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Nearly half of physicians expect to be working under capacity for at least a year, RCP survey finds

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2634 (Published 30 June 2020) Cite this as: BMJ 2020;369:m2634

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Rapid Response:

Impact of covid-19 on senior medical students

The covid-19 pandemic saw the UK’s medical schools close due to the shift in focus from medical education to patient care. As reported by the BMJ, the number of consultations conducted remotely has surged due to the pandemic (1). In addition, physicians predict that their departments will not return to full capacity for at least another year (2). I argue that students are at risk of not fulfilling the competencies and criteria required of junior doctors outlined by the General Medical Council, due to the changed clinical environment and its impact on medical education.

The clinical environment has changed in a number of ways: consultations conducted via video and telephone; reduced A&E attendance, and reduced hospital admissions (1,3). With the cancellation of clinical placements in March 2020, this has undoubtedly had an impact on the education of thousands of students, especially those progressing to the final year of their degree. Students in clinical years will be hard pressed to gain and develop vital skills such as patient communication, examination, and clinical skills. There is a risk that students won’t be fully prepared to enter foundation posts. Decisions needs to be made as to whether examinations are to reflect the changed clinical environment, or remain unchanged which would require face to face opportunities with patients.

Healthcare staff are currently limiting the amount of individuals seeing patients in the interests of infection control, with history taking, examinations, and bedside tests being conducted by one person (4). How will this work when teaching usually involves groups of sometimes up to 8 students seeing multiple patients and taking turns to examine. Along with a reduced number of patients in hospital for non-covid conditions, this limits the opportunities available to medical students (3).

Missed opportunities for students to present work at academic conferences again adds to their unpreparedness, as these skills are essential for career progression. It is difficult to quantify the missed skills and experiences that would have been gained from cancelled placements and electives abroad, however it’s undeniably had a detrimental effect on students’ knowledge, capabilities, and confidence.

An emphasis is needed to ensure final year medical students are able to catch up on the missed opportunities and experiences lost due to the pandemic. It is imperative that students meet GMC requirements, but more importantly feel confident within themselves to start their foundation posts in what will be a significantly changed clinical environment.

1. Rimmer A. Covid-19: Surgeons embrace virtual consultations to meet patients’ needs during pandemic. BMJ [Internet]. 2020 Jul 1 [cited 2020 Jul 1];370:m2644. Available from: http://www.bmj.com/lookup/doi/10.1136/bmj.m2644
2. Rimmer A. Nearly half of physicians expect to be working under capacity for at least a year, RCP survey finds. BMJ [Internet]. 2020 Jun 30 [cited 2020 Jul 1];369:m2634. Available from: http://www.bmj.com/lookup/doi/10.1136/bmj.m2634
3. McConkey R, Wyatt S. Exploring the fall in A&E visits during the pandemic | The Health Foundation [Internet]. The Health Foundation. 2020 [cited 2020 Jul 2]. Available from: https://www.health.org.uk/news-and-comment/charts-and-infographics/explo...
4. Reducing the risk of transmission of COVID-19 in the hospital setting - GOV.UK [Internet]. [cited 2020 Jul 2]. Available from: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infec...

Competing interests: No competing interests

02 July 2020
Cameron A Lynch
Fourth Year Medical Student
University of Manchester, Manchester M13 9PL, UK