Schools starting rotations again

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I see no good options, really. There's also the elephant in the room of a second wave that hasn't been addressed whatsoever at our dean's town halls. In 1918 it was the second wave in flu season that killed an order of magnitude more people. If we get another crazy COVID spike where much of the East Coast looks like NYC in April...I have absolutely no idea what they could do besides letting us complete online versions of our rotations.

I assume this is being discussed a lot at every SOM behind the scenes. Is there an LCME requirement written in stone that we train in the hospital or can we technically just do Aquifer + NBME shelf and be cleared to graduate? I have no idea myself
I wonder what med schools did during the Spanish flu pandemic?

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I wonder what med schools did during the Spanish flu pandemic?
They sent the students to work in the hospital, where they died. At least my med school did.
 
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Or from the mass of the population getting it (and all the survivors now having antibodies)

People will have antibodies from having contracted COVID; however, antibody response and longevity is generally proportional to severity of illness. If lots of people were asymptomatic/lightly symptomatic, their antibody titers may not be enough to protect from reinfection.
 
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They sent the students to work in the hospital, where they died. At least my med school did.

What i'm now curious is whether schools will take a similar risk. Because technically rising interns who are graduated MS4s will probably be in the frontlines dealing with the 2nd wave
 
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What i'm now curious is whether schools will take a similar risk. Because technically rising interns who are graduated MS4s will probably be in the frontlines dealing with the 2nd wave
We will. The hospital Im going to has like 150 beds and 40 of them are COVID patients. So gonna be the frontlines either way. My inpatient months are in November and December.
 
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And this thread is about ROTATIONS and RESIDENCY, not about general population.

I mean, it's pretty clear the posts preceding yours, including the one you quoted when you made your comment, are talking about the general population......
The Great Depression showed us we can survive an economic meltdown. A Spanish flu pandemic is far more dangerous.

And herd immunity only comes from Vaccination programs.

Quarantining until a vaccine is available was never the goal. It's completely within your right to quarantine until a vaccine is ready if you choose, but expecting that out of the rest of the country is unrealistic.

I'm at risk for COVID...your rights end where my lungs begin.

I expect arguments with more intellectual merit behind them out of you Goro, instead of emotional statements that attempt to paint anyone who disagrees as the bad guy. You and I both know this isn't true.

I assume this is being discussed a lot at every SOM behind the scenes. Is there an LCME requirement written in stone that we train in the hospital or can we technically just do Aquifer + NBME shelf and be cleared to graduate? I have no idea myself

Both LCME and COCA have straight up said that core LCME graduation requirement rotations cannot be completed fully online. At least 50% of the rotation must be done face to face with patients. I suspect schools will just do the online portions first and then next spring do the patient parts if needed.
 
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Both LCME and COCA have straight up said that core LCME graduation requirement rotations cannot be completed fully online. At least 50% of the rotation must be done face to face with patients. I suspect schools will just do the online portions first and then next spring do the patient parts if needed.
Now that's an interesting idea. 6 months of modules and knocking out all the shelves, followed by a few months of shortened wards rotations?

I like that a lot, actually.
 
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Now that's an interesting idea. 6 months of modules and knocking out all the shelves, followed by a few months of shortened wards rotations?

I like that a lot, actually.

That is similar to what my school has done for us finishing third year, Basically cut 1-2 weeks off of every rotation and added it to June for “abbreviated” clinical rotations. One of the weeks we even see night consults for one rotation while on a different one to make sure we get the 2 weeks required

I anticipate they would do something similar for the incoming M3s if we get kicked off the wards again for an extended period of time
 
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I mean, it's pretty clear the posts preceding yours, including the one you quoted when you made your comment, are talking about the general population......

No, it wasn't. The comment I replied to was replying to this:

"What I don’t understand is why the LCME isn’t stepping in and giving schools some direction? It sounds to me like every medical school is doing their own thing based on how worried they are about meeting accreditation requirements. Some are letting students return in June and cancelling AIs in order to get core rotations done. Others don’t have rotations until end of July and are allowing students to do their core rotations later in 4th year or reducing credit requirements altogether. Seems like a mess to me."


We were talking about rotations and AIs.
 
