Shutting down M3/M4 clinical rotations

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
O

odyssey2

Full Member
10+ Year Member
Joined
Jul 30, 2013
Messages
565
Reaction score
720
Members do not see this ad.
It seems like many med schools are making the move to limit in-class meetings and clinical work in M1/M2, but do you see any schools outright canceling M3/M4 clinical rotations for coronavirus? I don't see how this could possibly work.
 
According to my school I am an essential member of the healthcare team and a valuable asset for the frontlines against this pandemic.

*be me an M3 who’s main daily goals are to not break the sterile field, retract without getting yelled at, observe people write notes, and balance being friendly and social without being annoying*
 
tcon91 said:
I just got notice my EM rotation starting in April was canceled by the hospital due to COVID-19. Sucks because this is a graduation requirement. Had to scramble to find another nearby hospital.
Click to expand...

Is this for m3 or m4 requirement? If M4 I would call the school and inquire what if you cannot find one at such short notice. I would hope that the school can/will waive it. M3? You have a whole other year to fulfill it. Take a home elective or something during that time.

Not in a teaching hospital. But got a notice today regarding we “may” run out of ppe for the hospital, need to limit non-essential personnel and students (mostly observational roles).

I am allergic to the “regular” mask they have in the OR. Smelled shortage on masks weeks ago. Thank God had them ordered some back then.
 
Our hospital's ORs are now closed to med students in order to preserve PPE. Otherwise all other clinical rotations are being maintained for now. At first I thought staff might get lucky if they open up sick leave, now I actually think we're going to be working more. We're completely restructuring our staffing/clinics to minimize spread and prevent spread from the current patients that have it in our system.
 
IMGASMD said:
Is this for m3 or m4 requirement? If M4 I would call the school and inquire what if you cannot find one at such short notice. I would hope that the school can/will waive it. M3? You have a whole other year to fulfill it. Take a home elective or something during that time.

Not in a teaching hospital. But got a notice today regarding we “may” run out of ppe for the hospital, need to limit non-essential personnel and students (mostly observational roles).

I am allergic to the “regular” mask they have in the OR. Smelled shortage on masks weeks ago. Thank God had them ordered some back then.
Click to expand...


M4. Its my last rotation for medical school. I was lucky enough to find another spot nearby but I wonder what will happen in the near future. The next few weeks will be interesting.

For students that are currently at that particular EM site, they are being placed into an IM rotation instead and are being given EM lectures by rhe school. That hospital doesnt want any med students in the ED or ICU.
 
throwaway1000000 said:
students should be pulled from ED rotations. ICU is probably OK given most of them will hopefully be tested. ED is just too risky for any med student who is not really involved directly in the care and only there for learning
Click to expand...
Tell that to my school..
Maybe it’ll be different when i start in 2.5 weeks
 
throwaway1000000 said:
students should be pulled from ED rotations. ICU is probably OK given most of them will hopefully be tested. ED is just too risky for any med student who is not really involved directly in the care and only there for learning
Click to expand...
Maybe it's just me but wouldn't it be a good learning experience to be in the ICU during a pandemic? Getting to see how doctors make certain decisions, resource limited, etc. I understand it's still a risk to the patients to have unnecessary people around.
 
NicMouse64 said:
Maybe it's just me but wouldn't it be a good learning experience to be in the ICU during a pandemic? Getting to see how doctors make certain decisions, resource limited, etc. I understand it's still a risk to the patients to have unnecessary people around.
Click to expand...

Second this. I would love to be there to help wherever I could and experience it. But I understand that having nonessential personal is a risk... then again, there could be a point when a med student becomes essential if the healthcare system becomes overwhelmed. Considering I’m 26 and have a strong immune system, I would be more than happy to take on the personal risk in order to assist and do some good
 
Last edited by a moderator:
CherryRedDracul said:
If the M3/M4 year is glorified shadowing, they should just shut down the rotations and not let students get any unnecessary exposure or at least put them in "lower risk" rotations.
Click to expand...
This makes sense but it's hard to pull an entire class off rotations indefinitely and have them graduate on time.
 
longhaul3 said:
This makes sense but it's hard to pull an entire class off rotations indefinitely and have them graduate on time.
Click to expand...

