{"id":102468,"date":"2022-03-18T14:38:31","date_gmt":"2022-03-18T18:38:31","guid":{"rendered":"http:\/\/www.bumc.bu.edu\/busm\/?p=102468"},"modified":"2025-01-23T12:46:43","modified_gmt":"2025-01-23T17:46:43","slug":"from-socialization-to-isolation-md-class-of-22-responds-gracefully-to-uncertainty-challenges","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2022\/03\/18\/from-socialization-to-isolation-md-class-of-22-responds-gracefully-to-uncertainty-challenges\/","title":{"rendered":"From Socialization to Isolation: MD Class of \u201922 Responds Gracefully to Uncertainty, Challenges"},"content":{"rendered":"

Boston University School of Medicine\u2019s Class of 2022: proactive, passionate, inspiring, resilient, creative, collaborative, gracious. Did we mention resilient?<\/p>\n

During their first two years of medical school, members of this class displayed remarkable enthusiasm for collaborating with faculty and sharing their varied cultures with one another. Then the COVID-19 pandemic turned their medical education upside down, repeatedly delaying their first major licensing exam and the start of long-anticipated clerkships. When students eventually began clinical rotations, they often did so with extra layers of personal protective equipment (PPE) and the added anxiety of uncertain schedules and possible COVID exposure.<\/p>\n

\u201cMedical school is hard. It\u2019s hard on a good day,\u201d says Associate Dean for Student Affairs Angela Jackson, MD. Medical students endure intense academic pressures and deal with the extremes of human experience\u2014suffering and death, joy and sadness, she says. \u201cEmotionally, it\u2019s difficult.\u201d<\/span><\/p>\n

For the Class of 2022, that emotional stress was compounded by constant changes in plans and protocols as the School tried to keep students learning while also keeping them safe.<\/p>\n

\u201cWe all had to pivot on a dime to create resources and experiences for them,\u201d Jackson says. \u201cAnd they had to do the pivoting as well.\u201d Students accepted changes and disruptions with grace, she says, \u201cand that ability is something that\u2019s absolutely applicable to the rest of their professional lives.\u201d<\/p>\n

\n

Good doctors know how to make do with imperfect circumstances and uncertainty and how to respond gracefully in emergencies, <\/strong>Jackson says. \u201cThat ability to think quickly, to rework your plans and move forward\u2014this class got a lot of practice with that.\u201d<\/strong><\/em><\/span><\/h3>\n
\n<\/blockquote>\n

First Year<\/strong><\/strong><\/span><\/h4>\n

\"Class<\/a><\/p>\n

Members of the Class of 2022 began medical school as most students do, focused on building study habits and social ties. At the time, they couldn\u2019t have known how those habits would be tested or how important those ties would become.<\/p>\n

The Medical School hosted a White Coat Ceremony for the 160 members of the class on August 2, 2018, after a summer filled with news about immigrant families separated at the US\/Mexico border and Prince Harry and Meghan Markle\u2019s royal wedding. Speakers at the ceremony noted the diversity of the class: 50 percent are women, and 22 percent are from groups underrepresented in medicine. Class members come from 36 different U.S. states and were born in 19 countries. Almost 85 percent speak more than one language, and as a group they speak 26 different languages.<\/p>\n

During their first year, which was dominated by cycles of studying and test taking, class members made an effort to get to know one another.<\/p>\n

\u201cThat was a highlight of first year for me\u2014all the social gatherings with our classmates,\u201d says Max Vaickus (\u201922). \u201cAnd that was pre-COVID, so socializing could happen then.\u201d<\/span><\/p>\n

Class members held impromptu gatherings in their homes and at restaurants and bars to celebrate and unwind after exams. They organized ski trips, hiking trips and skit nights.<\/p>\n

