Hannah Watkin investigates the impact of COVID-19 on Welsh medical students’ lives and learning.
The Covid-19 pandemic has had a tough and challenging effect on all those working in the healthcare system.
Much has been done to try and recognise this in wider society, however, the students preparing to join healthcare workers on the front line have received less attention.
Shôn Thomas, a student at Cardiff University, was halfway through his first placement year at a GP surgery in North Wales when the pandemic hit.
“Beginning of January 2020, I remember a conversation in the staff room between some of the GPs about a new virus in China, and whether it was going to become something significant in the UK. In early February, we started being forwarded emails from Public Health Wales and were told to start taking travel histories from anyone that came in with a cough or a fever.
“Most of my course mates were optimistic, saying we now had more time to revise, but I felt differently. Because of Covid, I missed two placements that I will never get again.
“Two weeks before the lockdown, it really hit home. I was on a week-long placement in the emergency department at Bangor. On Monday COVID was not a problem in Wales; by midweek patients were asking whether it was a problem in the hospital; and on Friday I was being sent home.”
Selina Aziz, a student at Liverpool University, had a similar experience of Covid cutting short her first year on placement.
“I remember coming home really upset. Most of my course mates were optimistic, saying we now had more time to revise, but I felt differently. Because of Covid, I missed two placements that I will never get again. I’ll learn the theory, but I won’t get the opportunity to go and see it for real.”
After his placement was put on hold, Shôn found another way to gain experience during the pandemic through volunteering at the GP’s drug dispensary. But for some students, volunteering was not an option as they themselves had to shield or care for a loved one during the pandemic.
I spoke to one of the Deputy Directors of Cardiff University’s medicine course, Dr Duncan Cole, about how teaching was adapted to ensure everyone could keep learning.
“[When Covid hit], we had to switch rapidly to an online delivery method, across all five years. We never designed the course to be a long-distance learning programme, but despite that, we got it up and running quite quickly.
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“Throughout, we’ve been acutely aware of what different groups of students have missed in terms of practical experience. From this, we worked out ways of adapting the course so that they can regain that. Essentially, we have planned bespoke programmes to catch students up in the following years.”
According to Shôn, help was at hand from more than just the teaching staff in universities.
“Doctors across the UK started to appreciate that medical students were having a really hard time. Many put on additional zoom lectures to try and fill the gaps left by placements being cancelled.”
“Our students were not designated as key workers for several months, which was why we couldn’t keep them on placement.
Dr Cole explained how students in their final year were prepared to enter the workforce early to help the NHS cope with its increased workload.
“There was a big push to get students qualified early. To achieve this, we put various processes in place to get them through the remaining components of their final year.”
However, when it came to getting medical students back into hospitals for training, there were some preliminary issues.
“Our students were not designated as key workers for several months, which was why we couldn’t keep them on placement. Eventually this was changed, but it was a problem at first.”
Selina noted how this lack of key worker designation was a problem.
“All healthcare workers had to get tested every five days for COVID. For this, all of the hospital staff were sent home testing kits, but [as a result of not being designated as key workers] none of the medical students were. Their studies, research or social time would often get disrupted because they had to go home from placement to go to a test centre to get a test.”
Before entering the fourth year of their medicine courses, both Shôn and Selina chose to intercalate. Shôn joined the Pharmacology course at Cardiff, whilst Selina moved to UCL to study History and Philosophy of Science and Medicine.
Despite both explaining to me how Covid was only a small factor in informing their decision, they also told me they appreciated how intercalating had in many ways prevented them from missing out on too much of their medical training this year due to Covid.
“I think we sometimes forget how medical students and doctors are actually human, and how it’s really scary being there amongst Covid every day.
However, Selina believes there were some positives to being a medical student during the pandemic.
“I think it was beneficial that medical students could actually go out of the house to work. I think that really did positively impact their mental health compared to others, as they were still able to do some normal things which others couldn’t.”
But Selina was also struck by just how much medical students had to go through as part of this work environment.
“Most of my friends had to isolate at some point because there was a chance that they’d caught COVID. Living with this constant risk was not nice. I think we sometimes forget how medical students and doctors are actually human, and how it’s really scary being there amongst Covid every day. It really grates on your resilience and your bravery.”
Shôn stressed how the pandemic hospital environment has been difficult to cope with.
“Healthcare professionals, including students, have seen things that they probably never thought they were going to see. And they’ve seen them far too frequently. So many unwell people. And sadly, many people dying.”
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“Those in the early years of their course who volunteered have gained experience of delivering care earlier than they would have done in the past.
Selina also discussed how for students in the final years of their course such as her sister, also at Liverpool, hospitals have been a strange learning environment.
“My sister’s really interested in surgery, so she chose placements on surgical wards. Normally there would be 20 patients on the ward, but now it’s something more like three, and they’re all emergency ones because all routine procedures have been cancelled.”
Dr Duncan Cole expressed similar concerns about how younger medical students have had little to no experience of the NHS working on ‘normal mode’. But he also noted how there have been some pluses for medical students taught during the pandemic, as those in the early years of their course who volunteered have gained experience of delivering care earlier than they would have done in the past.
Dr Cole also believes the developments which have been made during Covid will go on to influence the teaching of medicine positively in the future.
“COVID has had a catalyst effect on things, it’s forced innovation and change. As course directors, we want to review that to work out what’s worked well and what we should keep going forward.”
For sure, looking to the future, whilst acknowledging the struggles students such as Shôn and Selina have faced in the last year and a half, it is good to hear that many of this period’s problems have had brighter sides and have been able to influence positive change.
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