There are a number of rotations they could easily just waive as a graduation requirement. Like we have 3 rural medicine/hospital rotations required, and there is no argument that will convince me that it is absolutely vital to my training that I do all 3 before I graduate.
 
AnatomyGrey12 said:
There are a number of rotations they could easily just waive as a graduation requirement. Like we have 3 rural medicine/hospital rotations required, and there is no argument that will convince me that it is absolutely vital to my training that I do all 3 before I graduate.
Click to expand...
Absolutely. I don't know what the LCME considers essential to undergraduate medical education, but if you start pulling people off of core rotations like medicine, obgyn, etc., there will be chaos, even though everyone knows the med students are far from "essential personnel."
 
NotSoObvious said:
Second this. I would love to be there to help wherever I could and experience it. But I understand that having nonessential personal is a risk... then again, there could be a point when a med student becomes essential if the healthcare system becomes overwhelmed. Considering I’m 26 and have a strong immune system, I would be more than happy to take on the personal risk in order to assist and do some good
Click to expand...
Not sure how much help you'd actually be. The risk/benefit of having someone who has seen the process for future pandemics may be useful or harmful. Not sure where the balance lies but everyone here seems to think that having medical students around is absolutely 100% bad. I don't think that's necessarily the case.
 
NicMouse64 said:
Not sure how much help you'd actually be. The risk/benefit of having someone who has seen the process for future pandemics may be useful or harmful. Not sure where the balance lies but everyone here seems to think that having medical students around is absolutely 100% bad. I don't think that's necessarily the case.
Click to expand...

Yeah I mean mostly for simple tasks. Not to be a provider or do things that a medical student would normally do on rotation. More so MA, triaging, running things, stocking supplies, documenting, transporting patients, etc. You know, basically just following orders and simple protocols. If hospital staff start getting infected or older and immunocomprimised staff are refusing to work (understandably so) they’re going to need any body they can get to do various jobs. In that event, willing medical students would become a valuable resource (not to mention we would be free labor)
 
Last edited by a moderator:
Although I would appreciate a vacation as much as the next guy, Its a little crazy to just shut down rotations, because of risk of exposure. We have plenty of risks in normal activities like operating on HIV+ patients, patients with undiagnosed TB , MRSA, Flu etc. If this was ebola or SARS i would understand..
also it is telling when the Uk has plans to give more responsibilities to final year medical students in the event of personal shortages vs here it is the exact opposite.

People should be given a choice as to how much risk they are willing to take as a student .
 
My school won't let anybody on campus for the rest of the month and made all 3rd years reschedule their shelf exams and the end of the month, but is still making us go to rotations. We have confirmed Coronavirus in our city too. Also all 1st and 2nd years are on spring break back home so they will all be returning from different states. Its gunna be a mess.
 
libertyyne said:
Although I would appreciate a vacation as much as the next guy, Its a little crazy to just shut down rotations, because of risk of exposure. We have plenty of risks in normal activities like operating on HIV+ patients, patients with undiagnosed TB , MRSA, Flu etc. If this was ebola or SARS i would understand..
also it is telling when the Uk has plans to give more responsibilities to final year medical students in the event of personal shortages vs here it is the exact opposite.

People should be given a choice as to how much risk they are willing to take as a student .
Click to expand...

