Harvard Medical School students mobilize

This is part of our Coronavirus Update series in which Harvard specialists in epidemiology, infectious disease, economics, politics, and other disciplines offer insights into what the latest developments in the COVID-19 outbreak may bring.

With more than 50,000 patients admitted annually and millions of outpatient visits each year, Massachusetts General Hospital (MGH), one of the nation’s premier hospitals and biomedical research facilities, is an extremely busy place.

Adding the new coronavirus pandemic to the mix is expected to exponentially increase patient demand at the Harvard Medical School (HMS) affiliate, and officials at Mass General  and other HMS affiliated hospitals have been working diligently to prepare for an expected influx of patients with COVID-19.

“We don’t know what’s coming, so we need to prepare for the absolute worst,” said Alberto Puig, HMS associate professor of medicine and the associate dean for undergraduate medical education at Mass General.

To help in that effort, within days of the escalation of infections in Massachusetts, hundreds of HMS medical students began mobilizing to provide voluntary support to clinicians.

“It’s incredibly inspiring,” said HMS Dean for Medical Education Edward Hundert. “We have a huge number of students who said, ‘Let me know what I can do.’ And they can make a huge contribution.”

Upon learning that their clinical clerkships would be temporarily suspended on March 15, the students quickly formed a COVID-19 virus medical student response team. Within five days, the team was organized into four committees that are focused on education and activism: medical education for the student community; educational information for the broader community; medical support to assist frontline clinical responders; and nonclinical support for the broader health care community, as well as for vulnerable populations within Boston, such as the homeless and elderly.

Some of the work they’ll be taking on includes tasks such as fielding regular, scheduled OB/GYN telephone calls with prenatal patients, translating vital information about the new coronavirus from English into other languages, and screening low-risk patients arriving at hospitals for routine, but necessary, procedures.

“We’re the first medical school to develop this sort of organizational structure,” said one of the team’s lead organizers, Derek Soled, an M.D.-M.B.A. candidate, who added that HMS students are now sharing what they’ve developed with 32 other medical schools across the country that are also looking for ways to get their own efforts off the ground.

“As long as someone is helped, then medical student involvement will be worth it,” said Soled. “We’re trying to explore all areas of need in which a medical student can be involved. Right now, it’s our job to mobilize and be ready to respond.”

The medical students themselves will not be working directly with any known COVID-19 patients, Hundert said. The team’s primary goal is to relieve pressure from frontline health care providers — such as physicians or residents — who will be caring for patients suffering from the virus.

Overall, the team’s aim is to create and streamline connections, linking M.D. students with requests for help, augmenting student-led initiatives to better respond to the emerging public health crisis, and efficiently mobilizing the medical student body.

“As our clinical expectations suddenly changed, we all felt a growing sense that we can’t just be idle,” said fourth-year M.D. student Kirstin Woody-Scott, one of the team’s lead organizers who is completing her clinical capstone course this month.

“It was clear that many students wanted to be part of the response and do something about this, so we asked, ‘How can we organize people quickly to optimize our impact?’” she said.

Following the first call for help to the student body, group leaders received an immediate response from more than 150 students.

By March 19, a group of students began volunteering at Brigham and Women’s Hospital from 6:30 a.m. to 6:30 p.m. each day, according to Erik Alexander, HMS professor of medicine and associate dean for undergraduate medical education at Brigham and Women’s.

The students have been helping to screen patients and patient families who are visiting the hospital for reasons not related to COVID-19, and they are also helping distribute personal protective equipment to hospital staffers.

“I think every step and every piece helps tremendously, because there are so many needs during a time of crisis,” Alexander said, adding that the students’ volunteer duties in the hospital will serve as valuable learning opportunities for them.

Brand new curriculum

Also, within a week of the first call to action, the students’ committee on medical education had generated a COVID-19 virus curriculum for HMS students. The work was led by fourth-year student Michael Kochis, with the support of Wolfram Goessling, advisory dean for the London Society and co-director of the Harvard-MIT Division of Health Sciences and Technology.

The medical education committee, composed of 35 HMS student volunteers, worked around the clock, meeting regularly via teleconferences and phone calls, to create a new, four-module COVID-19 virus curriculum. As of March 20, the curriculum was made available to all HMS students online through a school learning management portal.

The curriculum has been extensively peer- and faculty-reviewed. It covers topics such as virology, epidemiology, the current health care response and communicating information to nonmedical audiences. The curriculum is now being shared with medical schools around the world.

The other three committees, led by Danika Barry, Parsa Erfani, Shivangi Goel, Nicholas Joseph, Nishant Uppal, David Velasquez, and Kruti Vora, have worked to produce a wide array of deliverables related to the COVID19 response, including generating content on Twitter and Instagram (@FutureMDvsCOVID) and producing infographics that address common questions about the virus and promote social distancing.  Students also produced a video promoting social distancing.

Other teams have translated COVID-19 virus content on the HMS website into more than 31 languages and have developed pediatric-appropriate educational materials.  One project has involved connecting students with more than 150 outside health care resources in the Boston community, such as housing advocacy programs that focus on providing care to vulnerable populations such as the homeless and elderly.

Goel, one of the team’s lead organizers who is also 2021 class council president, co-leads a committee with classmate Barry. Their team is focused on providing clinical support for frontline health care workers by assisting in clinical research for questions related to the COVID19 virus. They are also gathering and distributing personal protective equipment for health care providers and helping to coordinate deployment of medical students into clinical settings.

The latter effort could, for example, involve having some medical students assist residents in cardiology clinics, providing patients who do not have COVID-19 with lab results and reducing the overall burden on the frontline health care workers.

Students may also help staff coronavirus telephone hotlines, which would also free nurses and residents to care for ill patients.

At Brigham and Women’s, some students have been assisting with the screening of low-risk visitors who arrive to see loved ones who are in the hospital but not affected by COVID-19.

Part of Goel’s role is to gather student volunteer offers, providing information to hospitals on the help that’s available, so that hospital officials can match volunteers with the current hospital needs and clinical opportunities.

One advantage to working with MD students who’ve completed much of their training, and who already have various hospital clearances, is that they are well prepared to help in many capacities, said Hundert.

“Everyone here is ready to contribute during this global health crisis, because this is what we signed up to do when we came to medical school,” said Goel. “This is our chance to really help.”

Puig said Boston hospitals are fortunate to have a wealth of MD student volunteers willing to relieve some of the burden of clinical staff.

Woody-Scott, who last week learned that she matched for an emergency medicine residency at the University of Michigan, said she never could have imagined medical school might end this way for her, but the response she’s seen from her fellow students, she said, has been heartening and affirming.

“This will change us all,” she said.

Medical students interested in volunteering for or participating in this initiative may contact hmscovid19studentresponse@gmail.com for more information.