\n
\"Headshot<\/a>
Jae Cho<\/figcaption><\/figure>\n

\u201cGetting people engaged in the social aspects of medical school is a great way to address the isolation you can feel when you\u2019re studying all the time,\u201d<\/strong> says Jae Cho (\u201922), one of the social leaders of the class. \u201cHaving events where you get to form relationships is really important. You need that support structure when you\u2019re in a really challenging environment.\u201d<\/strong><\/span><\/em><\/h3>\n<\/blockquote>\n
\"Headshot<\/a>
Delia Motavalli<\/figcaption><\/figure>\n
\n

It\u2019s especially helpful to build community early in your medical training,<\/strong> adds Delia Motavalli (\u201922). <\/em>\u201cMedical school gets progressively harder. You have less time the farther along you go,\u201d she says. \u201cSo, the time that I really valued these relationships was when I was a third year and had so little time but was on the wards with people that I could talk to and could trust.\u201d<\/em><\/strong><\/span><\/h3>\n<\/blockquote>\n

Class members took time that first year to learn about classmates\u2019 cultures. A group of dance enthusiasts, for example, started a dance interest group that met weekly to learn one another\u2019s choreography, which ranged from Afrobeats to Indian folk dances. In January 2019, BUSM\u2019s various cultural groups hosted the first-ever BUSM Culture Show, with the dance interest group providing the finale.<\/p>\n

The Culture Show provided one of Maria Suarez-Gama\u2019s favorite med-school memories. As a volunteer for the Delivery Resources, Education and Advocacy for Moms program, she spent most of the day of the show in the hospital supporting an expectant mother through labor\u2014and nervously watching the clock. The baby was born just in time for her to hurry to Heibert Lounge to perform.<\/p>\n

\u201cIt was such a memorable day,\u201d Suarez-Gama (\u201822) says, \u201cto run over and change into my dance outfit and put on my makeup. The show goes on, right?\u201d Being able to use her Spanish language skills to assist with a birth and then share her Colombian heritage all in one day confirmed that BUSM was where she belonged. \u201cI really felt like I was in the right place, where I needed to be,\u201d she says.<\/p>\n

As the academic year progressed, class members got involved with existing efforts to improve BUSM\u2019s curriculum, and several students approached BUSM deans with new ideas for enhancing medical education at the School.<\/p>\n

Megan Alexander (\u201922) asked about better integrating lifestyle medicine\u2014nutrition, exercise, stress management, healthy sleep habits\u2014into BUSM courses and was thrilled to find the administration receptive. Alexander\u2019s work has already resulted in changes to the way BUSM teaches medical interviewing and patient counseling, and she\u2019s working with faculty to update instruction about hypertension, diabetes, and other conditions so that lifestyle changes are presented alongside pharmaceutical interventions.<\/p>\n

\n
\"Headshot<\/a>
Megan Alexander<\/figcaption><\/figure>\n

\u201cThat\u2019s the really important idea,\u201d she says\u2014that lifestyle medicine be incorporated into standard curriculum rather than being separated into its own module or elective.”<\/span><\/strong><\/em><\/em><\/strong><\/span><\/h3>\n<\/blockquote>\n

A group of social-justice-minded students suggested examining systemic racism\u2019s impact on BUSM and its curriculum. Administrators helped the students form a Racism in Medicine Vertical Integration Group (VIG), which later published an exhaustive 139-page report that includes numerous recommendations for removing racist beliefs and stereotypes from medical education. Their work also resulted in the publication of a paper, authored by multiple members of this class and faculty, \u201cDeconstructing Racism, Hierarchy, and Power in Medical Education: Guiding Principles on Inclusive Curriculum Design,\u201d in Academic Medicine<\/em> in November 2021.<\/p>\n

\n

Second Year<\/strong><\/h4>\n

\"Empty<\/a><\/p>\n

Members of the Class of 2022 began their second year of medical school with the increasing confidence of experienced medical students and ended their year facing many unknowns.<\/p>\n

Members of the Racism in Medicine VIG knew their curriculum-development project would take time but wanted to begin making immediate impact, so they spent the summer before their second year creating an enrichment series, which they named Creating Leadership in Education to Address Racism (CLEAR).<\/p>\n

