Mary Higgins: The return of medical students to clinical practice is filled with uncertainty

But somehow the challenges will be overcome, hopes Mary Higgins

March 2020 was certainly a mad month. Increasingly aware of the impending nature of the covid-19 pandemic, watching international colleagues deal with increasing numbers of infected persons, wondering if we were all going to become intensivists (and really worried that, working in obstetrics, we were going to have to go one step further and become neonatologists), it felt (though I also feel guilty to write this) that the care of medical students became less important. We all, at all levels, were becoming students again ourselves. Attempting to keep up to date with the tsunami of information, adapting to what felt like sometimes hourly changes in protocols and guidelines, it felt that every day was another pivot. 

With our focus on clinical care, one eye still had to be kept on academia. Clinical tutorials were replaced with online tutorials. My idle wish to finally learn how to properly use the university electronic teaching system turned into a frantic late night watching of tutorials as we had to know how to have eighty students online the next day. Examinations in large halls were converted to online open book examinations. Students emailed apologies as they dashed for the last flight home. And then they disappeared—one day we had students in the hospital, the next day they were gone. 

The nice thing to say, the polite thing, would be to say that I missed them immediately. To a certain degree I did, but to a larger degree we were working clinically very hard. In a time where annual leave was cancelled and team meetings were online, where our wonderful colleagues in physiotherapy, or social work, or dietetics, became voices at the end of a phone line rather than physically there in clinics, clinical life was hectic. It became unusual to see men within the hospital as partners were asked to stay outside until women were in labour, and new fathers held their babies for the hour or so they had before saying goodbye until mum and baby went home. Extraordinary efforts were made to keep parents in contact with their babies in neonatal intensive care, and every day we handed out tens of ear plugs for the women recuperating from a birth in a noisy negative pressure room. We simply didn’t have the bandwidth to think about the students*, outside of an online tutorial timed to allow people in multiple time zones to attend.


Because the months melded into each other it is actually nearly hard now to remember when things started to change. When the testing time decreased, so we had reassurance of “non-detected” within hours rather than days. When the covid wards started to get quieter, and our colleagues in general medicine could report evidence of the curve falling. The streets outside of the hospital became slowly busier. I wasn’t the only one cycling along in the morning, and the wonderful coffee shops around us began to open. Lockdown started to rise, our allowed distance was increased and there was a gradual return to some form of new normality, with that feeling of coming out of a tunnel blinking in the sunlight. And then I really began to miss the students. 

It started really with the virtual graduations, where students’ photos were shown on a link and academic staff spoke of their pride in their success. Sharing photos on social media, new graduates spoke about virtual hospital orientations and first day jitters, making us feel like birds watching their young leave the nest. Suddenly I began to miss the joy of watching a student scrub for the first time, or see their face at a birth, or seeing them interact with a patient, or ask something that makes you question everything. I missed their enthusiasm, and their interest, and their joy in the privilege of medicine. With humility I also realised that while they learn a lot from us as academics, they were also missing the interactions with medical student colleagues, that informal peer assisted learning that occurs over coffee, or in reading rooms, or on the bus home when students talk confidentially about what they had seen that day. Just as we were missing them, they were missing each other. 

Similar to everything else in this new world, the return of medical students to clinical practice is filled with uncertainty. Every plan we have is followed by multiple “what if” scenarios. How-to run-in house socially distant tutorials while also including the students that may need to isolate or quarantine. How to ensure contact tracing, while also reconsidering our curriculum. Alternatives to bedside teaching, to lectures and workshops. Somehow we will do it; just as we have dealt with the clinical care, we can deal with the academic issues. Students, I am not the only academic who is looking forward to having you return. Welcome back (I hope). 

See also: Clinical exposure is essential to medical students’ training

Mary Higgins is an obstetrician working in Dublin.

Competing interests: None declared.

Twitter: @mairenihuigin