This morning I tried to memorise the causes of hyponatraemia. Does it help anyone unwell with covid-19 that a medical student knows this list by heart? Does it lighten the load on our healthcare system during the pandemic?
Compared to what others have been doing, studying seems a selfish use of time. I see heroes all around me. I took a year out of my medical degree to work at The BMJ, and my former classmates have graduated. Some have started their Interim Foundation Year 1 posts. At the start of the pandemic, my parents we considering whether to return to the healthcare jobs they retired from, and meanwhile they delivered groceries without payment, checked on vulnerable neighbours, and helped a single parent with childcare.
“It can be easy to feel guilty for ‘just’ staying at home when people are putting themselves at such massive risk of exposure day in, day out.” says medical student Issy Walker, in a post on the University of Nottingham student blog.
“[Guilt] is incredibly normal, incredibly common,” says Caroline Walker, a psychiatrist specialised in doctors’ wellbeing, “because we care. […] And we desperately want to do everything we can at this point in time to help.” Walker made a video for doctors who feel guilty for different reasons—including the doctors who, like medical students, are not in clinical settings and will be joining the workforce in the coming months or years. She goes on to say, “Please know you are going to do your bit and you are going to be needed.”
The health consequences of the pandemic will last longer than the pandemic itself, when the healthcare systems have to face the harm of postponed appointments and treatments, and the trauma of living through such an event. And there will be more pandemics to come. The world will need newly qualified doctors next year, the year after, and the year after that.
Remember the Medical Student Council’s first message in their statement of expectation for medical student volunteers: our first responsibility is to our medical education, readying us to be doctors in the near future. Though studying might feel selfish, and nothing like the apparent heroics of final year med students and healthcare professionals, it is valuable and will serve others in the longer run.
“The major concern within medical schools is to ensure the continuing education of students in ‘pre-final years’”, says Diana Wood, the dean of the University of Cambridge School of Clinical Medicine. She sits on the Medical School Council Covid Group with Health Education England, the General Medical Council, and the deans of several other medical schools. Wood and her Cambridge team have graduated final year medical students and established protocols for other medical students to volunteer. Now, they are throwing their efforts into preserving the pipeline of competent new doctors. “This presents enormous challenges, not least because it is yet unclear when clinical placements will be possible once more.”
With this hit on our education, will I be ready to qualify when it’s my turn? Will we be competent?
Usually at this time of year, upcoming exams prompt me to step up my learning: to commit information to memory and to revisit the parts of clinical medicine that I find most difficult. My annual rhythm is disrupted, my exams postponed by four months, maybe more. For others, exams are cancelled, or the format yet to be confirmed. One medical student asked on Twitter, “Does anyone else just not care about studying anymore?” Another replied, “I think it’s the uncertainty of not being sure if anything even counts.”
Without exams to drive our learning, we have to fall back on older motivations. Before the pandemic, before clinical exams, something drove us to choose a degree we knew would be a long slog. Whatever motivated us then still matters.
Want to help people? Then understand: you do good for your community when you continue to study as best you can. You will do your bit. You will be needed.
Laura Nunez-Mulder is a 5th year medical student at the University of Cambridge, UK, and former editorial scholar (2018-2019) at The BMJ.
Competing interests: Student affiliate of BMJ OnExamination.