\"Headshot<\/a>
Sabreea Parnell<\/figcaption><\/figure>\n
\n

\u201cIt was a six-series course that we rolled out over the next semester for students who are interested in learning more about racism in medicine\u2014the history of it, how to identify it, how to combat it, how we even talk about race in medical education,\u201d<\/span><\/strong> says Sabreea Parnell (\u201922).<\/span> \u201cWe had about 40 students sign up for the course, which was incredible.\u201d<\/span><\/strong><\/em><\/h3>\n<\/blockquote>\n

Many class members used their free time to lead student groups and to volunteer in the community, riding the Outreach Van to take hot meals and basic medical care to immigrant communities in East Boston, providing comfort to newborns suffering through opioid withdrawals, and offering tax-filing help to low-income families visiting the medical center\u2019s pediatrics wing.<\/p>\n

\"Headshot<\/a>
Rachel Rockers<\/figcaption><\/figure>\n

Rachel Rockers (\u201922), who was balancing schoolwork with family responsibilities during her second year, didn\u2019t have time to join her classmates in such activities, but was awed by their energy and passion.<\/p>\n

\n

\u201cI am shocked and inspired by how proactive my younger classmates are in trying to make the world a better place,\u201d <\/span><\/strong>she says<\/span>. \u201cThat my classmates have this type of conviction and aren\u2019t afraid to show it, I think it\u2019s very inspiring for the future of medicine.\u201d<\/span><\/strong><\/em><\/h3>\n<\/blockquote>\n

Classes were winding down and students were beginning the intensive study period before their crucial Step 1 licensing exam when the COVID-19 pandemic began, sending everyone into lockdown.<\/p>\n

At first, says Vaickus, the COVID quarantine didn\u2019t disrupt student\u2019s lives all that much, as they were already planning to shut themselves inside to study. But then their tests got canceled and rescheduled and rescheduled again.<\/p>\n

\n
\"Headshot<\/a>
Max Vaickus<\/figcaption><\/figure>\n

\u201cIt\u2019s such a finely orchestrated study plan that we put together,\u201d<\/span><\/strong> Vaickus says.<\/span> \u201cEverything was laid out and structured, and then COVID threw a wrench into all of that.\u201d<\/span><\/strong><\/em><\/h3>\n<\/blockquote>\n

When Boston-area testing centers closed their doors, Paige Curran, assistant dean for student affairs, worked around the clock to help students regroup.<\/p>\n

\u201cSeveral of these students were canceled, not once, not twice, but on average five times to sit for this exam,\u201d she says. \u201cMany showed up at their testing site under the impression that they were scheduled to take the exam, and the testing center was locked.\u201d<\/p>\n

Many students managed to take their Step 1 that spring, either at a typical testing center or at temporary testing campuses that area medical schools worked together to set up at BUSM and at Brown University. Others ended up waiting months to take the eight-hour exam, severely testing their ability to retain knowledge and maintain intense study.<\/p>\n

Rockers chose to delay her exam to the fall, which she says was both a blessing and a curse. During spring 2020, Rockers was caring for her ailing mother, mourning the loss of her father-in-law, and without childcare for her newborn and toddler. While she\u2019d have liked to tick the Step 1 off her list earlier, she says, she appreciated the opportunity to care for her family during quarantine, knowing she had the flexibility to test later.<\/p>\n

Curran was impressed by the grace with which students accepted such a major disruption to their academic schedule and with their willingness to collaborate with faculty and staff to make new testing plans.<\/p>\n

\u201cThe fact that they did not lay down and stay down is just remarkable,\u201d she says.<\/span><\/p>\n

\n

Third Year<\/strong><\/h4>\n

\"Students<\/a><\/p>\n

COVID influenced nearly every aspect of the Class of 2022\u2019s third year of medical school, just as it affected nearly every aspect of American life at that time.<\/p>\n

