The advent of the COVID-19 pandemic transformed MD-PhD training practically overnight: at the end of March 2020, classes were moved to zoom, laboratories were closed and clinical rotations were cancelled. Nonetheless, the resilience and leadership demonstrated by our students and faculty kicked in, with students shifting gears to help with rescheduling clinical visits to telehealth, getting involved in ground-breaking COVID-19 related research (see publications in the next article), and finding new ways to stay engaged with coursework, research and each other as the pandemic played out. Since March, adaptations such as hybrid asynchronous learning, frequent town halls, virtual lab rotations, BEERS (“Brief Explanations of Exciting Research by Students”) by zoom, socially-distanced and masked lab time have allowed students and faculty to maintain productivity, engagement and adjust to a new normal (for now). The longer-term consequences of this pandemic remain to be seen, but we continue to prioritize safety and remain flexible and innovative as we tackle these challenges together.
Matriculating MD-PhD students were allowed to engage in funded virtual research rotations beginning in mid-June or July 1 when research laboratories entered Phase 1 re-opening. Students were given the option to begin in person work at the end of July when labs entered Phase 2, and several were able to take advantage of this option. Mentors were surveyed at the end of the summer about the experience and were uniformly positive about the experience; we received suggestions that will improve the process should we again have lab access restrictions during the coming summer. Matriculating students were required to move to New Haven to participate in a hybrid in-person and virtual curriculum.
Second year students participated in a mix of virtual and in-person rotations during the summer, depending on whether specific labs could safely accommodate and/or train students for in person work. The second-year schedule has been altered to provide flexibility so that students can accommodate additional in person lab rotations before affiliating with a thesis advisor, if needed. Most students will use 6 weeks in Jan-Feb for an additional lab rotation; some hours of in person anatomy lab and clinical skills teaching will also take place during this time. All students will participate in a 2-week Medicine clerkship “precede” at the end of February. Students will then use the subsequent two 10-week blocks to (1) complete the Medical Approach to the Patient Clerkship and (2) study and take USMLE Step 1 exam. Students will be able to start research full time beginning mid-July (or schedule one more rotation, if needed) before beginning graduate school coursework in early September. Students who have already chosen a thesis advisor based on this past summer’s rotations have the option of completing two clerkships prior to the start of graduate school. They will have a 6-week period of uninterrupted time (mid-July-end of August) to study for and take Step 1 with this option.
Most third-year students took advantage of the quarantine time in the late spring and early summer to pass their qualifying exams and study for and take Step 1. All have affiliated with PhD labs. Unfortunately, this cohort was only able to complete one clerkship before beginning their PhD work, and will need to finish 3 additional clerkships upon return to the wards.
While the pandemic may have altered timing and scheduling of clinical rotations, it has not altered the content or depth of training. We have seen great creativity, flexibility, and resilience in our leadership and our student body.
Tamar Taddei, MD-PhD Program Associate Director for Clinical Training
For the graduating class of 2021, enhanced flexibility of scheduling was allowed to ensure completion of clerkship and graduation requirements in the setting of COVID-disrupted clinics and in-patient services. The residency application cycle was converted nationwide to an on-line process of virtual interviews and virtual program tours. The written Step 2 Clinical Knowledge exam remained a graduation requirement, but the in-person Step 2 Clinical Skills exam was suspended for the graduating class of 2021.
Yale has begun to administer COVID-19 vaccines from Moderna and Pfizer to our students and faculty (https://news.yale.edu/2021/01/13/yales-covid-19-vaccination-program-underway?utm_source=YaleToday&utm_medium=Email&utm_campaign=YT_YaleToday-Staff_1-13-2021). The first wave of innoculations started December 30.