Apparently it's documented that during the Spanish Flu there were a number of hospitals that used medical students as providers once the initial staff started getting sick
 
AnatomyGrey12 said:
Apparently it's documented that during the Spanish Flu there were a number of hospitals that used medical students as providers once the initial staff started getting sick
Click to expand...
What worries me is that those who do end up working might get little sleep because only those deemed "essential" are asked to work. They become immunosuppressed and then get taken out by the virus for 14 days at least/become seriously ill and are lost from the system completely. There are threads on twitter of MLPs asking if they should be taught how to do vents. I think someone needs to come up with a plan for how best to use medical students and MLPs in the case of a catastrophic surge in the system. No it shouldn't be adjusting vents but I'm sure there are tasks that can be completed that could actually help those few doctors who can stay in the hospital while allowing them to do the essential things (how it should be anyways, but that's a conversation for another time).
 
NicMouse64 said:
Maybe it's just me but wouldn't it be a good learning experience to be in the ICU during a pandemic? Getting to see how doctors make certain decisions, resource limited, etc. I understand it's still a risk to the patients to have unnecessary people around.
Click to expand...
I mean yeah, I think it would be too. I love the ICU. But you have to weigh the risks and benefits. For most students, if they no interest in ICU, they are putting themselves at risk. Although, I think it's a more informed risk compared to the ED where you are just going blind and have no idea who has COVID or not.
 
libertyyne said:
Although I would appreciate a vacation as much as the next guy, Its a little crazy to just shut down rotations, because of risk of exposure. We have plenty of risks in normal activities like operating on HIV+ patients, patients with undiagnosed TB , MRSA, Flu etc. If this was ebola or SARS i would understand..
also it is telling when the Uk has plans to give more responsibilities to final year medical students in the event of personal shortages vs here it is the exact opposite.

People should be given a choice as to how much risk they are willing to take as a student .
Click to expand...

I have a cousin in UK now in their clinical years and I'm told they are expected to work more on rotations specifically because of this reason.
 
libertyyne said:
Although I would appreciate a vacation as much as the next guy, Its a little crazy to just shut down rotations, because of risk of exposure. We have plenty of risks in normal activities like operating on HIV+ patients, patients with undiagnosed TB , MRSA, Flu etc. If this was ebola or SARS i would understand..
also it is telling when the Uk has plans to give more responsibilities to final year medical students in the event of personal shortages vs here it is the exact opposite.

People should be given a choice as to how much risk they are willing to take as a student .
Click to expand...

Your two paragraphs are contradictory.
 
allantois said:
I’m sure one consideration for schools is whether they will get sued if their students end up with a Coronavirus on rotations
Click to expand...
its a little absurd to compain about the possibility of being mauled by a bear when you sign up to become a bear trainer.
7331poas said:
Your two paragraphs are contradictory.
Click to expand...
They are not. Giving a choice innately allows people to take on more risk or lower risk, Avoiding sick patients I still hold is a little absurd.
 
libertyyne said:
its a little absurd to compain about the possibility of being mauled by a bear when you sign up to become a bear trainer.

They are not. Giving a choice innately allows people to take on more risk or lower risk, Avoiding sick patients I still hold is a little absurd.
Click to expand...
waiiiiitttt whatttt???? I have to be around sick people in medical school? damn that blows. I wish I knew that before I started.....*enter premed with no healthcare/patient care experience with super high gpa/MCAT, WHY CANT I GET ACCEPTED to medical school????*
 
NicMouse64 said:
waiiiiitttt whatttt???? I have to be around sick people in medical school? damn that blows. I wish I knew that before I started.....*enter premed with no healthcare/patient care experience with super high gpa/MCAT, WHY CANT I GET ACCEPTED to medical school????*
Click to expand...

Ridiculous premise. Why should I be spreading COVID for no reason other than to stand behind my attending and shadow? I have no problem treating a HIV patient. COVID is clearly a different equation.
 
7331poas said:
Ridiculous premise. Why should I be spreading COVID for no reason other than to stand behind my attending and shadow? I have no problem treating a HIV patient. COVID is clearly a different equation.
Click to expand...
Exactly. If i were “essential” personnel, that would make sense. As I am not, I just in the way and another source of transmission.
 
libertyyne said:
Although I would appreciate a vacation as much as the next guy, Its a little crazy to just shut down rotations, because of risk of exposure. We have plenty of risks in normal activities like operating on HIV+ patients, patients with undiagnosed TB , MRSA, Flu etc. If this was ebola or SARS i would understand..
also it is telling when the Uk has plans to give more responsibilities to final year medical students in the event of personal shortages vs here it is the exact opposite.

