The impact of Covid-19: a medical student perspective
By Carlos Escudero King and Ciara O’Donnell, medical students at King’s College, London, supervised by Dr Koravangattu Valsraj, Consultant Psychiatrist at South London and Maudsley NHS Foundation Trust
Three of us were role playing - the patient, the student and the examiner. We were practising cardiovascular examinations in our shared flat when we simultaneously received a notification from the medical school. Due to novel threat of coronavirus, the objective structured clinical examination (OSCE) and final exams were cancelled effective immediately, we were no longer to attend our scheduled clinical placements and all lectures were to be virtual. For medical students, like all of us in the healthcare system, the following months were shrouded with uncertainty. Many had no recourse but to return home while paying tuition for unattended school and rent for an empty student flat. These concerns were exacerbated for international students burdened by exorbitant student fees who had to risk travel and quarantine without knowing when they could return. Above all, the impact of the pandemic raised a question that many medical students may not have previously contemplated: what is our role in the healthcare system?
While final year medical students were fast-tracked through to foundation training so they could help where needed, the remainder felt the need to take action. Student-led initiatives popped up from universities across the country, including campaigns to help vulnerable demographics access medications, food, and shopping; providing companionship to those socially isolated during lockdown; and delivering care packages to overburdened hospital staff. Some medical students assisted in the role as on-boarders to support examiners with the new online assessment platforms.
However, there remained a pervasive sensation that more could be done to help. We knew that in the midst of a nationwide lockdown, the strength and ability of the NHS was being tested.
As a soon-to-be penultimate year medical student, I was eager to put my skills into practice, to help as much as I could during this once-in-a-lifetime healthcare crisis. My application to start as an HCA in a large teaching hospital was hastily approved, depending on permission from a representative of my medical school. At this point, I was disappointed to receive the news that my school, and many others, felt unable to provide this. The perceived risk of being responsible for the exposure risk and the unknown consequences of this was deemed to be too complicated without a legal framework in place. Despite expressing this decision to the hospital’s recruitment team, I was hounded by desperate phone calls for weeks for updates on the situation. I felt restless and guilty.
Returning to medical school after the last few months was, understandably, significantly more daunting. Refreshing emails to be greeted by uncertain optimism from our student union and beginning the move back to London, cloaked in our relatives' worry yet pride. When we think of student life, we think of bars, friends, sports and socials; integration not distance. Fourth year introduces students to longitudinal placements, a Monday to Friday hospital lifestyle, it would be one of our last years of normality before undertaking the daunting role of a junior doctor. Over the past few months we had all seen the flashing headlines of PPE shortages and NHS overburden. As a medical student feeling like a spare part becomes second nature in many hospital scenarios, but this was different. Would pacing around behind consultants be simply gratuitous now? Will providing PPE for us further strain the NHS? Will we have PPE? Can we help?
Our penultimate year of study already initiates an increased anticipation for the responsibilities of a vocational career that is soon to come. However, this has been overwhelmed by the unprecedented challenge a worldwide virus has pressed onto our NHS. Rumours are already circulating with regards to qualifying final years by Christmas if necessary. Rumours that will determine careers and the next phase of many medical students’ lives.
Uncertainty drives this need for adaptation. As lockdown restrictions ease, the pandemic forces us to reflect on our role in healthcare as we were set to begin placement on a psychiatric intensive care unit in the first week of September. This was an eye-opener, as we witnessed first-hand the relentless efforts of the team and how mental health has been forgotten during Covid. This experience was an interesting opportunity to learn about the complexities of Covid and mental health.