Wellbeing of students during the epidemic response
I welcome the news that trusts and schools are exploring routes medicals students can assist during the current crisis. Across the UK medical schools have suspended their face to face teaching or are transitioning to remote learning. Whilst medical students in pre-clinical years are able to engage in remote learning, clinical students are unable to learn on placement across hospitals and primary care. During the SARS outbreak in 2003, students in Toronto expressed their frustration at the suspension of their studies and I imagine many students feel the same way today. (1)
Many medical students want to help and can provide useful, valuable skills, however it is vital certain issues are considered and addressed before they start to help.(2)
The impact of the Covid-19 epidemic on the mental health of UK health care workers could have no comparison during the time since World War II. Health care workers involved with care during this crisis will be at risk of developing mental health symptoms, burnout and psychological distress. Many students and staff will feel a duty to work, putting others’ wellbeing ahead of their own mental and physical health.(3) Couple this with multiple stress factors such as conditions of work, witnessing colleagues become unwell, the fear of infection and finite PPE, it seems inevitable a lasting impression will be left across the workforce. A recent study of healthcare workers responding to Covid-19 in Hubei province reported high rates of depression, anxiety and distress amongst them, with previous studies examining the SARS outbreak of 2003 also reporting adverse psychological reactions.(4) We already know that medical students need better mental support at their institutions, so it is essential that throughout this upcoming period all students volunteering or working in the NHS have access to adequate psychological support or interventions. (5)
Without this support in place, we could see more junior doctors leaving the profession, but most importantly a group of people who could be suffering from work related stress or burnout after experiencing one of the worst health crises we will ever face at the very start of their career.
1. Clark J. Fear of SARS thwarts medical education in Toronto. BMJ [Internet]. 2003 Apr 12;326(7393):784. Available from: http://www.bmj.com/content/326/7393/784.4.abstract
2. Mahase E. Covid-19: medical students to be employed by NHS as part of epidemic response. BMJ [Internet]. 2020 Mar 20;368:m1156. Available from: http://www.bmj.com/content/368/bmj.m1156.abstract
3. Simonds AK, Sokol DK. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. Eur Respir J [Internet]. 2009 Aug 1;34(2):303 LP – 309. Available from: http://erj.ersjournals.com/content/34/2/303.abstract
4. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open [Internet]. 2020 Mar 23;3(3):e203976–e203976. Available from: https://doi.org/10.1001/jamanetworkopen.2020.3976
5. Coombes R. Medical students need better mental health support from universities, says BMA. BMJ [Internet]. 2018 Jun 27;361:k2828. Available from: http://www.bmj.com/content/361/bmj.k2828.abstract
Rapid Response:
Wellbeing of students during the epidemic response
I welcome the news that trusts and schools are exploring routes medicals students can assist during the current crisis. Across the UK medical schools have suspended their face to face teaching or are transitioning to remote learning. Whilst medical students in pre-clinical years are able to engage in remote learning, clinical students are unable to learn on placement across hospitals and primary care. During the SARS outbreak in 2003, students in Toronto expressed their frustration at the suspension of their studies and I imagine many students feel the same way today. (1)
Many medical students want to help and can provide useful, valuable skills, however it is vital certain issues are considered and addressed before they start to help.(2)
The impact of the Covid-19 epidemic on the mental health of UK health care workers could have no comparison during the time since World War II. Health care workers involved with care during this crisis will be at risk of developing mental health symptoms, burnout and psychological distress. Many students and staff will feel a duty to work, putting others’ wellbeing ahead of their own mental and physical health.(3) Couple this with multiple stress factors such as conditions of work, witnessing colleagues become unwell, the fear of infection and finite PPE, it seems inevitable a lasting impression will be left across the workforce. A recent study of healthcare workers responding to Covid-19 in Hubei province reported high rates of depression, anxiety and distress amongst them, with previous studies examining the SARS outbreak of 2003 also reporting adverse psychological reactions.(4) We already know that medical students need better mental support at their institutions, so it is essential that throughout this upcoming period all students volunteering or working in the NHS have access to adequate psychological support or interventions. (5)
Without this support in place, we could see more junior doctors leaving the profession, but most importantly a group of people who could be suffering from work related stress or burnout after experiencing one of the worst health crises we will ever face at the very start of their career.
1. Clark J. Fear of SARS thwarts medical education in Toronto. BMJ [Internet]. 2003 Apr 12;326(7393):784. Available from: http://www.bmj.com/content/326/7393/784.4.abstract
2. Mahase E. Covid-19: medical students to be employed by NHS as part of epidemic response. BMJ [Internet]. 2020 Mar 20;368:m1156. Available from: http://www.bmj.com/content/368/bmj.m1156.abstract
3. Simonds AK, Sokol DK. Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters. Eur Respir J [Internet]. 2009 Aug 1;34(2):303 LP – 309. Available from: http://erj.ersjournals.com/content/34/2/303.abstract
4. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open [Internet]. 2020 Mar 23;3(3):e203976–e203976. Available from: https://doi.org/10.1001/jamanetworkopen.2020.3976
5. Coombes R. Medical students need better mental health support from universities, says BMA. BMJ [Internet]. 2018 Jun 27;361:k2828. Available from: http://www.bmj.com/content/361/bmj.k2828.abstract
Competing interests: No competing interests