This summer, thousands of students began their journeys toward becoming the next generation of America’s physicians. Their journeys have already been significantly altered by a pandemic that also threatens the foundation of our future health care system.
Traditionally, medical education follows a similar pattern: two initial years of predominantly classroom instruction followed by two years of clinical experience. During clinical years, students receive clinical training in medical specialties under the tutelage of faculty physicians in both ambulatory and clinical hospital settings.
Unfortunately, the pandemic has caused some hospitals and physicians to rethink their participation in clinical skills training. For hospitals, there is a cost involved that is now compounded by factors such as the shortage of personal protective equipment (PPE), the concern for student and patient safety, and the potential for litigation should students become infected with the SARS-CoV2 virus.
Several months ago, as intensive-care units filled and grim reports of PPE and ventilator shortages filled headlines, agencies overseeing medical education recommended removing students from direct patient contact. This coincided with mandated closings of schools, universities, and professional schools. In response, most medical schools sent third- and fourth-year students, those typically immersed in clinical clerkships, to shelter at home and learn from online training modules and videos.
This paradigm shift was unprecedented. No one in our profession believed that clinical skills training of future physicians could be adequately provided in the absence of direct contact with patients. There is simply no way that distance learning can teach — and no way for medical students to learn — the unique skills needed to counsel a patient in the midst of drug dependency, help a young couple through the final stages of a difficult pregnancy, guide patients through a battle with chronic disease, or employ life-saving emergency surgeries.
A future threat to health care
Already, rising fourth-year medical students have lost months of clinical training. They, and those students entering their first year of clinical training, now face an uncertain future.
Another widespread surge in COVID-19 cases could cause them to again lose essential hands-on training with an impact that extends beyond the students alone. Medical schools could be at risk of their students not meeting the requirements for graduation. Future medical school graduates may not have their predecessors’ skill set at the beginning of their medical residencies. And students could experience delays in scheduling their required national board licensing examinations as testing centers restructure in consideration for social distancing.
A June 2020 report from the Association of American Medical Colleges highlights the critical need for safe, comprehensive, and uninterrupted medical education. Within the next 15 years there could be between 54,000 and 139,000 fewer primary- and specialty-care doctors than needed to meet the health care needs of Americans.
To help fill that gap, we need many stakeholders to come to the table to develop solutions that can ensure the continued ability to educate medical students.
At the same time, medical schools must adapt to the new reality of a pandemic with options that ensure a thorough education.
Federal and state governments with budgets besieged by the pandemic must still find a way to continue an adequate level of financial support and other resources to keep medical school doors open.
Hospitals, hospital associations, and state and federal agencies need to be involved in solutions that guarantee a continued pipeline of highly skilled medical school graduates to serve future generations of Americans.
As the deans of two of New Jersey’s medical schools, we can attest that our colleagues across the country stand ready to do their part to provide for a future physician workforce.
We call on all groups who can help us address the future physician shortage to come together to ensure seamless, quality education of the next generation of physicians. The future health care of an entire society depends on it.