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Did you bother to actually read that before you posted it? Also, it was the comparison between the great depression which took WW2 for us and the world to crawl back from and our current financial situation that had me taken aback. To say "oh look we came back from the Great Depression so we can do it again" is honestly ridiculous.
 
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Did you bother to actually read that before you posted it? Also, it was the comparison between the great depression which took WW2 for us and the world to crawl back from and our current financial situation that had me taken aback. To say "oh look we came back from the Great Depression so we can do it again" is honestly ridiculous.

Yes, I did. Did you? Why would you be taken aback when many economists are making that comparison? That article was just one. This can't be the first time you've heard that?
 
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Probably because the only reason we survived the great depression was World War 2 lol
It makes no sense as a comparison

When the Great Depression started, do you think people knew it would be WW II that would bring us out of it? Of course not. This is out recessions and depressions begin. None of us know what's going to happen, but the point is when our unemployment rate rivals Great Depression rates, we have to stop and consider what's going to happen to our economy. Hopefully, it won't be comparable to the Great Depression, but no one knows what's in store, especially if there's a second wave.
 
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Yes, I did. Did you? Why would you be taken aback when many economists are making that comparison? That article was just one. This can't be the first time you've heard that?

Didn't realize a "few economists" was many. The post that I quoted makes light of the Great Depression in favor of espousing the Spanish Flu pandemic as the more abhorrent event in our history. The two are not comparable. If that wasn't the intent of the post then I'll apologize, but I don't think I'm mistaken.
 
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Didn't realize a "few economists" was many. The post that I quoted makes light of the Great Depression in favor of espousing the Spanish Flu pandemic as the more abhorrent event in our history. The two are not comparable. If that wasn't the intent of the post then I'll apologize, but I don't think I'm mistaken.

Ah, I thought you were objecting to the comparison of the current economic climate and potential for Great Depression type collapse.

I will say I didn't think Goro made light of the GD at all. I think his point is that the death of Spanish Flu proportions can be worse than an economic collapse for the future of America.
 
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Ah, I thought you were objecting to the comparison of the current economic climate and potential for Great Depression type collapse.

I will say I didn't think Goro made light of the GD at all. I think his point is that the death of Spanish Flu proportions can be worse than an economic collapse for the future of America.

No I think anyone with their head not buried in the sand can see how much of a volatile situation we're in economically. I very much disagree that a great depression would be less catastrophic for the US, and the world, than a Spanish flu-esque scenario. I'm sure hoping for neither
 
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Ah, I thought you were objecting to the comparison of the current economic climate and potential for Great Depression type collapse.

I will say I didn't think Goro made light of the GD at all. I think his point is that the death of Spanish Flu proportions can be worse than an economic collapse for the future of America.

Goro's posts came across as crass and trivializing the negative economic impact which is why people took issue of it.

I think what bugs me a lot more is the stupidity of CS that's still in place. Idk how schools are going to adjust clinicals with the possibility of future waves.
 
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I post a lot less now than I lurk on this site but if there is something I have noticed @Lawper , it is the honest fight you have waged against CS. You are definitely fighting the good fight. Sorry for derailing.

...
I think what bugs me a lot more is the stupidity of CS that's still in place. Idk how schools are going to adjust clinicals with the possibility of future waves.
 
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I post a lot less now than I lurk on this site but if there is something I have noticed @Lawper , it is the honest fight you have waged against CS. You are definitely fighting the good fight. Sorry for derailing.

Thanks but others have expressed more cogent views than me

 
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Thanks but others have expressed more cogent views than me


I saw that! I meant longitudinally, over the year(s). In any case, i'm definitely derailing the thread. Carry on.
 
When the Great Depression started, do you think people knew it would be WW II that would bring us out of it? Of course not. This is out recessions and depressions begin. None of us know what's going to happen, but the point is when our unemployment rate rivals Great Depression rates, we have to stop and consider what's going to happen to our economy. Hopefully, it won't be comparable to the Great Depression, but no one knows what's in store, especially if there's a second wave.
No I agree with you, the economic situation after this pandemic is going to rival the great depression.
I just think when people say "we can survive a great depression", it removes a lot of context around the improbable circumstances and sheer luck that allowed us to escape it the first time around.
 
