An option to serve in COVID-19 fight

This year’s graduating Harvard Medical School (HMS) students will have the option to receive their diplomas early so that, if they choose, they can quickly be deployed into hospitals where regular staff might soon be overwhelmed with COVID-19 patients.

Fourth-year HMS students who have completed all their training and degree requirements, as well as graduating M.D. students from Boston University, Tufts University, and the University of Massachusetts, are being given the option to receive their diplomas before their scheduled graduation date in May.

The change comes in response to a request to the schools from Massachusetts Gov. Charlie Baker and Massachusetts Secretary of Health and Human Services Marylou Sudders, citing an expected escalation in local health care workforce needs.

Approximately 700 medical students in the Boston area are slated to graduate this spring.

Because Harvard University grants HMS M.D. degrees, there were administrative issues to address before the option can become official for HMS students, including deliberation and voting by the Harvard Corporation and the University’s Board of Overseers.

On March 30, the governing boards had approved the proposal, voting “… in view of the extraordinary circumstances posed by the COVID-19 pandemic, to authorize the dean [of the Faculty of Medicine] to approve the early conferral of degrees on students who are currently candidates for Doctor of Medicine (M.D.) degrees scheduled to be conferred in May 2020, once such students have been deemed to have completed the requirements for the M.D. degree by the registrar of Harvard Medical School.” The boards said approval must also be granted by University Provost Alan Garber.

“Students enter our medical schools aspiring to serve and heal. I have never been more proud of our students, many of whom have already expressed their eagerness to graduate early so they can join our hospitals on the front lines to help treat patients amid this pandemic,” said HMS Dean George Q. Daley. “We need their skill and compassion now more than ever, and many are ready, willing and able to answer the call.”

HMS Dean for Medical Education Edward Hundert told graduating students on a teleconference on March 26 that a number of details must be worked out in the coming weeks. He also emphasized that early graduation will be entirely voluntary and that individual hospital programs where students have matched may or may not build this option into their COVID-19 contingency plans.

“I feel very lucky that I am on the cusp of completing medical school at this time … because it means I have been trained with skills that might allow me to make a meaningful difference providing clinical care during this pandemic.”

Josephine Fisher, graduating HMS student

“This is evolving,” Hundert told the students, “and it will be entirely optional. We want to make this available for those who would like to respond if asked and give our students the option to serve in this way.”

Hundert and HMS Dean for Students Fidencio Saldaña told students that those meeting all degree requirements could be allowed to graduate as early as mid-April, more than a month before regularly scheduled Commencement ceremonies and two months before most internships begin.

Any student can also choose to wait until May to graduate.

Students considering the early graduation option will have to consider how losing student status early might affect their health insurance, their housing and visas, and their student loan deferral status. Hundert and Saldaña said HMS is working to provide answers to all such questions before mid-April.

“This decision is a personal one, and no one should feel pressured by it,” said Saldaña.

Graduating HMS student Josephine Fisher, who matched last week to Massachusetts General Hospital’s internal medicine/primary care program, said she is excited that HMS will be offering the early graduation option.

“One of the hardest parts for me is feeling that, as of right now, we are not able to help on the front lines as much as we would like,” Fisher said. “Though I feel nervous about the risks posed to myself, and even more so to my family, who I risk exposing when I return home from work, I feel very lucky that I am on the cusp of completing medical school at this time … because it means I have been trained with skills that might allow me to make a meaningful difference providing clinical care during this pandemic.”

Hundert said educational leaders at HMS teaching affiliates, such as Mass General, Brigham and Women’s Hospital, Beth Israel Deaconess Medical Center, and Cambridge Health Alliance, welcomed the news that they might be able to build the possibility of M.D. student reinforcements into their COVID-19 contingency plans,  particularly if current interns and residents become ill and are unable to care for patients.

“They all said this was new information for them as it is for us, and that they would assess how this new possibility could potentially enhance their options as they consider workforce needs,” Hundert said, telling the students on the call that it would likely be at least a week before hospitals let HMS know how and when graduating students might be invited to participate as needs evolve over the coming weeks.

“Each hospital, and each clinical department, will decide whether and how this would enhance their efforts,” Hundert said. “The hospitals will let HMS and the students know what their needs are.”

For many of the graduating students, the next few weeks will be a time of uncertainty.

“I know that some residency programs reached out to their future interns inquiring about their willingness to volunteer and join the intern workforce earlier. I will wait and see if my program has such an offering,” said graduating HMS student Ameen Barghi,who was accepted into the orthopedic surgery program at Wake Forest Baptist Medical Center in North Carolina. 

“I have matched at a hospital outside of Massachusetts, so out of this pool of newly minted doctors, I might not be anyone’s first call. This is because hospitals, for on-boarding and other purposes, will likely bring in those who matched at their institutions first. That being said, if one of the HMS hospitals or my new institution asked me to come in and help patients on the front lines, I’d do it in a heartbeat,” said Nora Torres Yordan, who matched to the obstetrics/gynecology program at the University of Chicago Medical Center.

According to Sudders, the Massachusetts Board of Registration in Medicine is prepared to grant M.D. students who choose to take the early graduation option a special 90-day limited provisional license to practice, after which they would be able to start in a pre-internship COVID-19 service role, according to Hundert.

Students also have the option of graduating early and not working in the hospitals immediately, Hundert said, and some hospital programs may not issue a call for them.

It is unclear whether the provisional license issued by Massachusetts would be accepted in other states where HMS students have matched. Saldaña and Hundert said medical schools across the U.S. are considering early graduation options, with New York universities leading the way in giving students the choice.