Third-year clerkships, a highlight of the medical school experience, were set to begin in May 2020. Boston Medical Center and affiliated sites and practices, however, were so overwhelmed with COVID patients that it didn\u2019t make sense to begin clerkships then, increasing the density of healthcare workers in limited spaces and putting students at risk of exposure. Assuming hospitals and practices would be in better shape come fall, BUSM administrators quickly reworked the third-year curriculum so the Class of 2022 could delay its clinical start but still graduate on time. Clerkships are typically a mix of classroom and hands-on learning; for this class, all classroom lectures took place virtually over the summer. When students later entered the hospital for clinical experience, most of their rotations were shortened by two weeks but were entirely focused on hands-on learning. Faculty worked hard to make the virtual learning period as productive as possible, says Associate Dean for Medical Education Priya Garg, MD, walking students through virtual cases and even mailing them sewing kits for suturing practice.<\/p>\n

While creating the two-week virtual modules from scratch on such short notice was an amazing amount of work, says Assistant Professor of Pediatrics Rachel Thompson, MD, who directs pediatric clerkships, BUSM faculty didn\u2019t face the challenge alone.<\/p>\n

\u201cSo many people across the country were going through something similar,\u201d she says. \u201cThere was an incredible amount of knowledge sharing and sharing of resources on the medical educators\u2019 listservs. Places were offering cases they had done, models they had used.\u201d It was heartening, she says, to see such a spirit of sharing of volunteerism in the medical education community.<\/p>\n

BUSM solicited feedback on its initial virtual modules and then did its best to incorporate students\u2019 suggestions into later modules.<\/p>\n

\u201cOne of the things we learned,\u201d says Thompson, \u201cwas that students really wanted more small-group opportunities.\u201d With more than 150 students enrolled in a module at the same time, however, trying to find enough faculty to supervise small groups was mindboggling, she says. Then a colleague at Boston Children\u2019s Hospital mentioned that COVID shutdowns had left fellows at Children\u2019s with little to do. \u201cSo, I staffed a huge number of our small-group sessions with fellows from Boston Children\u2019s who just volunteered their time.\u201d<\/p>\n

The virtual modules were a challenge for students as well as for faculty, especially given the intensity of summer 2020.<\/p>\n

\u201cSome of us were doing virtual rotations on Zoom while trying to juggle studying for Step 1, so that was definitely a chaotic time,\u201d says Motavalli.<\/span><\/p>\n

Following news coverage of that summer\u2019s Black Lives Matter protests made focusing on academics difficult for many students, especially students of color. Parnell remembers how exhausting it felt to be Black in America at that time, and yet still needing to find the energy for hours of online class sessions each day.<\/p>\n

\n
\"Headshot<\/a>
Meshelle Hirashima<\/figcaption><\/figure>\n

Even the logistics of taking online courses became a challenge for some students. When lockdown was looming in the spring, Meshelle Hirashima (\u201922) booked a flight home to Hawaii.<\/span><\/em><\/h3>\n

\u201cThere was no way I was going to quarantine in<\/em> Boston,\u201d<\/em><\/strong> she says.<\/em><\/span><\/h3>\n

She chose to stay safely in Hawaii through the summer, which meant logging in to virtual learning modules at 3 a.m.<\/span><\/em><\/h3>\n<\/blockquote>\n

Students were thrilled to finally begin in-person clerkships in late August. Despite their shortened rotations, students had the formative experiences typical of the third year of medical school: interviewing patients face-to-face, assisting in the delivery of their first babies, witnessing death for the first time.<\/p>\n

The presence of COVID-19 affected some clerkships more than others. Cho says his rotation through minimally invasive surgery (MIS) was drastically impacted by the cancelling of elective surgeries.<\/p>\n

\u201cDespite spending a month on MIS, I did not see a single bariatric surgery, which was crazy because that\u2019s 90 percent of what they normally do,\u201d he says.<\/p>\n

Initially, students weren\u2019t allowed to treat COVID patients or even see patients presenting with COVID symptoms because faculty felt they should first be familiar with the hospital and with clinical care and be well prepared for the experience.<\/p>\n