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Goro's posts came across as crass and trivializing the negative economic impact which is why people took issue of it

Meh, it's hard to get tone online. I doubt Goro was trying to trivialize it. It's been a war or economic downturn versus lives lost from the beginning. Everyone stands on a different side of that spectrum. Me? I'd rather save lives. Some would rather save the economy. Who's to say who's right or wrong? We all have different agendas.
 
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Meh, it's hard to get tone online. I doubt Goro was trying to trivialize it. It's been a war or economic downturn versus lives lost from the beginning. Everyone stands on a different side of that spectrum. Me? I'd rather save lives. Some would rather save the economy. Who's to say who's right or wrong? We all have different agendas.
It's definitely more complicated than that...
Of course we have to follow CDC protocols and try to contain the virus as best we can. No one wants casualties that rival the Spanish flu.

However, after we eventually open up, businesses across the country will close down. A quarter of the country may end up unemployed. Millions of families might be thrust into poverty and homelessness. We might see a generation that grows up under the cloud of total economic ruin and despair.

If you've ever read the Grapes of Wrath, then you know that eking out an existence during the great depression was near impossible. That nightmare may resurface as a reality.

I don't have the solution, but I'm just trying to let you know that this is a complex issue and there are points to be made on either side. People's fears are legitimate.

That doesn't justify reopening recklessly, but it does merit some empathy at the very least.
 
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It's definitely more complicated than that...
Of course we have to follow CDC protocols and try to contain the virus as best we can. No one wants casualties that rival the Spanish flu.

However, after we eventually open up, businesses across the country will close down. A quarter of the country may end up unemployed. Millions of families might be thrust into poverty and homelessness. We might see a generation that grows up under the cloud of total economic ruin and despair.

If you've ever read the Grapes of Wrath, then you know that eking out an existence during the great depression was near impossible. That nightmare may resurface as a reality.

I don't have the solution, but I'm just trying to let you know that this is a complex issue and there are points to be made on either side. People's fears are legitimate.

That doesn't justify reopening recklessly, but it does merit some empathy at the very least.

But you don't need to let me know anything. I know what happened with the Great Depression. I studied it at length in college. No one said it was an easy issue. But I was pointing out what Goro's argument came down to was the fight that's been going on since the beginning of quarantine.
 
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But you don't need to let me know anything. I know what happened with the Great Depression. I studied it at length in college. No one said it was an easy issue. But I was pointing out what Goro's argument came down to was the fight that's been going on since the beginning of quarantine.

A lot of the current problems would've easily been avoided if state and federal responses were actually good from the start. It's likely that we'd be on our way to rapid economic recovery and a rapidly declining death toll/cases if we implemented aggressive measures like rapid testing, contact tracing and early, national coordinated shutdown like in South Korea and New Zealand. It's what I was thinking back in early stages of the pandemic but unfortunately i'm not a politician so i can't do anything.

Sorry for the derail.
 
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A lot of the current problems would've easily been avoided if state and federal responses were actually good from the start. It's likely that we'd be on our way to rapid economic recovery and a rapidly declining death toll/cases if we implemented aggressive measures like rapid testing, contact tracing and early, national coordinated shutdown like in South Korea and New Zealand. It's what I was thinking back in early stages of the pandemic but unfortunately i'm not a politician so i can't do anything.

Sorry for the derail.

I very much agree. Much of Europe, and I think its fair to say they did a worse job than New Zealand or South Korea, is on the downslope and gradually opening up. This was never supposed to be permanent, a couple of months with a slow roll out over the next 3-4 mos. The economic impact is huge, but the whole point was to avoid the often much worse economic impact that an unchecked pandemic has.

The problem is as a country we failed. For what seems like every step of the way we reacted too slowly, had an utter lack of coordination, and simply relied on delusional thinking. The lack of organization and coordination honestly feels like Katrina again, but on a nationwide scale. The type of money and resources we have in this country it really should have been better. Now we're making the same mistakes by opening up in a disjointed manner.

This whole thing is just depressing.

