As many of us sit alone in our spare rooms, our home offices, our converted garages, as we perch on our couches doing what we can to find a kind of equilibrium of normalcy in the midst of the greatest public health crisis of the past 100 years, there are UNLV students already counting the days to when they will be on the front lines of the coronavirus pandemic.
For some of those future healthcare professionals, the virus presents a chance to take stock, to observe, to consider the implications of how the outbreak will impact the healthcare industry — and public health as a whole — as they deal with disruptions of remote learning as well as delays in the national tests needed for credentialing. But for those further along in their studies, the moment is becoming an early initiation into their professions as the crisis inevitably deepens.
"There's a whole mix of emotions," said Dr. Neil Haycocks, interim vice dean of academic affairs and education at the UNLV School of Medicine. "But the students went into medicine to help, to roll up their sleeves and do this stuff. There's a lot of pent up eagerness to get in and put their boots on the ground and get working. There is some anxiety and trepidation, but overall they want to get in there. We're just trying to make that happen in a way that is appropriate."
For the Phase 3 students in the School of Medicine — those furthest along in their studies — there's an immediate opportunity to make an impact as volunteers. Through the school’s clinical arm, UNLV Medicine, medical students are volunteering to screen callers who want to be tested in the curbside coronavirus testing program. The screening follows Centers for Disease Control and Prevention guidelines.
And for Phase 3 students who have already experienced clerkships at hospitals and practices, the need for healthcare workers in the coming weeks may require their services. "Students can be very valuable to handle a wide variety of tasks," Haycocks said. "Medical students can take vitals, they can draw blood, they can do a lot of things. In a way, it's a challenge but it's an opportunity, as well, if they get called into service."
Initially, the School of Dental Medicine fourth-year students were slated to continue working in the school's clinics for procedures like seating crowns and bridges as well as providing essential care to alleviate pressure on area emergency rooms for patients experiencing dental pain. The school had to re-evaluate its emergency clinic plans and staff it with faculty as the potential dangers to students became clearer. Dentists, according to the New York Times, are among those professions most susceptible to becoming infected.
"It definitely puts in perspective the danger of this profession," first-year dental student Mac Jackson said. Jackson has worked internationally treating patients who are HIV-positive and suffering from tuberculosis. "I think it's super healthy for [prospective dentists] to look through that. We can become accustomed to comfortability and safety. As influential as this public health crisis is, it certainly impacts the way individuals who go into the health field should look at the profession in its entirety. It's good to be talking about this. It's good but also an eye-opener."
Like their counterparts in the schools of Medicine and Dental Medicine, School of Nursing students have moved much of their work online. As professors have adapted their courses for remote education, losing clinical work has proven challenging, even for those already certified to work in hospital settings.
Ally Keefe, a UNLV School of Nursing graduate is working in a Reno hospital's emergency room, working with COVID-19 patients while completing her master's to become a family nurse practitioner.
“I’m 50 hours short this semester," Keefe said referring to her clinical studies. "They created some online modules and, of course, I appreciate the professors work on trying to get us something. But nothing’s like being in the clinic. Nothing compares to that.”
Dental students, too, face the possibility of joining the front lines of testing and other services to expand the capacity of Southern Nevada’s healthcare systems. They are versed in the fundamentals of health education, and a dialogue must be considered between the schools of Medicine and Dental on how best to lean on each others' skills and experiences.
But for medical and dental students who haven't reached advanced points in their academic careers they are, like UNLV students in most other disciplines, learning remotely. Neither dental students earlier in their studies nor Phase 1 medical students would be expected to work in clinical settings anyway, so the transition is a smooth one for them.
"The fewer people in the hospital right now, the better, to conserve a lot of the personal protective equipment," said first-year medical student Fadi Azar, who earned a biology bachelor's from UNLV last year. "We're being told to stay away just to lessen the burden upon the supplies.”
But, he notes, that a unique aspect of UNLV’s medical program is that all first-year students are EMS-certified. “If the opportunity was out there, I know a lot of my classmates and I, we'd be willing to help out anyway,” he said. “Right now, we're trying to follow the instructions of the school, staying out of the way where we have to."
Phase 2 med students would normally be slotting into their clerkships but those experiences are delayed while they focus on remote classroom instruction. Some clinical information can be studied through online education portals, with more being added daily as medical schools around the country all face the same challenges. Tentatively, those students will begin their clerkships on April 13, though as with most endeavors right now, there's a degree of uncertainty about timelines.
Testing and Credentialing
Dental students, who are on a three-semester schedule, had almost wrapped their spring semester at the outset of the pandemic. Fourth-year students were able to complete licensing testing on the first day back after spring break, before moving fully to remote learning.
"Our fourth-year students, many of them have job opportunities," said Lily T. Garcia, dean of Dental Medicine. "Many of them are going on to specialty programs, so we're trying to focus our best to make sure they're getting the fullest sense of the curriculum possible and to make sure they're going to meet those competencies to be considered a general dentist and go on to these other studies."
Phase 3 medical students weren't quite as lucky as their dental counterparts when it comes to testing. The rigorous "shelf" exams that third-year medical students nationwide take once they begin clinical rotations were postponed. The situation gives students more opportunity to front-load learning experiences. Normally, more classroom-oriented studies are ad-hoc during clinical rotations for students, tended to in fleeting spare moments. The hope is that now, students will have more time to dedicate to classroom experiences during a hectic phase of their time at medical school
In a way, the pandemic might better prepare this upcoming generation of healthcare workers. "One of my favorite sayings is: What do you get when you don't get what you want? You get experience,” Haycocks said. “There's a huge amount of experiential opportunity here to see the healthcare system functioning in a way that you don't get to see a whole lot. You get a front-row seat of an unprecedented-in-modern-times pandemic situation and all the clinical reactions that are going to happen. Even if you feel completely brand new and utterly useless, you can still observe and soak up what's happening and try to extract something useful from that from an educational standpoint."
Additional reporting by Joseph Gaccione.