Medical school is demanding regardless of the circumstances, but now is an especially challenging time to be studying medicine. The COVID-19 coronavirus pandemic has sparked public fear, and it's understandable for a medical student to feel anxiety -- especially if he or she is in clinical rotations and interacting with patients.
The best course of action for med students to take, some experts say, is to strictly follow safety protocols and make an effort to "keep calm and carry on," as a popular British saying goes.
In response to the coronavirus outbreak, some medical schools have canceled clinical rotations or shifted medical students away from emergency rooms and intensive care units. Medical students and residents tend to be steered away from patients who are suspected of being infected with COVID-19, and these patients are often redirected to fully trained practicing physicians, some experts observe.
Medical students who are still interacting with patients and who might encounter those with COVID-19 infections should keep safety guidelines in mind, experts say.
Rodney Rohde, a medical laboratory professional who specializes in virology and has an education-related Ph.D., says medical students should meticulously go through all the sanitation rules they are supposed to follow so that they can rely on that knowledge during a crisis.
"In general, the best way for all of us to remain calm is to be prepared," Rohde, a former public health official for the state of Texas, wrote in an email. "Understanding the institution's policies around infection prevention and control is critical."
Rohde, chair of the clinical laboratory science program at Texas State University College of Health Professions, where he is also a professor and associate dean for research, says it's perfectly reasonable for medical students to feel stressed about the current situation with the coronavirus. But he urges them to do their best to take care of themselves by attempting to get high-quality sleep, food and exercise.
Medical students also should be vigilant about shielding themselves from potential exposure to COVID-19, since a diagnostic test is the only way to determine whether a patient has this contagious respiratory disease, adds Rohde, who has more than two decades of experience addressing infectious disease outbreaks ranging from West Nile Virus to SARS.
Dr. Jill Waggoner, a family medicine physician in Texas, says medical students should make a special effort to adopt healthy habits during the coronavirus outbreak because inadequate sleep and other unhealthy behaviors could compromise their immune system.
Medical students also need to safeguard their mental and spiritual health, Waggoner says, because it is hard to be compassionate toward others without self-compassion. Meditation might be useful, she suggests, and med students who are religious might find a sense of peace through prayer.
Dr. Chad Sanborn, a pediatric infectious disease specialist with KIDZ Medical Services in Florida, advises how to maintain a sense of levelheadedness during the current public health crisis: "I would recommend taking each case one at a time and to remember that most people will handle infection quite well," he wrote in an email.
Medical students should also remember that "they are part of a concerted worldwide team effort" to defeat the disease, Sanborn adds.
Getting fit-tested for N95 respirator masks can help ensure that the face mask is tightly secured and functions properly, he adds. Med students "should take extra special care" when putting on and taking off safety gear, "as they are likely to be less experienced at performing these tasks," Sanborn adds.
Additionally, med students should meticulously follow recommendations regarding contact and droplet precautions, use N95 respirators when warranted by federal labor regulations and "take care not to fall to temptation and divulge protected health information when discussing these unique cases so as to not violate HIPAA guidelines," Sanborn explains, referring to privacy laws.
Dr. Eric Mizuno, an attending physician with the Weiss Memorial Hospital in Chicago and director of medical education with the OMNI Medical Student Training Program affiliated with that hospital, says medical students should use protective barriers between themselves and patients, including personal protective equipment, or PPE, when appropriate and available.
"You can never completely eliminate a risk," he says. "All you can do is minimize it or mitigate it or contain it, and that's the basic approach we take to everything in life."
Echoing the importance of appropriate masks, Mizuno says medical students can shield themselves from the respiratory droplets of sick patients by covering their mouths and noses. He compares the face to a bowling ball, noting that the nostrils and mouth are vulnerable spots where infectious particles are most likely to enter.
"Unfortunately, we have to breathe in air on a continuous basis, and something is sometimes in the air that we don't want," he says.
Mizuno also advises med students to shield and be mindful of their hands, especially their fingertips, which tend to touch objects and then the face. "We do everything with our hands," he says. "Either culturally or through necessity, we use our hands more than anything else in the human body."
Medical students should be using gloves and washing their hands frequently, Mizuno says. They should also be minimizing the use of their fingers by touching buttons and opening doors with their knuckles or elbows, he adds. Plus, students should never place gloved hands near their noses or mouths, because that creates a risk of breathing in the coronavirus, Mizuno warns.
Medical students should avoid getting within six feet of a COVID-19 patient or, if that isn't feasible, guard their body using a protective barrier, he says. "As long as we keep our bowling ball head away from an environment that has coronavirus floating in it, and as long as we don't get our infected fingers and hands around those bowling ball holes, theoretically you're not going to get it. It doesn't matter if the whole environment is swimming in it," he says.
"I believe strongly that we should undergo universal precautions," Mizuno says, adding that the threat of the coronavirus is invisible to the naked eye but still a significant threat. "You want to hope for the best, but you have to assume the worst -- that every single person on the planet is infected with the coronavirus -- if your goal is not to perpetuate this problem."
Mizuno says he has been self-disciplined about social distancing over the past two weeks because he is a first responder during an emergency, so he doesn't want to be incapacitated at a time when his expertise is needed.
He recommends that medical students consciously avoid panicking. Getting highly emotional makes it hard to think clearly and treat patients effectively during a crisis, Mizuno says. "You need to calm yourself down. Everyone is looking at you to be the calm leader."
Dr. Jordana Haber, a Las Vegas emergency room physician, says medical students should stay tuned for regular updates from their school leadership on safety measures and what to do if they feel ill.
Danger is inherent in the medical profession, Haber adds.
"We are not afraid," she wrote in an email. "This is what we signed up for. So we don't panic. We care for sick patients every day who have contagious symptoms. We take precautions. We touch our patients, we listen with our stethoscopes. This will not change. We are trained for the unexpected and the worst case scenarios."
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