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King COVID: Training During a Pandemic, Watching Safety Nets Break, and Becoming a Person I'd Rather Not Be



When my class’ third year of medical school started in June 2020, we all knew that the beginning of our clinical training would look dramatically different from that of other classes due to the COVID-19 pandemic. The emergence of SARS-CoV-2 in late 2019 and its global impact became the context of our core clerkships, an omnipresent backdrop that has colored our first immersive view of clinical medicine. Prior to 2020, we had been present in clinical settings as patients ourselves, through doctoring, occasional shadowing, or work experience but had never  dedicated our days to clinical activities in the way we would throughout year three of medical school. We arrived at our sites in June with an idea of what to expect but an understanding that every day of third year is different and the COVID-19 pandemic is perpetually changing.  

          Throughout the past eight months I have learned so much, met incredible and supportive clinical educators, enjoyed spending time with patients, and watched as countless people in the US are let down by the structures that could be keeping us safe amid a pandemic. As my class has continued our clerkship blocks, the number of US deaths from COVID-19 infection has crept up to over 600,000 people, a number that is so large I have a hard time making sense of it. We have watched the COVID-19 pandemic hit already marginalized groups the hardest and racism in and out of medicine perpetuate health struggles faced by BIPOC communities. We have continued to show up to our clinical sites and do our practice problems because life goes on in the face of suffering and hardship, a lesson that’s far from new in medicine but feels particularly salient at this moment in time. MyProgress checklists of tasks to complete remain, USMLE Shelf exam passing scores stay constant, and OSCEs roll around at the end of every clerkship. 

          Learning continues and the discoveries and challenges of third year mix with the discoveries and challenges of living and caring for others during a pandemic. On both fronts, a lot of unknown and a lot of accepting this moment for what it is.  Patients are scared for themselves and their families and so are healthcare providers. As a medical student that found myself symptomatic with a COVID-19 infection in late 2020 following clinical exposures, I have landed somewhere in between.  

          During one of our class-wide reflection sessions in the fall, we completed an online quiz  that identified our primary values from a list of dozens of values. My top five were friendship,  family, compassion, health, and strength. If each of these values is to be seen as existing through not just our internal priorities but also our actions and how we navigate the world, I have compromised every single one of them throughout third year. I have not visited my family since the pandemic began for fear of getting them sick due to my high exposure level and their chronic diseases, I have little time to see my friends and check up on them due to our conflicting schedules and social distancing, my health is still recovering from having COVID-19,  and my strength is also still on the mend. Compassion I have tried to hold on to but the combination of exhaustion and confusion has landed me in a position where showing compassion to patients, colleagues, and myself is not coming as naturally as it once did.  

          Without a doubt this year has shaped my professional identity formation, specifically in that I have seen how it is possible to move through a medical career without truly caring for my patients or my family and friends. I have found a renewed commitment to bring care and active compassion with me into residency, fellowship, and wherever my career may take me. Through the COVID-19 pandemic I have seen the strength and gratification that comes with learning and  working as a part of a team and the immense importance of remaining connected to the people around me.  

1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet  Inf Dis. 20(5):533-534. doi: 10.1016/S1473-3099(20)30120-1

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