That said, I think its good for med students to come back. At least at my institution we are acutely aware of keeping them out of unnecessary risk, while simultaneously giving them a good experience. This is working better in outpatient clinics than it is in inpatient or some other departments. They're participating in telemed visits and are seeing pts for the first time in over a month.
 
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I very much agree. Much of Europe, and I think its fair to say they did a worse job than New Zealand or South Korea, is on the downslope and gradually opening up. This was never supposed to be permanent, a couple of months with a slow roll out over the next 3-4 mos. The economic impact is huge, but the whole point was to avoid the often much worse economic impact that an unchecked pandemic has.

The problem is as a country we failed. For what seems like every step of the way we reacted too slowly, had an utter lack of coordination, and simply relied on delusional thinking. The lack of organization and coordination honestly feels like Katrina again, but on a nationwide scale. The type of money and resources we have in this country it really should have been better. Now we're making the same mistakes by opening up in a disjointed manner.

This whole thing is just depressing.

That said, I think its good for med students to come back. At least at my institution we are acutely aware of keeping them out of unnecessary risk, while simultaneously giving them a good experience. This is working better in outpatient clinics than it is in inpatient or some other departments. They're participating in telemed visits and are seeing pts for the first time in over a month.

It's much worse than Katrina. At least with Katrina, some acknowledgement was ultimately made that "hey we screwed up" and things were ultimately corrected. I have no faith that's going to happen in this case and all of us are going to pay the price, whether that's through loss of employment/income or loss of life or loss of education.
 
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I very much agree. Much of Europe, and I think its fair to say they did a worse job than New Zealand or South Korea, is on the downslope and gradually opening up. This was never supposed to be permanent, a couple of months with a slow roll out over the next 3-4 mos. The economic impact is huge, but the whole point was to avoid the often much worse economic impact that an unchecked pandemic has.

The problem is as a country we failed. For what seems like every step of the way we reacted too slowly, had an utter lack of coordination, and simply relied on delusional thinking. The lack of organization and coordination honestly feels like Katrina again, but on a nationwide scale. The type of money and resources we have in this country it really should have been better. Now we're making the same mistakes by opening up in a disjointed manner.

This whole thing is just depressing.

That said, I think its good for med students to come back. At least at my institution we are acutely aware of keeping them out of unnecessary risk, while simultaneously giving them a good experience. This is working better in outpatient clinics than it is in inpatient or some other departments. They're participating in telemed visits and are seeing pts for the first time in over a month.
It's much worse than Katrina. At least with Katrina, some acknowledgement was ultimately made that "hey we screwed up" and things were ultimately corrected. I have no faith that's going to happen in this case and all of us are going to pay the price, whether that's through loss of employment/income or loss of life or loss of education.

What happens to schools where MS3s core rotations are done entirely online? I don't think this will happen but i'm curious/confused if future waves are unavoidable and schools don't want to risk students in wards.
 
What happens to schools where MS3s core rotations are done entirely online? I don't think this will happen but i'm curious/confused if future waves are unavoidable and schools don't want to risk students in wards.

I think we'll see students back on the wards again. We've gotten enough of a stock of faceshields and masks to have them in clinic. We're even giving them to pts who don't have a face mask when they walk in. The only difference might be that they spend more time outside if patient rooms or in the workroom which is unfortunate, but probably won't be that different for some student.
 
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No, it wasn't. The comment I replied to was replying to this:

"What I don’t understand is why the LCME isn’t stepping in and giving schools some direction? It sounds to me like every medical school is doing their own thing based on how worried they are about meeting accreditation requirements. Some are letting students return in June and cancelling AIs in order to get core rotations done. Others don’t have rotations until end of July and are allowing students to do their core rotations later in 4th year or reducing credit requirements altogether. Seems like a mess to me."

We were talking about rotations and AIs.

You are right. I thought you were responding to the other poster who was talking about the general population.
 
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It's much worse than Katrina. At least with Katrina, some acknowledgement was ultimately made that "hey we screwed up" and things were ultimately corrected. I have no faith that's going to happen in this case and all of us are going to pay the price, whether that's through loss of employment/income or loss of life or loss of education.
“I take no responsibility”
 
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I mean, if you shut down the economy you cant complain when small businesses start failing.
 
