SARS disrupts medical education in Canada

Toronto's medical students cope with suspended classes, lost hospital clerkships.

By Myrle Croasdale, amednews staff. May 5, 2003.

Gurinder Sangha, a third-year medical student at the University of Toronto Faculty of Medicine and president of his class, is feeling uneasy.

He's been idle for the past three weeks, missing his general surgery clerkship since the university cancelled students' clinical activities on March 29 because of the severe acute respiratory syndrome outbreak. Sangha needs the clerkship for a surgical residency application and he doesn't know if he'll get to make it up.

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"Students are feeling anxious and worried about how this will play out," Sangha said.

In the United States, the impact of SARS has been less disruptive to date. David Pegues, MD, infectious disease clinical program director for UCLA's David Geffen School of Medicine, said SARS hadn't had a dramatic impact on clinical care or medical education.

Because of SARS, Toronto's medical school suspended classes for 10 days for students with patient contact.

But since Los Angeles County has the largest number of suspected SARS cases in the United States, he's found university employees to be very apprehensive.

"I get all sorts of questions, 'We're having an employee returning from a funeral in Hong Kong. What do we do?' Thankfully we're not on the front end of the learning curve," he said.

At press time, the situation in Toronto was beginning to look more stable. Rick Frecker, MD, associate dean for the University of Toronto medical school, said third- and fourth-year students would return to the nine Toronto-area teaching hospitals April 23.

"It's a significant disruption, but it won't having a lasting negative impact on their education," he said.

A 10-day disruption

Toronto's medical school suspended classes for 10 days for students whose education involved clinical contact with patients, which meant virtually all but first-year students had no classes for two weeks. Second-year students then went back to class, but without any exposure to patients. Third-year students in the middle of core clinical clerkships had lectures on the specialties they were missing, but third- and fourth-year students on elective clerkships did not.

In addition, three of the university's 800 medical students underwent voluntary 10-day quarantines because of possible exposure to SARS, as did a few of the school's 5,000 faculty.

Medical residents set to rotate within their programs had to stay a week longer before moving on, and faculty meetings were canceled.

Yet despite all this, students still learned. Sunu Thomas, a second-year medical student, said watching the public health system's response unfold was a powerful lesson on the value of preventive medicine.

"It's inspiring to see the [Centers for Disease Control and Prevention] and the World Health Organization and what they're doing right here at home," Thomas said. "An entire branch of medicine has been opened up to me, and I'm interested in exploring it further."

As of April 18, Canada was investigating 306 potential cases of SARS and had reported to the CDC 126 probable cases and 12 deaths. The United States had 35 probable cases, 173 suspected cases and no deaths.

California had the most suspected and probable cases in the United States, at 43, with Los Angeles County seeing the largest cluster at eight.

As of April 17, the WHO reported total probable SARS cases at 3,389 with 165 deaths.