Now We Turn Unto Our Calling: Medical Students During the COVID-19 Pandemic

Calvin Schaffer, Sabahat Rahman, Sarah Ferreira, Bennett Vogt and Paula Whitmire

We came to medical school with the desire to address social issues. But as the pandemic devastated our community, we often heard the best way we could help was to stay home and study. However, we felt our physician identity, our lifelong oath and commitment to serve our patients, began when we put on our white coats. With countless health care providers risking their lives every day to continue to uphold their own oaths, we felt compelled to do the same. While the authors were involved in many of the student volunteer efforts, we cannot begin to take credit for the magnitude of the projects taking place. However, we wish to share some of these projects to emphasize how impactful mobilizing the often untapped medical student population has been to a public health response.

Despite lacking a framework for student action, students at UMass Medical School were able to create a COVID-19 Student Task Force. In collaboration with mentors, school administrators and community partners, the group supervised over 25 student-led projects across two hospital systems and several counties in Massachusetts (1). Within a few months, students helped collect and deliver over 20,000 pairs of gloves and 1,000 N95 masks to local hospitals, performed respiratory fit testing of over 1,000 hospital employees, created 130 gallons of hand sanitizer and trained an entire hospital network of 850 staff across 60 outpatient clinics on telehealth technology. Students supported local nursing homes by partnering with elders to provide social connection, aided schools by helping students navigate digital learning, assisted in contact tracing efforts, raised money to provide food and drinks to front-line staff and volunteered at a field hospital (1).

Through these experiences, as students got a more nuanced understanding of community needs, addressing inequity became a key focus of student efforts. Medical students worked to transform their in-person, free clinic program to telehealth to ensure patients had access to care. Organized Medicine at UMMS and the Massachusetts Science Policy Network advocated on a state and national level to address policy issues related to COVID-19, including promoting the establishment of fellowships for medical students to participate as science policy advisors to leaders in state government. Lastly, students engaged with the Sustainable Health Equity Movement, an international movement pushing for a health equity-focused approach to the global COVID-19 response, presented a review of health inequalities in the United States. With the emergence of vaccines, students have again stepped up and hundreds have joined efforts across the city and state in partnership with Commonwealth Medicine. Through many of these efforts, we have had the opportunity to directly work with and learn from vulnerable and marginalized communities.

Medical students and health care workers have risen to the occasion and worked countless extra hours and done a miraculous amount of work in the face of a chaotic and deadly pandemic, sometimes while dealing with personal tragedy. However, we are left wondering if the need for such sacrifices could have been avoided, not just in our field, but in all sectors of society. Would addressing systemic inequalities have lessened suffering and dependence on emergency action by an overstretched health care system and community?

Prior to this pandemic, too often medicine and public health were considered to be separate entities. This crisis has shown the dangers of that line of thinking and how medicine is the most downstream net for addressing health sequelae caused by inadequate public health interventions upstream. As current health professional trainees, we are not surprised that the gaps of health care, especially regarding health inequities, have been put in a harsh light during this pandemic. We have seen the disproportionate health and economic impact that this pandemic has had on people of color, people in the service industry, low-income families, and vulnerable populations, exacerbating inequalities that social scientists have been warning us about for decades. It is an unfortunate reality that our collective failure to take adequate action on these warnings has cost people their lives.

Going forward, it is essential that we treat health inequities as an urgent public health issue and that we recognize the role of socioeconomic inequalities in health disparities. As public health becomes a more significant shared concern, there is a greater need to include a wide range of equity-minded experts representing the various concerns of the community when making decisions dealing with life and death . We must guarantee public health officials are given the credibility they deserve and have a seat at the table when decisions that will affect the health and safety of our population are discussed. We must commit to funding public health and community organizations that can address systemic issues plaguing our country from its foundation, including racism, access to care and uninformed leadership. We must empower individuals from diverse backgrounds to lead these efforts and ensure that equity is at the forefront of all levels of medical education, practice and leadership. Invigorated by these tenets and the work we have contributed over the past year, we look forward to building better representation in medicine and being a part of creating a more equitable future.

Acknowledgments:

Thank you Drs. David Chiriboga and Michael Hirsh for their early guidance on this perspective piece. We’d like to acknowledge and thank the leaders of the COVID-19 Student Task Force and the faculty for their guidance and support. We’d also like to acknowledge all of the 170-plus students, community members and faculty who volunteered their time to participate in these efforts. Finally, we’d like to thank all health care workers and essential workers who risk their safety and well-being to keep Worcester going during this pandemic

Reference:

1. University of Massachusetts Medical School Collective Student Response To COVID-19. https://icollaborative.aamc.org/ resource/11059/. Accessed August 16, 2020.