\u201cI did two weeks of outpatient pediatrics,\u201d says Vaickus, \u201cand they didn\u2019t let us see any person who had a runny nose or an ear infection or a slightly suspicious cough, which is, you know, all kids.\u201d<\/p>\n

Parnell says her most trying third-year experience was her time in the medical ICU.<\/p>\n

\u201cIn the beginning, there were almost no patients that I could actually see because everyone had COVID,\u201d she says. \u201cI still had patients that I was rounding on in the morning, but I couldn\u2019t go into their rooms, so I\u2019d have to stand outside the door looking through the windows to see how my patients were doing.\u201d<\/span><\/p>\n

COVID especially complicated rotations for students forced to quarantine after catching the virus or being exposed, leaving them to make up lost time during vacation breaks.<\/p>\n

\u201cAccidental exposures happened,\u201d says Motavalli, \u201cbut overall, I felt very protected.\u201d<\/p>\n

Stephanie Vaughn (\u201922) agrees that BUSM struck the right balance between education and safety. She appreciated being shielded from COVID exposure.<\/p>\n

\u201cThere truly isn\u2019t that much educational value in taking care of COVID patients,\u201d she says, \u201cbecause you just follow an algorithm, and the cases are usually quite straightforward. So, the residents would say, \u2018This is COVID. It\u2019s just risky and not interesting. You should not take that patient.\u2019\u201d<\/p>\n

\n
\"Headshot<\/a>
Stephanie Vaughn<\/figcaption><\/figure>\n

Vaughn adds that COVID had much less impact on her clerkships than she initially feared. <\/em>\u201cI think there\u2019s a sense among doctors that we need to keep prioritizing education even in a pandemic, because if we don\u2019t make time and space for that, we\u2019re going have a generation of doctors who<\/em> are unprepared.\u201d<\/em><\/strong><\/span><\/h3>\n<\/blockquote>\n

Even while busy with clerkships, members of the Class of 2022 found ways to help with pandemic relief. To pay tribute to his grandmother, who died of COVID early in the pandemic, Tyler Kalajian (\u201922) spearheaded a fundraiser to buy masks for the homeless community in Boston\u2019s South End.<\/p>\n

\u201cWe thought we\u2019d be able to donate 1,000 or so masks,\u201d Kalajian says, \u201cbut we got such an outpouring of support from both the South End community and the Boston University community that we were able to give seven to eight times as many as we expected. It was so humbling to see a community come together and help a very vulnerable population in our neighborhood.\u201d<\/p>\n

\n

Fourth Year
\n\"Medical<\/a><\/strong><\/h4>\n

With proper PPE, vaccines and treatments available to blunt the impact of COVID-19, the Class of 2022 saw a near return to normalcy in its fourth year of medical school. Students were allowed to see patients with COVID symptoms and schedule \u201caway\u201d rotations in outside hospital systems. Elective surgeries returned.<\/p>\n

The geriatric rotations required of all fourth-year BUSM students remained impacted by COVID. When students made home visits, they wore gowns, N-95 masks and eye protection.<\/p>\n

\u201cThe biggest barrier with PPE is that we\u2019re communicating with a lot of patients who have sensory and cognitive impairment,\u201d says Assistant Professor of Medicine Megan Young, MD, who directs the geriatric clerkships. Knowing their patients may struggle to hear and understand them, she says, pushed students to improve their communication skills.<\/p>\n

\u201cWe\u2019ve gotten a lot better emoting with our eyes, since nobody can see the rest of our face anymore,\u201d says Cho, only half-jokingly.<\/p>\n

Rockers, who plans to specialize in pediatrics, says many of her fourth-year patient appointments have been telemedicine visits, at least partially because the Omicron variant of SARS-CoV2 caused a spike in virus cases and a temporary return to cautiousness.<\/p>\n