Goro's posts came across as crass and trivializing the negative economic impact which is why people took issue of it.

I think what bugs me a lot more is the stupidity of CS that's still in place. Idk how schools are going to adjust clinicals with the possibility of future waves.
I am appalled that people who supposedly did well on the MCAT CARS section completely misinterpreted what I wrote, which was in response to psoas' post about printing trillions of $'s.

I'm not going to comment further because we're thread hijacking the OP, which has to do with rotations stating again.
 
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I mean, if you shut down the economy you cant complain when small businesses start failing.

And if you rush to visit hair salons and massage parlors, you can't complain when you spread the virus to your family members who get severely ill. It's a Catch 22 and we all have our own personal priorities.
 
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And if you rush to visit hair salons and massage parlors, you can't complain when you spread the virus to your family members who get severely ill. It's a Catch 22 and we all have our own personal priorities.

I won't complain. Just like I won't complain when the health experts decide it's safe and we spread the virus anyway.
 
I mostly skimmed the thread since it's going off on a bunch of tangents, but part of the problem is having the hospital wards being "ready" for students anyway. We're starting to slowly see things coming back to normal in some of the early hit areas, but we're still in a situation where the residents in the program I'm faculty at are working COVID wards and I'm doubling up on inpatient and outpatient coverage due to everyone being shifted around to plug the gaps. I could take students right now but giving them adequate supervision and teaching might be tough. Plus non-COVID patient volume is way down right now on a lot of services, so there's not a lot for them to see and do, especially on rotations like Surgery.

My HOPE is that we start seeing some movement downward in our case trends soon (although we're still climbing in my state as the rural areas are getting hit) and students can start coming back by July 1, but there's other things to consider besides students just being virus vectors.
 
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People will have antibodies from having contracted COVID; however, antibody response and longevity is generally proportional to severity of illness. If lots of people were asymptomatic/lightly symptomatic, their antibody titers may not be enough to protect from reinfection.
All it takes is some mutations for the antibodies to be useless. Much like they are for the common cold. It’s really an unknown what sort of immunity we can experience expect.
 
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I understand that schools are trying their best to help students fulfill graduation requirements on time, but I wish my school would share with us why they chose such an early start date (end of May) and describe how they plan to ensure students' and patients' safety. Simply saying that we won't be taking care of COVID-19+ patients is not enough--anyone could have it, and we could easily catch it as well as pass it onto other patients, staff, our own families.

I'm also thinking of what a disaster it would be if schools called students back only to shut down in a few weeks when the number of cases inevitably rises again.
 
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Good, there is no clear end game to this quarantine. We flattened the curve, that was the goal. Now is time to start returning to daily living to achieve herd immunity.
The problem here is that we still dont know with this new virus, if antibodies will last a sufficient amount of time to prevent us from being vectors of the disease and not pass it on to others ie to create herd immunity. We do not know how each person's body will react if they were to contract COVID. Some people who seemingly look ok, healthy with no comorbidities are dying. Even children are getting weird inflammatory sx. So far in my school, we've been told that we may go back to in-person rotations at the end of June. I am glad I am not in one of the schools that is making students return sooner, this month. I'd rather not gamble with my life. What good can you do if you get sick! You actually can harm your community starting with your own family at home.
 
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The problem here is that we still dont know with this new virus, if antibodies will last a sufficient amount of time to prevent us from being vectors of the disease and not pass it on to others ie to create herd immunity. We do not know how each person's body will react if they were to contract COVID. Some people who seemingly look ok, healthy with no comorbidities are dying. Even children are getting weird inflammatory sx. So far in my school, we've been told that we may go back to in-person rotations at the end of June. I am glad I am not in one of the schools that is making students return sooner, this month. I'd rather not gamble with my life. What good can you do if you get sick! You actually can harm your community starting with your own family at home.
I can understand your concern. The great thing about our country is there are choices. Some will go back sooner, others later. You keep yourself safe. I wish you the best.
 
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How is starting in June any safer than starting in May?
 
