By David Brill
You probably thought preparing for finals was stressful enough. Now there’s the small matter of a global coronavirus pandemic to deal with too. Eeek.
Here are some suggestions of what medical students should expect over the coming weeks and months, some coping strategies and ways you can help out. Please share and comment: I’d love to hear about your experiences so far, what’s happening at your med school and how you are supporting each other.
What to expect
At present, the only certainty is uncertainty. Each day brings newsflashes, updates, changes and a torrent of WhatsApp messages beyond anything I’ve ever seen. No one knows how this is going to play out – but it seems likely the NHS and medical education are facing upheaval on an unprecedented scale.
At the time of writing, here are just some of the changes affecting medical students in the UK:
- All teaching moving online – no more face to face contact
- Exams and OSCEs delayed, moved online or cancelled
- Clinical placements drastically scaled back
- Electives cancelled, postponed or changed
- Graduation ceremonies suspended
- Relaxation of requirements on portfolios, written assignments etc
- Early GMC registration for final-year students who have completed exams, so they can begin working in the NHS
- Potential introduction of zero-hours contracts for final-year students to work in paid roles away from the front line
- Students volunteering in various ways, such as providing childcare for NHS workers
Not a lot of good news there I’m afraid – apart from exams being cancelled of course. At least there’s still Glastonbury to look forward to … right? Oh crap. Netflix anyone?
(If it’s any consolation – which I’m absolutely sure it isn’t – junior doctors are also facing chaos and change on a massive scale: our April rotations have been cancelled, our rotas are being re-written on an almost daily basis, annual leave is being slashed and we are going off sick in huge numbers … but enough about us, let’s focus on you!)
Coping with COVID: Seven strategies for students
With all this upheaval going on, try to:
Recognise your anxiety. Uncertainty and change are scary at the best of times – it is completely, 100% normal to be feeling anxious and stressed right now, so do not do that thing of thinking you’re above it just because you’re training to be a doctor. You’re human: it’s okay to be worried about your training, your career, your health and, well, everything really.
Try your best to stay calm and positive. Double down on whichever self-help techniques you normally use to manage stress such as exercise, deep breathing or talking to friends and family. We are probably in this for the long haul, and it’s essential to preserve your mental and physical health. Panic is not your friend.
Regulate the flow of information. I don’t know about you, but personally I seem to be developing a new condition I’ll call SMIT: Social Media Induced Tachycardia. I can literally feel my heart rate rise every time I check Whatsapp, Facebook or Twitter and get bombarded with terrifying new information. So try to limit yourself to short time slots online, say half an hour, with breaks of at least 2 hours in between. This will help you stay calm – spending the whole day on the internet right now is a recipe for a breakdown.
Remember why you want to be a doctor. You got in this game for the intellectual challenge, the variety of medicine as a career, and your desire to help people, right? Coronavirus, despite being a complete bastard, actually ticks all these boxes: it’s new and unknown, it’s fundamentally changing the healthcare system and patients need our help and reassurance like never before. So we the medical profession – students and doctors alike – must do our best to rise to the challenge.
Keep up your studies. I know, I know, it must be tempting to sack it all off and spend the day playing PlayStation in your pyjamas. But you can’t let your brain turn to mush at this crucial period: get up, get dressed and force yourself to study for a few hours a day. Otherwise you risk getting caught with your pants down when exams are rescheduled and you discover you’ve wasted weeks and forgotten everything. If nothing else, studying will provide some normality, variety and intellectual stimulation, particularly if you are self-isolating, and a welcome distraction from all the doom and gloom.
Realise this won’t go on forever. Yes the short-term forecast is bleak and unpredictable, but at some point this pandemic will be under control and life will start to return to something resembling normality. I find it reassuring to cling onto that thought, even though I don’t know when it will be or what will happen in the intervening period.
Seek help and support. Loads of great resources are rapidly appearing about managing coronavirus-related anxiety. Check out these pages from the CDC, Guardian and Australian Psychological Society for starters. If you are really struggling, speak openly to your friends and family or try to arrange a telephone consultation with your GP, psychologist or psychiatrist (I realise this is likely to be a lot easier said than done, but the coming weeks should see a significant scaling up of capacity for telephone and online consultations, so be persistent and keep trying).
How you can help
Your focus right now probably depends on which stage of your medical studies you are at. Early years are presumably wondering how and when their teaching will resume; final years are naturally more worried about being pitched into work much earlier than planned, at a time when the NHS is under maximum pressure.
But whichever year you are at, there is in fact a lot you can do to help out during the coronavirus pandemic. Here are some suggestions:
Keep on top of communications from your medical school. Check your email daily and cast an eye at the website every now and then. This is a fast moving situation which varies across the country, and you don’t want to be out the loop on the latest developments affecting you. Other important groups to keep an eye on for updates are the Medical Schools Council, Health Education England, the Academy of Medical Royal Colleges and Universities UK.
Be patient and flexible. Your med school does not have a rulebook for this and they too are figuring it out as they go along. Staff are also anxious about their jobs and health. Don’t make it worse for them by demanding certainty and information that they simply cannot provide.
Stay up to date with information about COVID-19 from credible sources such as the NHS, World Health Organisation, US Centres for Disease Control and mainstream media outlets. Avoid sharing unsourced, unreliable drivel from social media which worsens the spread of fear and fake news.
If you’re really keen, go a step further by reading the latest research papers and medical commentary on coronavirus. If you’re not sure where to look, the big four general medical journals are a good place to start: the BMJ, Lancet, New England Journal of Medicine and JAMA. This is a rare opportunity in medicine to be equally knowledgeable – or even more so – about a topic as your tutors and lecturers. And if you’re on clinical placements, I can guarantee the junior doctors will be super impressed if you know what to look for on blood tests, chest x-rays and CT scans in COVID patients.
Support your friends, family and neighbours during this difficult period. People really trust medical students, and you can do a lot to reassure them and provide accurate information.
Volunteer to help out in any way you can, such as providing childcare to NHS workers or helping out vulnerable members of society.
Hopefully this doesn’t need to be said but … do follow all the official government advice on hand washing, self isolating if you become ill and so on. It’s not a good look for medical students to be spreading pandemic viruses.
If you are on clinical placements, be super proactive and helpful. Support the doctors as best you can and try not to get in their way or be demanding. Learn as much as you can, but bear in mind that your education is unfortunately not the priority in clinical settings at present. Sorry. If you find you’re just twiddling your thumbs and being ignored then it is definitely fine to leave. In fact you should.
Don’t work above your competencies. For those being drafted into clinical work, things are likely to be chaotic with many of the normal procedures and protocols going out of the window. Do as much as you can, but never cross the line: if you’re asked to do things you’re really not comfortable with, or which aren’t safe, it’s important to stand firm and politely explain why you can’t do it, rather than putting patients and yourself at risk. The pandemic will pass, but a clinical incident on your record might stick around forever.
Strive to keep patient care your priority. It’s natural and appropriate to want to keep ourselves safe first and foremost, and you should absolutely ensure you minimise risk by following infection control guidance and seeking senior advice when working with COVID patients. But self preservation should be a by-product, not your main aim. Finding this balance is going to be immensely challenging for all of us, but we have to try our hardest. Caring for patients is why we got into this business, and now is the time they need us most of all.
Keep healthy, stay safe and feel free to comment on the blog below if you need any other help or advice.
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Thanks for writing this David.
Fantastic article with a wealth of good information in there. These are truly testing times and we as doctors in practice and doctors in training must rise to meet the enormous expectations that will be put on us.