What it's like learning medicine during the COVID pandemic

I think we can all probably agree that this year has been an absolute rollercoaster ride. Just take a second to pause and think about what we've been through in 2020. I can still remember the day when I was visiting my family for spring break. I was going to my sister's birthday dinner when I received the email that school was going to be completely online for the last half of the semester. I remember that there were just two courses left in my second year of medical school: gastroenterology and multisystem.

In medical school, doing things online is actually extremely common. My lectures are recorded and uploaded so that we can watch them at our own pace. A lot of my classmates use this as a way to speed up the lectures--watch them at two-times speed--so that they have more time to do other things like practice questions or review other boards materials. Personally, I was a lecture-goer. I remember trying to do things "the efficient way"; while it definitely was more efficient, I felt like it was isolating and sucking the joy out of the learning process. 

So I felt a lot of things when I found out that things were shutting down. First, I was grateful that I could continue my education relatively undisturbed and at least I knew a rough routine I could follow. I was also grateful to be able to social distance and do my part to flatten the curve. Second, I was glad to be near my family during this time. There were a lot of terrifying and uncertain news about COVID especially in March, and I wanted to be available for my parents if they were to get sick. It was comforting for me to know that I could be physically close to them should something happen, versus being in another state and being unable to travel easily.

I had some fears, though. I was nervous about what this could mean for the quality of my education. I wondered if my friends would be okay, if I would be able to focus on my studies at home as optimally as I was able to at school with my little study routines. I was able to address my fears. I checked in on my friends through FaceTime and messaging, and the effort turned out to help our friendship grow. I additionally quickly developed a new routine for studying so I could stay efficient at my parents' home.

There were some frustrations while studying remotely. Some lectures were uploaded 12-24 hours late--some lectures weren't uploaded at all. There was also a lot of stress surrounding a big exam for us M2s in the United States, the USMLE Step 1. (Classically, the score on this test has been a major determinant in what residency programs we are more competitive for.) Since taking a test is more on the nonessential side of jobs to do, our tests were cancelled and rescheduled multiple times. It was easy to feel anxious during this time because we didn't really know what was going to happen. Med students tend to have a lot of control issues; tensions rose when everyone realized that nobody really knew what was going on. There was also all the other issues surrounding COVID and the Black Lives Matter movement...so there was a lot to be worried about.

The way I coped with the stress was to consider my life purpose. Was my life purpose to get a 260+ on Step 1 USMLE? No! My life purpose is to be a loving daughter/friend/sister/Christian/human to the best of my ability. My purpose in medical school is to learn how to serve and heal others in this unique setting. So having my life purpose (or compass, or whatever you wanna call it) helped center me as I socially distanced, called my friends, cooked for my family, and studied for my boards. I was grateful to be able to study and do some of the things that I felt were fulfilling my life purpose. My life purpose sounds imple in light of everything that was going on, but I'll have posts on social justice and community service in the future. 

My board exam was cancelled and rescheduled three times! But I returned to my school state, took the test, and started clinical rotations.

The rotations I've done so far are: pediatrics, emergency medicine, and internal medicine. Pediatrics and emergency medicine made me really think about the social implications of this pandemic. The rates of overeating and depression have been increasing in the kids in my community. I consider my childhood (how much fun it was to play outside with my friends and pass notes during class!) and wonder how difficult it must be for kids to lose out on playing with their friends and participate in extracurricular activities because of the pandemic. In the ED, I saw patients who were terrified of coming into the hospital to get an arrhythmia or heart attack treated for fear of catching COVID. I heard stories of people dying in their homes from things that we could treat because they were so terrified of being exposed to COVID if they came for help.

This pandemic is hard. The more I know, the more I feel like I don't know. In medical school, when people are infected with a virus, we're mostly taught to treat with supportive care. The main treatment we have for viruses is preventative, with vaccines. But with COVID, there are people dying in sad ways, and some of the sequelae we see even in kids can be devastating. So we should look for treatments and we should look for vaccines. There's a collision between the ability of medicine to heal and its limitations. I see it as people are admitted for COVID, get better with the help of a ventilator, steroids, and remdesivir, and leave. But it's scary when the hospitals around me are reaching capacity, and we're starting to shut down certain parts of the hospital to make more space for the increase in cases.

When I think about some of the people my age who are going out to parties, I contrast this image to watching my attending in internal medicine don protective contact measures while the rest of us hover outside the patient room in our masks and goggles during rounds. I think about what it takes to care for others and the sacrifice our healthcare workers are making. When I think about who the pandemic impacts the most, it makes me sad to know that it's those with lower socioeconomic status and our elderly population who are being severely impacted--the very people who our society don't pay enough attention to. 

Learning medicine during this pandemic has highlighted intersectionality for me. It's tough having to choose between seeing my friends or going to church versus isolating in order to limit the spread of the virus. I see classmates who are terrified of getting COVID because they're afraid of missing out on learning opportunities if we're pulled from clinic, and I see some who go out in public every week to socialize. I have friends who are suffering from mental health issues as they socially distance themselves. I hear about people dying from the pandemic, and I witness the buzz over potential vaccines and new treatments. The way we care for patients who are COVID positive is constantly changing. People's opinions about social distancing and going to school/work have been polarized.

It's sensory overload!

So to summarize what it's like learning medicine during COVID: It's confusing. Ultimately, I want what's best for my friends, patients, and family. It's tough pitting mental health issues that come with social distancing versus doing what we can to prevent the spread of this virus that's killing people across the world. What it boils down to is there is still more to learn and more to do about this virus. 

I see people trying their best to help society and the sick, and I want to deepen this compassion inside of me as well.

For now, I'm just going to do my best. I'm going to learn medicine as best I can, COVID and non-COVID-related. I'm going to keep in mind that it's a difficult time for everybody and try to be compassionate to everyone, especially the patients I encounter and those who are in my social circles. It might not be a lot. I might not be going out there to change the world. But wearing my mask, finding ways to be entertained and do the things I want to do at home, and balancing risks and benefits is all I can really offer right now. 

Thank you for listening to my thoughts. Stay safe!