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Melanie Cole: Welcome to The GW HealthCast. I'm Melanie Cole and today's topic is COVID-19 in medical education. The latest updates joining me is Dr. Juliette Lee. She's an Assistant Professor of Surgery at the George Washington University School of Medicine and Health Sciences and the Director of Undergraduate Surgical Education. Dr. Lee is affiliated with the George Washington University Hospital. Dr. Lee, I'm so glad you could join us and what a great topic. Help us to understand COVID-19 and where the medical students that are in school right now, where are they in this picture that we're seeing in this unprecedented time?

Dr. Lee: You're exactly right, Melanie it is unprecedented and we've had to make some very flexible and nimble responses to medical education. For our fourth year medical students this is probably the happiest time of their medical education when they've matched into their residencies, so they are right on the precipice of starting their medical careers and entering education for the residencies right at the onset of the worldwide pandemic. So they are actually entering their careers in a very interesting time. Our third year medical students are very similar in that they are in the middle of their clinical clerkships, when they finally left the classroom, and they're engaging in direct patient care and that has been suspended in large part all over the country and all over the world for these new clinical medical students. So we have had to adjust how we teach and train these medical students

Host: Well before we get into some online learning and things like that. Where do they stand, the seniors as to graduation?

Dr. Lee: Unfortunately all across the country, many of the universities and medical schools have actually canceled a traditional graduation, and ceremony. So the traditional cap and gown, walking across the stage in front of your loved ones and parents and friends and family are probably not going to happen in the traditional way. We still have yet at GW to decide how we're going to celebrate their amazing accomplishment.

Host: So then on to online learning, because obviously they have to finish their education before even that graduation could take place. So I imagine it's challenging to keep students engaged and maintain interaction. I mean with any of the schools, I'm thinking we're seeing that. But with medical students it's more imperative than ever, right?

Dr. Lee: Oh, absolutely. Many of the differences of being a professional medical student compared to law school or business school is that direct human interaction. And as a student you are actually practicing and learning the skills that you'll need to be a resident, a practicing or a surgeon. So not having that direct patient interaction can be quite challenging. We're very lucky at our medical school to have an amazing office of medical education who had skilled people in distance learning and some of the tools that we're using. And we've become quite creative to try to teach some of these skills and to even look at some of the things we have around our house that can teach them certain skills such as using a water bottle to simulate a mass to ventilate the patient.

Host: Well, I certainly think you would have to get very clever and very creative. And what about guidance on clinical rotations and direct patient care during this outbreak? Are they able to help where needed or are there other specialties that they can lend a hand in during this shortage of healthcare providers?

Dr. Lee: I think for right now we are exercising extreme caution and safety for our medical students because they are not physicians just yet. They're not licensed to be functioning on their own and would still need direct supervision. So to minimize that contact with the supervising resident or an attending, we're just exercising extreme caution right now with our students. They are, however looking for ways that they can be of service and they've done things from reaching out to older patients to make sure that they're okay and they've been on volunteer drives to gather PPE and other things to support our communities and our medical community as well.

Host: How does this change the approach to licensing exams? Dr. Lee, is that been a question you've received from students a lot?

Dr. Lee: We have definitely had a lot of questions and some anxiety about it because they are quite high stakes examinations for our students. We do know that the medical boards have delayed taking the boards for about a month. I believe so that will give this pandemic some time to reveal exactly how much of a surge we'll see in this country. But we are trying to continue to engage with our students and prepare them for the possibility that their exams may be delayed and medical school rotations need to be adjusted accordingly.

Host: Have we added telehealth as an option to classroom experience and teaching the medical students how to engage in telehealth with patients once it's time?

Dr. Lee: Yes we have. I think the penetrance among the different departments is quite different. The faculty practice has given us some guidelines in how to engage in telehealth and that is an opportunity that we can have our students be involved. How the actual electronic logistics worksite, I don't have as much facility in explaining how that would work with the students. We are definitely thinking about how we can engage our students in those telemedicine and telehealth interactions with our patients.

Host: Dr. Lee, one important point I think is the stress. Of course there's a worldwide stress that we're all feeling, but medical students and healthcare providers alike are at a certain extra risk than the rest of us. In some ways. They're out there on the front lines. You all are. How are you helping your medical students with not only the stress of coming into their own at this unprecedented time, but also the stress of the exams and graduation and the fact that school is cut short and classes are online and I mean it must be a very stressful time for them.

Dr. Lee: I think if there's one silver lining that can come out of this time is that it really has allowed all of us in the medical fields, who've chosen this career in this path to really get back to the root of why we decided to go into medicine. It is really reaching out and helping our patients and our communities in any way possible. So it really, even though it has been stressful and it has been a little bit disappointing in terms of things that may not happen in their usual way, it really has galvanized I think all of us to be really thinking of each other and not our positions as a surgeon or an internist or thinking that there's not a job that is under my purview. I think we're all pitching in and really retooling our skillset to wherever it's needed and I think it's shown the students what it is, what it means to be a physician and it's the care of the patient at the very core.

Host: Do you have any final thoughts on students and medical education? Help us put this into perspective and manage the expectations of not only your medical students but the public at large about our incoming doctors and residents and interns and for the public. That's wondering what's going on as well. Give us your final thoughts or summarize for us.

Dr. Lee: I think that the public has been completely supportive of the medical field. I think it will show patients and our communities that at the core of being a physician is making sure that the welfare and the safety of the patients is key and I don't think that any physician would have it any other way. I've been quite moved at some of the things that I see online, especially some videos in Vancouver and Atlanta with people just spontaneously going out in their balconies and applauding as a change of shift for all the healthcare workers at seven and 8:00 PM and in the evenings. So that we can hear that we have that support and that is enough to keep us going in this very challenging time.

Host: Thank you so much, Dr. Lee for everything that you're doing, but certainly thank you for coming on and joining us today and sharing your expertise. You're listening to the GW Healthcast. Please visit GWDocs.com to get connected with Dr. Lee or another provider, or call 1-888-4GW-DOCS to schedule an in-person or virtual appointment. Thanks for listening. I'm Melanie Cole.