COVID and Med Ed: Resident and Student Describe 'New Normal'

Cherie A. Fathy, MD, MPH; Ramie A. Fathy


April 10, 2020

Frontlines and Sidelines

Cherie: Have you decided to volunteer anywhere?

Ramie: I reached out to a mentor for guidance on how best to use this newly unscheduled time. He motivated me to support the efforts of those combating the virus in the hospital however I could. Initially I set out to volunteer at the hospital, hoping to draw from my clinical experience, as limited as it is. But we are not permitted to get involved in any activities that involved face-to-face, in-person interaction, at least for the time being. This is to help avoid additional spread and to reduce overall use of personal protective equipment (PPE). I keep thinking about how I used to wear masks, gloves, and gowns just to stand near a patient and listen to the doctor. All of that PPE seems like such a waste now when I could have just gotten a debrief after the fact.

I still wanted to find a way to support the community and healthcare workers on the frontlines of the pandemic. I started an organization for health profession students across Philadelphia to coordinate and optimize efforts across the city. With over 2000 members in 2 weeks, the group has begun to support various projects, including calling companies, schools, labs, and museums across the city to locate and donate PPE, as well as collecting and developing informational resources to share with the public. We've also been working on wellness initiatives for medical students and healthcare workers. A team of med students is also working to fight Joel Freedman's recent prevention of the reopening of Hahnemann, which would be an invaluable resource in managing this crisis.

I should mention that all of these efforts are being conducted independently of my medical school.

You're on the frontline more than I am. Have you heard about other ways we can help?

Many of us are wondering if this is the calm before the storm.

Cherie: Any support is truly appreciated. For residents, offers to help with childcare, grocery shopping, and routine errands would be incredibly helpful. On a systems level, donating both blood and PPE are incredibly important. I've also seen community efforts to purchase and provide food from local businesses to feed those who are working overtime in the hospital; this also supports the local businesses that are struggling at the moment.

Have you heard about medical students joining on the frontlines at all?

Ramie: Here in Philadelphia, medical schools are trying to involve their students remotely through activities like helping to reschedule patient appointments, supporting and optimizing telehealth services, monitoring ICU patients, and helping with large-scale quality improvement initiatives to track and quantify COVID cases in the hospital. Students are also helping to collect and deliver much-needed PPE to hospitals at nearby buildings.

That said, the number of positive test results is exponentially rising by the day in Philadelphia; it looks like we have hit the turning point, where cases really start to present themselves. I wouldn't be surprised if our medical students find themselves helping through additional pathways, perhaps even in the hospitals, in the coming weeks or months.

Have you heard of non-internists having to work on the wards at this point? Do you think you'll have to?

Cherie: Not here yet, but the recruitment of residents from specialties other than internal medicine or emergency medicine is definitely in our "disaster plan." We are aware that we may be asked to work in the emergency room, on inpatient floors, and maybe in the ICU if enough residents are out sick with the virus or are put into quarantine. I can't tell you the last time I worked in an ICU, so I'm pretty nervous about this. To prepare for this potential role, I've been keeping up-to-date with the latest guidelines on how to diagnose and manage COVID.

Ramie: How are you and your peers holding up physically and mentally?

Cherie: Many of us are wondering if this is the calm before the storm. We are anxious, but mostly because we're not sure what is coming up ahead. Hopefully, we'll see a positive impact from the quarantine/closure of nonessential businesses in "flattening the curve," and we'll continue to see unified messaging on how to effectively manage this virus and halt its transmission. Hopefully, more information will come out on how we can protect ourselves as well—fewer bandana recommendations and more innovative and validated ideas on PPE.

Ramie: Have you talked to any of your friends on the frontline?

Cherie: I have. They are tired, they are scared, but they are so brave. It is incredible and humbling to see my medical school classmates and friends rise to the challenge, to choose action in the face of paralyzing uncertainty. I am honored to be their colleague.

Cherie A. Fathy, MD, MPH, is a PGY-3 resident in ophthalmology at the Wills Eye Hospital in Philadelphia. She is interested in global health initiatives and disparities research.

Ramie Fathy is a third-year medical student and curriculum representative at the Perelman School of Medicine at the University of Pennsylvania. He is interested in the interaction between medicine, the media, and the public.

The opinions expressed in this article are the authors' own and do not represent those of any institution or organization.

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