I understand that schools are trying their best to help students fulfill graduation requirements on time, but I wish my school would share with us why they chose such an early start date (end of May) and describe how they plan to ensure students' and patients' safety. Simply saying that we won't be taking care of COVID-19+ patients is not enough--anyone could have it, and we could easily catch it as well as pass it onto other patients, staff, our own families.

I'm also thinking of what a disaster it would be if schools called students back only to shut down in a few weeks when the number of cases inevitably rises again.
I completely agree. My school is saying the same "you will not be caring for COVID patients." To be cautious, I'd like to treat anyone I see with a cough, SOB etc as a "suspected covid" until tests say otherwise. Once again, major probm is when seeing those asymptomatic pts and then finding out they tested (+), or we may not even know, if they d/c soon or seen as outpatient. Not caring for corona patients, is not a good guarantee for me. I think this all came from someone or an organization saying that this is how they guarantee they will protect us, and it has just being echoed from one school to another without giving it sufficient thought, or without 'wanting' to give it sufficient thought. This prevalent scripted info seems to be also used by conservative physicians (not talking about a political party here, but a way of thinking) that come from a school of thought that believe that we will be "better" physicians once we face these situations directly. What they forget is that we are not yet paid interns, with a specific contract and training to treat patients with a NEW virus that we've never treated before nor we know what the future consequences of the disease are to even really consider, if not obliged, if i'd want to volunteer to care for these patients putting my health and that of my loved ones at risk.
 
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How is starting in June any safer than starting in May?

Yes that's my point exactly! I just happen to be in a school that for whatever reason decided June is an appropriate month to retin.
 
I completely agree. My school is saying the same "you will not be caring for COVID patients." To be cautious, I'd like to treat anyone I see with a cough, SOB etc as a "suspected covid" until tests say otherwise. Once again, major probm is when seeing those asymptomatic pts and then finding out they tested (+), or we may not even know, if they d/c soon or seen as outpatient. Not caring for corona patients, is not a good guarantee for me. I think this all came from someone or an organization saying that this is how they guarantee they will protect us, and it has just being echoed from one school to another without giving it sufficient thought, or without 'wanting' to give it sufficient thought. This prevalent scripted info seems to be also used by conservative physicians (not talking about a political party here, but a way of thinking) that come feom a school of thought that believe that will be "better" physicians once we face these situations directly. What they forget is that we are not yet paid interns, with a specific contract and training to treat patients with a NEW virus that we've never treated before nor we know what the future consequences of the disease are to even really consider if not obliged, if i'd want to volunteer to care for these patients putting my health and that of my loved ones at risk.

Well COVID is going to be around for a long time in one form or another, so basically you can either put off the completion of medical school for another 18 months or more, or we have to come to some sort of middle ground. Things were really dicey a month ago but now we have the ability to do rapid testing on all of our inpatients at least where I work. We'll theoretically get to a point of being able to do the same for all in-house employees shortly.
 
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Well COVID is going to be around for a long time in one form or another, so basically you can either put off the completion of medical school for another 18 months or more, or we have to come to some sort of middle ground. Things were really dicey a month ago but now we have the ability to do rapid testing on all of our inpatients at least where I work. We'll theoretically get to a point of being able to do the same for all in-house employees shortly.
I agree COVID will be around us for quite some time. Also, I am currently putting off my education due to health reasons, the same ones that make me really nervous about going back to in-person rotations at this moment in time. I also have a couple of friends that decided to take a leave of absence and another one registered for online classes to get his MPH, and get back to MD school next year, so there are other available opportinities out there. I am hopeful that we will find something, a vaccine that will improve things in the near future. Finally very different situation where I am. Not enough testing being done, to the point that employees that conitune to work at a major hospital I worked in as well, have been denied testing despite of working directly wit COVID cases. I understand there is different points of view according to your location and current experience, but I really wish people who are in "safer" areas to really see whats going on, the suffering, frustration etc.that really is going on in places that have been hit hard.
 
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Yeah, I'm basically double covering inpatient and outpatient stuff right now because regular inpatient ppl have been stepping away due to underlying health conditions. There's not a lot of great options for the immunocompromised.

Though on a darkly positive note, our public health governmental decisions in places has been so bad that being in the hospital won't be much worse than going to the grocery store soon enough.
 
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