\u201cI think they\u2019re also trying to train us in telemedicine because they realize it\u2019s more convenient for a lot of the patients to do telemedicine,\u201d she says, \u201cso it\u2019s a skill they want us to have.\u201d And despite the initial awkwardness of trying to conduct a child\u2019s neurological exam over a computer screen, she says, she\u2019s become adept at it over time.<\/p>\n

Garg says these students\u2019 ability to master telemedicine is evidence of their exceptional clinical skills. Because clinicians can\u2019t examine patients during a telemedicine visit, she says, they must rely more on asking patients the right questions. \u201cThat takes a lot of clinical acumen, to know what\u2019s the right question to ask,\u201d she says. And phrasing questions in a way that patients will understand takes impressive communication skills.<\/p>\n

With COVID restrictions easing, members of the Class of 2022 have generously used their time to help underclassmen organize the social and professional events they badly need.<\/p>\n

\u201cWhen the current second-year class came in, all group events were canceled, all indoor gatherings were canceled,\u201d says Cho. \u201cThe feedback I\u2019m getting from them is they really feel they suffered in their social connections and in their connectedness to the community as a whole.\u201d<\/p>\n

Class members have also volunteered at COVID vaccine clinics. Members of the Latino Medical Student Association spent time in Chelsea, a primarily Spanish-speaking Boston suburb, helping with patient recruitment, education and registration.<\/p>\n

\"Headshot<\/a>
Maria Suarez-Gama<\/figcaption><\/figure>\n
\n

\u201cI didn\u2019t directly give out the vaccine,\u201d <\/span><\/strong>says Suarez-Gama, <\/span>\u201cbut it was still very rewarding to volunteer there, as I was usually one of maybe two Spanish-speaking volunteers in the clinic, and it was very much needed to have bilingual staff.\u201d<\/span><\/strong><\/em><\/h3>\n<\/blockquote>\n

Members of the Class of 2022 completed their fourth year as all medical students do\u2014balancing their final clerkships with residency interviews. But theirs were not typical interviews.<\/p>\n

\u201cYou\u2019re sitting there in your suit top and your blouse,\u201d says Rockers, \u201cbut then you have pajama bottoms on.\u201d<\/p>\n

All interviews happened virtually this year, so instead of booking flights and hotel rooms, students fussed with their lighting, hoped their internet service wouldn\u2019t drop, and tried not to appear fidgety on camera. To help students prepare for virtual interviews, BUSM Student Affairs developed a range of resources, including mock interviews for each student with specific feedback.<\/p>\n

\u201cI was really disappointed that the interviews were virtual again this year,\u201d says Vaughn. \u201cI\u2019m going to be moving with my partner, and I don\u2019t want to move him somewhere we\u2019ve never been.\u201d On the other hand, she says, virtual interviews saved time and money, valuable commodities for most medical students.<\/p>\n

Despite their awkwardness and other downsides, virtual interviews may be here to stay. Students say they appreciate that virtual interviews reduced their carbon footprint, made scheduling easier, eliminated the stress of flight delays, and\u2014perhaps most importantly\u2014helped level the playing field for students of lower socioeconomic status.<\/p>\n

This group of students has always focused on advocacy and equity, says Garg, so she\u2019s not surprised they\u2019ve spent time thinking of ways to make residency interviews more fair.<\/p>\n

This class\u2019s passion for helping improve medical education also remains strong, she says. Even as fourth-year students in their final weeks of medical school, members of this class keep coming to her with ideas for curricular improvement.<\/p>\n

\u201cI\u2019m just so impressed,\u201d Garg says. \u00a0\u201cMany students would have been so fatigued and burnt out by the experiences of COVID and medical school in general, but they just keep going. It gives you a lot of confidence and hope for the future of medicine.\u201d<\/p>\n

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BUSM\u2019s fourth-year medical students: proactive, passionate, inspiring, resilient, creative, collaborative, gracious. Did we mention resilient?<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[124,91,156],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/102468"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=102468"}],"version-history":[{"count":34,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/102468\/revisions"}],"predecessor-version":[{"id":129661,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/102468\/revisions\/129661"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=102468"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=102468"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=102468"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}