Medical Students Are Not Essential Workers: Examining Institutional Responsibility During the COVID-19 Pandemic

Abstract

In light of the evolving COVID-19 pandemic, the Association of American Medical Colleges (AAMC) and Liaison Committee on Medical Education (LCME) released a joint statement in March 2020 recommending an immediate suspension of medical student participation in direct patient contact. As graduating medical students who will soon begin residency, the authors fully support this recommendation. Though paid health care workers, like residents, nurses, and environmental services staff, are essential to the management of COVID-19 patients, medical students are not. Students’ continued involvement in direct patient care will contribute to SARS-CoV-2 exposures and transmissions and will waste already limited personal protective equipment. By decreasing nonessential personnel in health care settings, including medical students, medical schools will contribute to national and global efforts to “flatten the curve.” The authors also assert that medical schools are responsible for ensuring medical student safety. Without the protections provided to paid health care workers, students are uniquely disadvantaged within the medical hierarchy; these inequalities must be addressed before medical students are safely reintegrated into clinical roles. Although graduating medical students and institutional leadership may worry that suspending clinical rotations might prevent students from completing graduation requirements, the authors argue the ethical obligation to “flatten the curve” supersedes usual teaching responsibilities. Therefore, the authors request further guidance from the LCME and AAMC regarding curricular exemptions/alternatives and adjusted graduation timelines. The pool of graduating medical students affected by this pause in direct patient contact represents a powerful reserve, which may soon need to be used as the COVID-19 pandemic continues to challenge the U.S. health care infrastructure.

Effect of the COVID-19 pandemic on medical student career perceptions: a national survey study

“…However, lack of in-person clinical exposure may pose a challenge to medical students, particularly those attempting to choose a specialty or apply to residency programs. Published commentaries by medical students have indicated a simultaneous sense of duty to do their part by staying home, as well as concern about how their education will proceed [10,11].…”

Involvement of Medical Students During the Coronavirus Disease 2019 Pandemic: A Cross-Sectional Survey Study

“…In this context, the role of medical students is unclear and contentious [1][2]. Due to legal 1 2 2 requirements, social distancing was implemented and in-person medial classes have been cancelled and replaced with online lectures and virtual teaching for most medical students [3]. However, the educational situation is crucial for final year students, as they are completing clinical clerkships.…”

Medical Students’ Commitment during the SARS-CoV-2 Pandemic: Preparedness, Motivation, and Impact on Students’ Skills

“…At the beginning of the SARS-CoV-2 pandemic in early 2020, the commitment of medical students as supporters of health care staff and their possible roles in the system were discussed more than ever before (8)(9)(10)(11)(12)(13)19,27). This discussion led us to perform a survey of medical students voluntarily working in a large-scale SARS-CoV-2 cohort study.…”

“…As the students are clearly not permitted to perform all tasks, their work has to be regularly supervised or even repeated by professional staff. Some authors argue that, through this redundant work, the transmission rate may be increased (27). Furthermore, this may lead to a waste of personal protective equipment, for which a shortage has already been reported (3).…”