People should be given a choice as to how much risk they are willing to take as a student .
Click to expand...

Call me a cynic, but I doubt the concern is for med students per se. The concern is where you're going to take the bug when you get it. Will you go from patient to patient spreading the germs? Not the same with HIV.
 
AnatomyGrey12 said:
Lol our class president brought this up in a meeting and was instantly shot down with, "you signed a waiver when you started med school blah blah blah."
Click to expand...

And how do we know he/she caught it on the rotation? Could have easily come from your Starbucks barista.
 
Mass Effect said:
Call me a cynic, but I doubt the concern is for med students per se. The concern is where you're going to take the bug when you get it. Will you go from patient to patient spreading the germs? Not the same with HIV.
Click to expand...

I guess, but realistically the Nursing staff, the PCAs, the food workers, the residents, the attendings seem to be a larger nidus of infeciton. I understand that I am not essential to the care of patients. But then it seems like it s problem with the system not utilizing me.

The resident theoretically is non-essential as well , you could say that they are increasing the number of people in that room considering the attending has to see the patient anyway .

To everyone talking about how not going into these rooms is going to be somewhat protective of them, community spread is probably the largest risk right now, and once they graduate they magically will not have this option left to them to not see patients as a resident.
 
libertyyne said:
I guess, but realistically the Nursing staff, the PCAs, the food workers, the residents, the attendings seem to be a larger nidus of infeciton. I understand that I am not essential to the care of patients. But then it seems like it s problem with the system not utilizing me.

The resident theoretically is non-essential as well , you could say that they are increasing the number of people in that room considering the attending has to see the patient anyway .

To everyone talking about how not going into these rooms is going to be somewhat protective of them, community spread is probably the largest risk right now, and once they graduate they magically will not have this option left to them to not see patients as a resident.
Click to expand...

Actually residents are pretty essential. Not sure how to even make sense of the notion they're not. As for everyone else you mentioned, they are directly involved in caring for the patient. They HAVE to go into the room. Not so for med students. I do think there's some role for med students, but in trying to stop the spread in hospitals, maybe not in the ED.
 
Mass Effect said:
Actually residents are pretty essential. Not sure how to even make sense of the notion they're not. As for everyone else you mentioned, they are directly involved in caring for the patient. They HAVE to go into the room. Not so for med students. I do think there's some role for med students, but in trying to stop the spread in hospitals, maybe not in the ED.
Click to expand...
There are hospitals that function without residents all the time.
The attending has to lay eyes and hands on the patient. The resident does not. If you want to truely reduce extraneous hands you would cut out any touch or exposure that is not absolutely necessary.
 
libertyyne said:
There are hospitals that function without residents all the time.
The attending has to lay eyes and hands on the patient. The resident does not. If you want to truely reduce extraneous hands you would cut out any touch or exposure that is not absolutely necessary.
Click to expand...

Those hospitals are not academic hospitals. Academic hospitals, for the most part, are resident-run. The attending lays eyes to bill and to make sure the right diagnosis/treatment plan is made, but let's not compare the necessity of med students to the necessity of residents.
 
Mass Effect said:
Those hospitals are not academic hospitals. Academic hospitals, for the most part, are resident-run. The attending lays eyes to bill and to make sure the right diagnosis/treatment plan is made, but let's not compare the necessity of med students to the necessity of residents.
Click to expand...
we are talking about eliminating all unnecessary risks here. I am just talking about a logical conclusion of this argument.
You are allowing another set of trainee's to continue to train because its easier on your work flow. Not because they are necessary for the care of the patient.
 
libertyyne said:
we are talking about eliminating all unnecessary risks here. I am just talking about a logical conclusion of this argument.
You are allowing another set of trainee's to continue to train because its easier on your work flow. Not because they are necessary for the care of the patient.
Click to expand...

