Medical Education

Making the most of clinical rotations during COVID

Although in-person opportunities may be more limited this year, there are still things students can do to get acquainted with residency programs and get the best education possible.

In typical years, students participating in clinical rotations would have many opportunities to connect with patients and other residents. But for 2021, as the COVID-19 pandemic continues, processes have to be slightly adjusted, since there are fewer opportunities available, especially in-person ones. Instead, students are spending more of their time studying on their own and spending less time interacting with patients and physicians.

“It’s still currently a hybrid experience,” says Nancy Bono, DO, chair of family medicine at NYITCOM. “Students are still going to a hospital or clinical setting, but for only three days a week instead of the usual five. The rest of the time they can use for remote study time, or taking didactic sessions.”

Below, Dr. Bono, along with a resident and a program director, share their top advice for getting to know residency programs and getting the best education possible during clinical rotations in 2021.

Seek volunteer opportunities

Although most medical students do try to have the audition rotation experience, it’s still possible, in some cases, to get similar exposure via volunteering. With COVID, it’s been hard for some students to get all the same opportunities, and Dr. Bono’s team understands that flexibility is necessary.

“It’s not typical to get involved without audition rotations, but with COVID, it’s a learning experience,” says Dr. Bono. “We want to help them get opportunities to be recognized without all the experience, so that they know residents who can speak on their behalf in the future.”

NYITCOM, has a committee, called the Clinician Support Group, that helps students who are having difficulty connecting to hospitals or getting involved with residency programs; the support group helps students make the necessary connections for experience. It’s highly recommended by Dr. Bono’s team that students reach out via phone or email to hospitals, to see if there are ways to get involved with a volunteer program, health fair or vaccine screening. Although it’s still possible to get audition rotations this year, they have been harder to come by.

Getting involved in any manner possible can show residents whether a student will work well with the other members of the residency program; otherwise, it can be more difficult for students to stand out as a name on a piece of paper.

Give 100% to each experience

Jozia McGowan, DO, the director of COM student success at the Kansas City University College of Osteopathic Medicine (KCU-COM), recommends giving your best on every rotation, no matter what it is or how much you think this might be the specialty for you. Your dedication will be reflected on course evaluations and letters of recommendation, which are important aspects of the application for program directors to get to know you if they’ve never had the chance to physically work with you.

“I am 100% for the audition rotation, if possible,” says Dr. McGowan. “To get to know someone as more than the documents they submit, they need to have interactions with the program—preceptors, program directors and residents. It’s a very valuable experience for both the applicant and the program.”

With COVID-19, at KCU-COM, virtual rotations were incorporated into the curriculum. They started out as temporary, but continuing circumstances have required brainstorming and innovation to keep adapting to what’s going on, Dr. McGowan says.

“If you are committed to this, then you will find a way and make sure you make up any lost ground, primarily clinical skills, when you have the opportunities to have in-person rotations,” says Dr. McGowan.

It’s a challenge to get in-person audition rotations for this year, but Dr. McGowan knows of students who have successfully done so.

Connect with residents

Capt. Jacob Olejarczyk, DO, USAF, a first-year family medicine resident, was in this position last year during COVID, and due to restrictions was unable to rotate or audition at the program he matched into.

“If possible, I would highly recommend getting to see your top programs in person,” said Dr. Olejarczyk, who is in a joint program between the Air Force, St. Louis University, and SIHF Healthcare in O’Fallon, Illinois. “It gives you a better feel for the environment and people that you could work with, and whether it is a good fit for you.

“However, I understand that this year it still may be unavoidable as it was in my case,” Dr. Olejarczyk continues. “When there are limitations, it may take a little bit of extra work to become as familiar with a program that you didn’t get to see in person, but it can be done. At the end of the day, I felt comfortable ranking my program above others, and was both excited and grateful to have matched here.”

Dr. Olejarczyk recommends doing your best to develop a personal connection, finding another resident to answer your questions as they arise throughout the year. It can be a big help to have someone who’s familiar with the process walk you through it, especially someone who also had to adjust the experience to COVID restrictions.

“Ask them to be honest, sharing both the highlights and ways the program could use some growth,” says Dr. Olejarczyk. “In my case, one of the current residents gave me his email address and his responses helped me learn more about the program and grow more excited about the chance to match there. Having this connection will not only provide you with more information, but also help to show the program you are interested.”

Focus on the positive

Although 2021 students might not be able to get the exact same opportunities as their peers in previous years, so far, NYITCOM has seen many face the added COVID challenge with gratitude.

“They’re just so grateful to have the time onsite, they’re not bothered that they might be getting less experience,” says Dr. Bono. “They love having the interactions now, and getting to be with patients. For some of their patients, it’s the only time they’re leaving the house, so both sides enjoy finding ways to connect and interact.”

Dr. Bono believes the combination virtual and in-person process might be here to stay – NYITCOM likes how it is going, and with more flexibility and less crowds around the hospitals, many interview and rotation opportunities may stay hybrid or virtual. It’s also a money saver for both students and the hospital, since there are fewer meals and less parking and travel involved on both sides. Some hospitals are using the money saved to purchase extra supplies needed to supplement educational gaps.

“Hospitals have supplemented the possible gaps by having students come back for simulation labs,” says Dr. Bono. “It’s similar to what’s been done in the past, basically like a bootcamp training style, and students can get experience with patient simulations, IV labs, obtaining PPE and documenting health records.”

While difficult, learning during a global pandemic will help set students up to handle future public health crises, Dr. Bono says.

“There will always be a flu season or something similar going on that they’ll need an awareness of, and sense of precaution for,” she says.

Dr. Olejarczyk agrees, and advises students who feel disappointed about the different experience of rotations during COVID to still try to learn as much as they can.

“At some point, we will all look back and have an appreciation for this unprecedented time in history and see how we grew as a result, despite the challenging circumstances,” he says.

Disclaimer: Please note the views of Dr. Jacob Olejarczyk are his own personal opinions and not representative of the United States Air Force or Department of Defense.

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