Rethinking the role of senior medical students in the COVID-19 response

On 11 March 2020, the World Health Organization declared COVID-19 a pandemic. Australia has enacted public health measures to reduce the number and severity of cases (1). These measures, alongside disease burden, profoundly impact the healthcare system. It is unclear what the place of medical students in the COVID-19 response is.

The gravity of the COVID-19 crisis has led governments to take drastic measures. Over 10 000 Italian final year students have had graduation expedited to supplement the overburdened workforce (2). In the UK, the Medical Schools Council has encouraged prioritising qualification of final year students to support the over-encumbered National Health Service (2).

The Medical Deans of Australia and New Zealand recognise the value of final year medical students, releasing a statement outlining appropriate roles (3). These involve routine aspects of care independent of the COVID-19 response, in various clinical setting that students are already familiar with. Moreover, with clinical placements being disrupted, senior students may gain valuable practical exposure aligning with course requirements. Considering the noted mental health effects of COVID-19 (4), student contributions may relieve burden on professional staff while alleviating any sense of helplessness, improving the mental wellbeing of students and staff alike. Importantly, medicine embodies altruism and humanity, with many students preferencing this vocation for these moral reasons. If imminent doctors feel impassioned to contribute, it is just to respect this desire as the system would, had COVID-19 surfaced mere months later.

Involving students, however, is not without risk. With the reported asymptomatic infectious period, expanding the workforce elevates infection risk. Exposure to COVID-19 patients should thus be minimal. Furthermore, the risk of litigation is pertinent as students are less experienced than professional staff. Responsibilities should be within capabilities, under supervision and institutional medico-legal protection. Lastly, additional work hours may impede formal medical education; academic penalties should not be levied with due acknowledgment of on-the-job learning and accessibility of course materials should be maximised. Indeed, medical student involvement should be implemented following principles developed by key stakeholders (3, 5). Extraordinary times call for extraordinary measures. With appropriate legal, operational and training safeguards, senior medical students have a role in the COVD-19 response if they desire.

References

1. Dalton CB, Corbett SJ, Katelaris AL. Pre-emptive low cost social distancing and enhanced hygiene implemented before local COVID-19 transmission could decrease the number and severity of cases. The Medical Journal of Australia. 2020 Mar 18;212(10):1.
2. Ivana Kottasová, I. Thousands of medical students are being fast-tracked into doctors to help fight the coronavirus. CNN (Atlanta, Georgia). 2020, 20 Mar. https://edition.cnn.com/2020/03/19/europe/medical-students-coronavirus-intl/index.html (accessed 23 March 2020)
3. Medical Deans Australia and New Zealand. Principles to support medical students’ safe and useful roles in the COVID-19 health workforce. Sydney: Medical Deans Australia and New Zealand, 2020. https://medicaldeans.org.au/md/2020/03/2020-March-20_principles-for-medical-student-roles-in-COVID-19-health-workforce.pdf?fbclid=IwAR1UhmcEdfixI11SwNK0h-7ptorkjsg7V3HBzgnlpS4mNUvBslyxzWCspqg (accessed 23 March 2020)
4. Forbes D. What is COVID-19 doing to our mental health? InsightPlus (Australia). 2020, 23 Mar. https://insightplus.mja.com.au/2020/11/what-is-covid-19-doing-to-our-mental-health/ (accessed 24 March 2020)
5. Australian Medical Students’ Association. AMSA COVID-19 Response. Canberra: AMSA, 2020. https://www.amsa.org.au/amsa-covid-19-response (accessed 15 March 2020)