Residents ARE necessary for the care of the patient. The above shows a profound lack of knowledge of how academic hospitals operate.
 
Mass Effect said:
Residents ARE necessary for the care of the patient. The above shows a profound lack of knowledge of how academic hospitals operate.
Click to expand...
Oh come on. I know how academic hospitals work. Your comment shows a profound lack of understanding between what is necessary for treating a patient, and what is necessary for efficiency or how academic hospitals are structured.
 
libertyyne said:
Oh come on. I know how academic hospitals work. Your comment shows a profound lack of understanding between what is necessary for treating a patient, and what is necessary for efficiency or how academic hospitals are structured.
Click to expand...

If you knew anything about academic hospitals, then you would know the significant ramifications of sending hundreds of licensed physicians at your hospital home during a pandemic.
 
Mass Effect said:
If you knew anything about academic hospitals, then you would know the significant ramifications of sending hundreds of licensed physicians at your hospital home during a pandemic.
Click to expand...
Oh gosh, i wonder how non academic hospitals even function. Maybe you should actually address the argument instead of attacking my understanding.
Ask yourself a simple question. Do academic physicians carry a higher case load compared to their private practice counterparts?
 
Last edited:
Not sure if this has been answered but is there a certain amount of rotations (clinical hours) that 4th years need to graduate? Like mandated by whomever makes the rules (the LCME?). Is it even possible to pull 4th years without having them make up the time missed so they can graduate?
 
MerYangBey said:
Not sure if this has been answered but is there a certain amount of rotations (clinical hours) that 4th years need to graduate? Like mandated by whomever makes the rules (the LCME?). Is it even possible to pull 4th years without having them make up the time missed so they can graduate?
Click to expand...
Lcme is going to have to make some exceptions if there is going to be widespread displacement of medical students .
 
Wouldn't it be funny if we aren't able to graduate for being unable to finish a required rotation lol..
 
NicMouse64 said:
What worries me is that those who do end up working might get little sleep because only those deemed "essential" are asked to work. They become immunosuppressed and then get taken out by the virus for 14 days at least/become seriously ill and are lost from the system completely. There are threads on twitter of MLPs asking if they should be taught how to do vents. I think someone needs to come up with a plan for how best to use medical students and MLPs in the case of a catastrophic surge in the system. No it shouldn't be adjusting vents but I'm sure there are tasks that can be completed that could actually help those few doctors who can stay in the hospital while allowing them to do the essential things (how it should be anyways, but that's a conversation for another time).
Click to expand...

Medical students used to manage lots of patients with minimal supervision. That was a different time, before liability and complexity of medicine.

Besides, the number of qualified physicians to run vents won’t be the limiting factor. It will be the ICU beds and vents themselves.
 
NITRAS said:
Medical students used to manage lots of patients with minimal supervision. That was a different time, before liability and complexity of medicine.

Besides, the number of qualified physicians to run vents won’t be the limiting factor. It will be the ICU beds and vents themselves.
Click to expand...
The city of Philadelphia is considering reopening Hahnemann if things get too bad...
That is already the problem in Italy, lack of beds and lack of vents.
 
You must log in or register to reply here.

Similar threads

mtsapko
  • Poll Poll
Transition from preclinical to clinical (M2 to M3)
Replies
8
Views
2K
eteshoe
eteshoe
S
MD & DO What makes a student successful during their clinical rotations?
Replies
1
Views
773
J_doc1
J_doc1
Lifeblood_20
MD Bottom quartile for M3 grades, feeling down
Replies
13
Views
4K
Splenda88
S
C
Questions for M3/M4 Students
Replies
9
Views
2K
pierty
pierty
kinnencan
  • Solved
Manic episode advice M3
2
Replies
78
Views
9K
GoSpursGo
GoSpursGo
Top