The start of spring is a cherished time for New Yorkers. Temperatures climb, daffodils in Central Park creep up through the mulch, and restaurants open their al fresco dining spaces.
For medical students about to graduate, the end of March is especially exhilarating. Nearly a decade of scientific and medical education culminates in Match Day: finding out where we will train as newly minted physicians.
This year, spring became the season of canceled Match Days and graduations, virtual weddings, missed family reunions, and dream vacations deferred as COVID-19 took hold in New York City, where we live, and across the country.
Fear and confusion soon set in, manifesting in people hoarding personal protective equipment, toilet paper, and hand sanitizer. All the while, state and local governments scrambled to enforce social distancing and sheltering in place without adequate federal guidance or oversight.
Medical schools like ours converted all in-person classes and clinical rotations into virtual alternatives. Meanwhile, we watched this year’s intern class, our former upper classmates, working impossible hours to care for those with the coronavirus, while being forced to reuse N95 masks and developing flu-like symptoms themselves, only to be recycled back into the workforce once those symptoms subsided.
Without an ability to assist clinically, our medical school peers impressively responded by forming a coalition of 400-plus student volunteers, charged with nonclinical tasks such as calling patients to set up telemedicine appointments and restocking clinics with PPE.
We were optimistic when it was announced that we would have the opportunity to graduate from medical school one month early so we could join the medical workforce. For many in our class, we saw this as a turning point that would reduce the burden on already overwhelmed hospital personnel. Our school was poised to inject as many as 140 new doctors into our health system’s ranks.
As details of the roles we would play materialized, it became clear that they differed by institution within New York state, and even within New York City, the pandemic’s epicenter. Options for graduating medical students even varied among peers in the same class.
The Accreditation Council for Graduate Medical Education, responsible for accrediting all physician residency training programs in the U.S., issued a statement acknowledging that our institutions “are facing or will face significant challenges as they respond” to the pandemic and that some have been given “emergency pandemic status.” However, the council’s statement also said, “Except in unusual or exigent circumstances, the ACGME does not recommend the early graduation of medical students” and suggested that “there would be serious ramifications to early appointment.”
Conversely, New York Gov. Andrew Cuomo recently tweeted that he would be “signing an Executive Order to allow medical students who were slated to graduate this spring to begin practicing now.” Based on these guidelines, national recommendations and state policy are in conflict. And we, fourth-year medical students and soon-to-be doctors, stand in between them.
Overwhelmed hospital systems have been trying to figure out what to do. Each system has a different plan. … There is no clear organization, and currently dozens of new physicians who want to clinically help in New York City are unable to do so.
Overwhelmed hospital systems have been trying to figure out what to do. Each system has a different plan. Some hospitals will only allow students who matched into their residencies to work early, while encouraging all other graduates to see if the programs to which they matched, often in cities other than New York, need their help. Other hospitals have chosen to allow all graduates to work early, but with different designations depending on where they matched. There is no clear organization, and currently dozens of new physicians who want to clinically help in New York City are unable to do so.
These are unprecedented times, and we are on the brink of infusing the medical profession with 18,000-plus new physicians across the country. We want to help. We entered medicine for this reason. We are watching our peers and mentors struggle in our beloved city ravaged by COVID-19.
It seems wrong for hundreds of new doctors to sit idly by due to inconsistent hospital policies while the crisis surges in New York City, especially as these same hospitals call back retired nurses and physicians in their 60s and 70s to battle COVID-19. The peak of the virus is predicted within the next two weeks. New York City needs manpower in the same time frame in which we will be graduating. We learned medicine here, we know our health systems’ layouts, workflows, and electronic medical record programs. And while we are certainly not invincible, we are better suited due to our age to have favorable outcomes if we do contract the virus.
There needs to be coordination or at least agreement among national accreditation committees, medical schools and health systems across the country so that we and our fourth-year medical student peers elsewhere have the ability to join forces to battle this pandemic. Included in this discussion should be ways that new doctors are covered as they enter into their first jobs, such as employee benefits, health insurance and appropriate access to PPE. We acknowledge that this is not an easy administrative task, but the absence of a transparent national policy compels hospitals to currently reject critical help from qualified new physicians in a time of dire need.
Four weeks ago, we were celebrating birthdays, running in Central Park and planning vacations. Now, in a turn of events, next week we will be M.D.s, a new militia that stands ready to help combat this disease. What can we do with these two letters added to our names if no clear, systematic plan is in place?
Sneha Subramaniam and Jordan Francke are both fourth-year medical students in New York City.
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