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Clare Gerada: Doctors on the covid-19 front line also need to protect themselves and their colleagues

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1121 (Published 24 March 2020) Cite this as: BMJ 2020;368:m1121

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Re: Clare Gerada: Doctors on the covid-19 front line also need to protect themselves and their colleagues

Dear Editor

We read with interest the recent article by Clare Gerada on the importance of protecting ourselves and those around us during this unprecedented time (1). We feel this advice is crucial for current medical students.

“From next week, 5,500 final-year medics...will move to the frontline”.

What? Wait! Is that us?

Queue the anxious tweets and Instagram updates from final year medics, the inquisitive texts from non-medical friends and ‘don’t panic!’ emails from our university. Matt Hancock’s announcement on national television certainly sparked a wave of anxiety amongst us. There has been a level of steady speculation of our role within the NHS - but was anyone going to tell us that we’d be on the frontline next week? It’s no wonder medical students have been left feeling terrified. Our peers are questioning their capabilities and mental readiness, whilst others have been left frustrated by the lack of clarity.

The scary reality is most of the information we’ve found is through social media. On one tab, there’s a serious document outlining our futures and on the other, emails that Medic Support is offering only limited services. Some are not aware of the BMA helpline number, and don’t even realise its availability to medical students. However, the unity demonstrated between medical students has been instrumental in this process. There have been encouraging comments, support and signposting towards helpful apps such as HeadSpace. But are we really on our own, or is anyone listening to our views?

It’s vital to consider the amount of support medical students can be safely offered. On a typical placement day with no pandemic, multiple emergency cases and heaving wards, you can easily spot the medical student lingering in the corner, thinking they’re a hindrance. For this situation to improve in the face of a pandemic, our roles must be clearly defined with an official contract and the multi-disciplinary team must be pre-informed of our limitations. This will enable minimisation of risk and maximisation of patient care. There needs to be national agreement between roles, shifts and hours and we must be involved in the decision-making. The headlines outlining the lack of personal protective equipment are deafening - so is providing for an extra 5,500 students feasible?

You’d be forgiven for thinking it’s April Fools but yes, this is reality. It’s the first time we’re going to be given real responsibility, but we’re still small fish in the big pond. It's a period of extreme change that requires a great need to adapt, nevermind having the worst national health crisis in decades thrown in on top of that. It is important to appreciate the impact that recruiting senior medical students into this crisis could have. We all emphasise the importance of ensuring that patients are “holistically” cared for, but what about medical students? What about their mental health? What about their financial situation? What about their family lives? We aren’t seasoned professionals, we don’t have the comfort of understanding exactly how the system works and most importantly we have little experience in the ‘real-world”. There needs to be an appreciation that medical students need time to transition from being a student to being a professional doctor - definitely more than a week.

Imagine a see-saw - one side represents our personal risk of being infected with COVID-19 and the other, patient survival and recovery. Medical students are undoubtedly eager to take on the risks for a chance at bettering patient care. However, who’s looking out for us? The news of young people losing their lives to this disease is a scary thought, and even the royals aren’t invincible. Many are left feeling guilty for not grabbing opportunities to help, in fear that loved ones may be exposed to the risk that they bring through the front-door.

Despite the country being under lockdown with a storm impatiently brewing - medical students should be reminded of the importance of prioritising well-being and reassured that it is okay to feel unproductive at this time.

References:
1. Clare Gerada. Clare Gerada: Doctors on the covid-19 front line also need to protect themselves and their colleagues. BMJ 2020;368 :m1121.

Competing interests: No competing interests

26 March 2020
Matthew J Mo
Medical Student
Angelica Sharma, Medical Student, Cardiff University School of Medicine
Cardiff University School of Medicine
University Hospital Wales Main Building, Cardiff, CF14 4XN, UK