Medical students have largely returned to campuses—though much of preclinical learning remains online. With their return comes a different set of expectations than those that existed a year ago. Safe, responsible behavior is imperative during a pandemic that has uprooted norms in education and life.

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The realities of the pandemic and the hands-on nature of medical training have created a dynamic in which students—in some cases, even in their first year—are interacting with patients. Their behavior must consider the safety of their peers and patients.

“All our students are working and learning in the health system, even our first-year students soon will be. So we all need to abide by the safety protocols in order to protect the patients we serve,” said Rajesh Mangrulkar, MD, associate dean for medical student education at University of Michigan Medical School, a member school of the AMA Accelerating Change in Medical Education Consortium. “By and large, our incoming medical students understand they are entering a profession that is at the center of the pandemic and is responsible for keeping our patients safe.”

Learn about six factors that dictate the resumption of clinical training.

Rising to the occasion

As part of the care team, medical students are being held to the same standards that apply to their clinical faculty and residents during the pandemic at Michigan Medicine. That means:

  • Medical students are fully masked anywhere on the Michigan campus or in the health system—inside or outside.
  • Students must follow local guidance on social gatherings that limit capacity to groups of 10 people indoors or 25 people outdoors.
  • Frequent handwashing is a “must”.
  • They must monitor their own wellness and use a health-screening app to govern their access to university buildings, the hospitals and clinics.

Implicit in all of these guidelines is that their career path, and role in fighting against the pandemic, may require them to act in a manner that differs from others around them who are not in the profession of medicine.

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“What we let students know is that they have permission to not do what they may be seeing around them,” Dr. Mangrulkar said. “That’s been part of our messaging. You may see others act unsafely, be inside a crowded room and [not wear masks]. You have permission to not do that. We ask them to keep in mind what their ultimate mission is in our profession: to keep each other and our patients safe.”

Find out how medical schools are starting training for first-year students.

The honor system

Attending medical school in typical times is a weighty commitment. The pandemic has added gravity to nearly every decision.

“We created a compact that students, faculty and staff have to sign, setting a level of expectations of behaviors when they are not on campus,” said Isaac J. Kirstein, DO, a dean at the Cleveland campus of Ohio University Heritage College of Osteopathic Medicine (OUHCOM), which is also member school of the AMA’s consortium. “For us to maintain a safe campus, everybody has to be safe every hour of the day that they are not on campus. Appealing to the need for collective responsibility, we outlined expected behavior in a compact that everybody signed.” Dr. Kirstein noted that other medical schools are asking medical students to make similar pledges.

Medical students have some extra motivation to be on their best behavior: An increase in COVID-19 caseloads to surge levels is likely to put a halt to in-person training.

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“Overwhelmingly, students are grateful and excited to go to medical school,” Dr. Mangrulkar said. “They are very mission-oriented. Right now, our preclinical students are pleased they can do even “a little bit” of learning in person.

“I’m so proud of all of our students. They really take this very seriously and are committed to their professional journey.”

The AMA has curated a selection of resources to help residents, medical students and faculty during the COVID-19 pandemic manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time. 

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