment over the course of a week. Patients are anxious, unsure what the future holds for their medical care and overall health. Furthermore, aggressive social distancing and rapid changes in institutional policy has made people feel isolated and less informed.
I made over a hundred calls to patients, providing information, reassurance, and resources. Prior to each call, I felt shaken by the adversity the patients must be experiencing. The experience of being pregnant is laden with uncertainty, and I imagine the pandemic only exacerbates these sentiments. Yet, as I informed patients of reductions in appointments and shifts to virtual visits, they expressed a sincere desire to do their part to help with social distancing and thanked me for my involvement in their care.
COVID-19 placed us all in positions we could never have anticipated. My conversations with patients showed me how, to varying degrees, we are all on the “front lines” as each of us has a role to play in fighting the pandemic. We are bonded by forging through the uncertainty, and drawn to one another in ways we, only a few short weeks ago, could never have anticipated.
Nabeel Salka is a 3rd year medical student at the University of Michigan. He is passionate about traveling and engaging with people from different communities. In his spare time, he enjoys running and eating chocolate.
On Saturday, March 28, a group of developers, engineers, analysts, medical students, and surgeons met virtually over coffee to develop a new initiative: the COVID Staffing Project. The goal was to develop a suite of staffing projection and allocation tools that would help Vanderbilt University Medical Center (VUMC) – central Tennessee’s largest hospital system – prepare for an imminent surge of COVID patients.
The project leads – two academic surgeons, one at VUMC and one at Michigan Medicine – laid out the project aims and the technologic and implementation gaps that needed to be addressed. The project team spent the weekend working from couches and home offices, switching between all-team conference calls and smaller group huddles. Unique perspectives from the Center for Surgical Training and Research (C-STAR), the Department of Learning Health Sciences, the Center for Healthcare Engineering and Patient Safety and the Procedural Learning and Safety Collaborative quickly converged into an initial project plan with 250 person-hours of total work logged by Sunday evening.
Part of the COVID Staffing Project team
By Monday, a Covid Staffing Project website had been launched, with three initial tools and many more in development. As of today, nine tools are available, along with user guides, instructional videos, educational modules, and provider care resources – all at no cost. Hundreds of health care professionals have visited the website and joined informational webinars. Connections have formed with residency program directors; clinicians at large teaching hospitals in the southeast and midwest; rural nursing home networks; an ambulance fleet in Alberta, Canada; and an epidemiologist constructing state-level patient projections in India.
In retrospect, no one knew exactly what would develop from that Saturday morning. The inherent uncertainties of typical research projects and health endeavors – publication, transferability, impact doubts – were all doubled as the team put their pre-COVID research projects and coursework on hold, in order to tackle an acute health care systems problem.
As medical students and junior researchers, we have collaborated on several previous projects with C-STAR and other research groups. We understand the typical flow of academic medical research. Define your question, explore the literature to determine the “gap” you endeavor to fill, design your analysis or intervention carefully, and follow a prescriptive format to write up your results. We are used to working closely with our research mentors, on a predetermined timeline and with a clear sense of our roles. The COVID Staffing Project flipped this structure on its head. The pandemic created an urgent need for our tools – yesterday. We had no precedent or guide, and each of us needed to map the project goals to our individual skills in determining the value we could add.
Ultimately, each of us determined our roles. Erkin, whose background is in engineering, took point on designing the architecture of the modules and a plan for them to flow into each other synergistically. His mental model became our project roadmap. Ken, who is proficient in several coding languages, built the COVID-19 Response Planner, an application to help hospital administrators allocate staff to different phases of COVID responses, based on patient demands. Alex jumped in to articulate the initial mission and vision of the COVID Staffing Project, collaborated in building the first and second versions of the website, and drove early external communications to disseminate our tools. Alex also worked with Erkin in designing the Daily PPE Calculator, which can estimate a given hospital or other health system’s 24-hour Personal Protective Equipment (PPE) needs. Each of our contributions to this project combined our previous skill sets and medical knowledge with new responsibilities, not unlike our previous experiences as clinical students.
We are thrilled to have taken part in the COVID Staffing Project’s development and growth. The impact that an enthusiastic, thoughtful and skilled team of researchers can have on an immediate public health problem is something we will take with us through the remainder of our medical careers.
Kenneth Abbott is a fourth-year MD student who enjoys quantitative research and data science, and is applying into General Surgery.
Alexandra Highet is a fourth-year MD student originally from Wellington, New Zealand. She is finishing her Masters of Science in Clinical Research this August and will apply into General Surgery.
Erkin Otles is a MD-PhD student from Madison, Wisconsin. He is currently pursuing his PhD in engineering, and his research focuses on creating machine learning and artificial intelligence tools for physicians and patients. He plans to apply into Emergency Medicine for residency.