Physician Health & Wellbeing — COVID-19 and Beyond
COVID-19 Pandemic and Medical Student Mental Health
O
n Wednesday March 11th, 2020 at 1:02 PM President Gabel notified the University of Minnesota community that in-person instruction, due to the COVID-19 pandemic, was suspended and all courses would return in virtual form. Those on clinical clerkships finished the week but soon afterward, the wards and clinics were empty of medical students. Faced with the prospect of student training grinding to a halt across the UME continuum, faculty and staff responded swiftly and in remarkably innovative ways. Course directors and the Curriculum team scrambled to transform the Year 1 and 2 Pre-Clerkship Foundation courses to an all virtual platform. Year 3 and 4 Clerkships were split with didactic components (and Shelf Exams) placed in virtual (Part A) courses while the (Part B) clinical experiences were deferred to an undetermined future period. On May 25th, four miles away from the Twin Cities Campus, the challenges of COVID were exacerbated when the murder of George Floyd sent reverberations across the world and reminded us of the other ongoing pandemic of institutional racism. All students faced increased isolation, uncertainty about their futures, living in fear of being infected with COVID-19, and concerned about the equity of their education. Meanwhile, nationwide, average anxiety and depression severity scores
By Michael H. Kim, MD and Wm. Scott Slattery, PhD
22
Winter 2021
Michael H. Kim, MD
Wm. Scott Slattery, PhD
increased 13% from August to December 2020.1 Data is now emerging suggesting that impacts on medical students associated with the pandemic resulted in even higher levels.2 As the year progressed, uncertainties lingered, and the new-normal set in. The 2020 graduates were left with a virtual Match Day and Commencement and entered residency programs clouded by an evolving pandemic few were prepared for. The class of 2021 lost access to advanced training and away rotation opportunities, faced a virtual Match, and joined their 2022 peers in encountering a seemingly relentless barrage of USMLE Board exam cancellations. These same 3rd year peers also faced a summer without clinical experience, and concerns about being adequately prepared to be doctors. The Class of 2023 completed their first year virtually and faced the prospect of another year of isolation from classmates. Lastly, the incoming matriculants of 2020 didn’t physically meet most of their classmates until a year later. In short, this has been
an unquestionably horrible year, and, with the customary world of medical education turned on its head, how are we doing? Prior to the 2020 Spring, considerable efforts were already underway to improve the mental health support of our medical students. Described previously3 and built upon a prevention model, efforts focused on a theoretical conceptualization of wellbeing in terms of three interdependent dimensions: 1. impact of the learning and working environment; 2. access to supportive relationships and community; and, 3. ability to engage in an effective self-care plan. Prevention efforts in each dimension further intersect to foster a sense of belonging, emotional capacity, and self-efficacy. These efforts guided responses to the impacts of the dual pandemics as well as how to monitor and respond to them. For example, the year before a pulse survey process where randomized student groups across classes were surveyed on wellbeing, empathy, and depression at the start of the school year and then longitudinally as part of follow-up groups
MetroDoctors
The Journal of the Twin Cities Medical Society
