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Early Graduation Could Send Medical Students to Virus Front Lines Early Graduation Could Send Medical Students to Virus Front Lines
(2 months later)
The battle to treat an ever-growing number of patients infected with the new coronavirus just gained its newest recruits: soon-to-be medical graduates. Several medical schools in Massachusetts and New York announced this week that they intended to offer early graduation to their fourth-year students, fast-tracking them into front-line hospital care as the need for medical workers surges.The battle to treat an ever-growing number of patients infected with the new coronavirus just gained its newest recruits: soon-to-be medical graduates. Several medical schools in Massachusetts and New York announced this week that they intended to offer early graduation to their fourth-year students, fast-tracking them into front-line hospital care as the need for medical workers surges.
On Tuesday, the Grossman School of Medicine at New York University became the first in the United States to announce an offer of early graduation, in an email to students. That followed similar moves earlier this year in Italy and Britain, which advanced many final-year medical students into intermediate clinical service.On Tuesday, the Grossman School of Medicine at New York University became the first in the United States to announce an offer of early graduation, in an email to students. That followed similar moves earlier this year in Italy and Britain, which advanced many final-year medical students into intermediate clinical service.
On Thursday, the medical schools at Tufts University, Boston University and the University of Massachusetts announced that they planned to move up their graduation dates to April from May, after a request from the state of Massachusetts to help expand the medical work force. Harvard Medical School said it was “actively considering” the same step.On Thursday, the medical schools at Tufts University, Boston University and the University of Massachusetts announced that they planned to move up their graduation dates to April from May, after a request from the state of Massachusetts to help expand the medical work force. Harvard Medical School said it was “actively considering” the same step.
In Massachusetts, the state would provide 90-day provisional licenses for early graduates, allowing almost automatic entry into clinical work. The move would make some 700 medical students in Massachusetts eligible to offer patient care at least eight weeks earlier than expected.In Massachusetts, the state would provide 90-day provisional licenses for early graduates, allowing almost automatic entry into clinical work. The move would make some 700 medical students in Massachusetts eligible to offer patient care at least eight weeks earlier than expected.
On Friday, Columbia’s Vagelos College of Physicians and Surgeons became the latest to announce that final year students would graduate early, on April 15, rather than May 20. Graduates would have the option to temporarily join the staff at NewYork-Presbyterian Hospital.On Friday, Columbia’s Vagelos College of Physicians and Surgeons became the latest to announce that final year students would graduate early, on April 15, rather than May 20. Graduates would have the option to temporarily join the staff at NewYork-Presbyterian Hospital.
Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. Grossman, said the school’s decision came as its hospitals were overwhelmed with an increasing number of Covid-19 patient cases, including in critical care. He said several fourth-year students had approached school administrators to volunteer their service.Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. Grossman, said the school’s decision came as its hospitals were overwhelmed with an increasing number of Covid-19 patient cases, including in critical care. He said several fourth-year students had approached school administrators to volunteer their service.
“We’re running into issues of manpower,” Dr. Abramson said. “That led us to conclude: Why not graduate students who are interested in serving in hospitals now? They’ve completed their requirements and they’re prepared.”“We’re running into issues of manpower,” Dr. Abramson said. “That led us to conclude: Why not graduate students who are interested in serving in hospitals now? They’ve completed their requirements and they’re prepared.”
Most American medical schools last four years, at which point the medical degree is granted, followed by residencies and internships to develop the specialties of new doctors.Most American medical schools last four years, at which point the medical degree is granted, followed by residencies and internships to develop the specialties of new doctors.
