July 1 is a big day in medical education. It’s traditionally the day newly minted doctors start their first year of residency.
But this year is different. Getting from here to there, from medical school to residency training sites, has been complicated by the coronavirus.
“We were all really freaking out,” said Dr. Christine Petrin, who just graduated from medical school at Tulane University in New Orleans and is starting a combined residency in internal medicine and pediatrics at MedStar Georgetown University Hospital in Washington, D.C. Students “matched”, the term for finding out where they will spend their next several years training, in March, just as everything was shutting down because of the pandemic.
After getting the news of their placements, Petrin said, some of her friends were worried about being able to enter states that were closing their borders. They “just rapidly picked up and moved. Found an apartment, packed up the car, and went.”
Petrin said she was lucky. Although she shopped apartments online, her sister, who lives in Washington, could check them out in person. Dr. Erin Fredrickson was not as fortunate. She graduated in May from Campbell University School of Osteopathic Medicine near Raleigh, North Carolina, and matched in a family practice residency at the University of Washington in Seattle.
She and her partner were already planning to drive across the country with their dog, but the trip turned out to be much different than the leisurely journey they had envisioned. “We were going to visit friends in different places along the way,” she said. “We were going to camp, but a lot of places to camp were closed. We ended up staying in Airbnb guest houses” in an effort to minimize contact with anyone else. Meanwhile, she said, she was forced to pick out housing remotely. “I did a lot of FaceTime tours of apartments” in Seattle, she said.
Dr. Janis Orlowski, chief health care officer for the Association of American Medical Colleges, agreed this has been a year like no other. “It’s been really messy,” she said. “But it looks like it’s coming together.”
Among other things, graduates traveling from states that are or have been hot spots are being asked to quarantine for 14 days upon arrival. That has required more flexibility than usual from administrators used to starting programs at an exact time.
“Everyone is pretty much going to start July 1 — or a little after,” she said.
In some instances, the medical students graduating this year — some of whom graduated early to help in the hospitals attached to their medical schools — have it easier than students directly behind them.
Almost from the start of the outbreak, third- and fourth-year students who would typically spend much or all of their time in the hospital were shut out to avoid being exposed to the coronavirus. Even the newly graduated doctors were generally kept away from COVID-19 patients.
The restrictions were intended not only for their own safety, said Orlowski, but also to help protect patients. “If you have a COVID patient, you don’t need 14 people marching into the room,” she said. “We wanted to decrease the team size.” And shortages of personal protective equipment made smaller care teams necessary.
For most of the graduating seniors, required rotations were generally finished by the time the virus had upset their plans. Those that were not could be made up.
But for third-year students, the time out of the hospital will be more difficult to recoup as the pandemic drags on — and continues to spread. For the moment, most students are also barred from rotations at hospitals other than their own. (Students frequently work at hospitals that have programs their home hospital does not offer.)
At the same time, those soon-to-be fourth-year students who normally would be traveling around the country to interview for residencies will be limited to online visits only. That’s a real shame, said Petrin, because being on-site in some cases “changed my perception for better or worse.”
But right now it’s about safety, Orlowski said. “We’re trying to cut down on any travel,” she said. “But we’re also trying to make it fair. We don’t want some students to have in-person interviews and others not.”
For those starting residency this week, one of the hardest things, said Fredrickson, is getting through all the errands she won’t have time for later. “I moved to a new state and I need a new driver’s license and license plates,” she said. “And the DMV is still closed.”