At N.Y.U., Dr. Abramson said, fourth-year students would be able to graduate in early April and begin patient care at N.Y.U.’s hospitals, on medicine floors and in the emergency room. They would then depart in late June or July for the start of their scheduled residency programs, with a two-week quarantine in between. Of 120 fourth-year students surveyed this week, he said 69 responded that they would be interested in early clinical service.At N.Y.U., Dr. Abramson said, fourth-year students would be able to graduate in early April and begin patient care at N.Y.U.’s hospitals, on medicine floors and in the emergency room. They would then depart in late June or July for the start of their scheduled residency programs, with a two-week quarantine in between. Of 120 fourth-year students surveyed this week, he said 69 responded that they would be interested in early clinical service.
While the Liaison Committee on Medical Education, which accredits medical degree programs in the United States, has offered guidelines for early graduation, N.Y.U.’s decision awaits final approval from the New York State Department of Education.While the Liaison Committee on Medical Education, which accredits medical degree programs in the United States, has offered guidelines for early graduation, N.Y.U.’s decision awaits final approval from the New York State Department of Education.
A number of New York medical schools are still developing proposals for early graduations. Dr. David Muller, dean for medical education at the Icahn School of Medicine at Mount Sinai, said the school hoped to have a proposal ready to share with students by early next week. The early graduation would most likely occur in mid-April, he added, and would be voluntary, although details need to be worked out. The Albert Einstein College of Medicine also is working toward early graduation.A number of New York medical schools are still developing proposals for early graduations. Dr. David Muller, dean for medical education at the Icahn School of Medicine at Mount Sinai, said the school hoped to have a proposal ready to share with students by early next week. The early graduation would most likely occur in mid-April, he added, and would be voluntary, although details need to be worked out. The Albert Einstein College of Medicine also is working toward early graduation.
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Medical students around the country have spent recent weeks mobilizing to support local physicians. They have staffed coronavirus hotlines, coordinated meal deliveries and even offered their time as babysitters to other medical workers. Many said they were excited to contribute their medical training.Medical students around the country have spent recent weeks mobilizing to support local physicians. They have staffed coronavirus hotlines, coordinated meal deliveries and even offered their time as babysitters to other medical workers. Many said they were excited to contribute their medical training.
“We see everything the physicians around us are going through and we’re excited we can bring some relief to the physicians who trained and mentored us,” said Greg Peters, a fourth-year student at Harvard who plans to start a residency in emergency care in Boston.“We see everything the physicians around us are going through and we’re excited we can bring some relief to the physicians who trained and mentored us,” said Greg Peters, a fourth-year student at Harvard who plans to start a residency in emergency care in Boston.
He added, though, that the prospect of early graduation and fast-tracked service came as a surprise. “My classmates and I are Type A people who plan everything out, and our plans are out the window,” he said. “We’re confident in our training, but we’re a little worried about getting thrown in there.”He added, though, that the prospect of early graduation and fast-tracked service came as a surprise. “My classmates and I are Type A people who plan everything out, and our plans are out the window,” he said. “We’re confident in our training, but we’re a little worried about getting thrown in there.”
Updated June 5, 2020
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
The Association of American Medical Colleges, a research and advocacy group for medical schools and major teaching hospitals, said it supported the early graduations following L.C.M.E. guidelines, but emphasized the importance of supervision for new graduates.The Association of American Medical Colleges, a research and advocacy group for medical schools and major teaching hospitals, said it supported the early graduations following L.C.M.E. guidelines, but emphasized the importance of supervision for new graduates.
“As we think about what the role of these new graduates would be, it would need to be under supervision,” said Dr. Alison Whelan, the association’s chief medical education officer.“As we think about what the role of these new graduates would be, it would need to be under supervision,” said Dr. Alison Whelan, the association’s chief medical education officer.
Dr. Abramson said he expected more medical schools around the country to move toward early graduations.Dr. Abramson said he expected more medical schools around the country to move toward early graduations.
“We aren’t the only school that has needs for taking care of patients in this Covid environment,” he said. “I fully anticipate other schools will look at this and do it as well.”“We aren’t the only school that has needs for taking care of patients in this Covid environment,” he said. “I fully anticipate other schools will look at this and do it as well.”