COVID-19: Dealing with uncertainty

This pandemic has introduced a lot of uncertainty in our lives. None of us could have known a few months ago that our world would be in the state it currently is in and none of us know for sure what the situation will be like in the coming months or weeks – everything changes on the daily and each of us is forced to some extent to live day-by-day. The uncertainty that this pandemic has brought to the entire world is vast, and certain groups are impacted much more severely than others. Students are experiencing a lot of turbulence whether you are an undergraduate student or in a professional program.

Medical School Changes

Medical schools responded to the pandemic by shifting their preclerks to a completely online format. At the University of Toronto for instance, all of our lectures that are normally held in our lecture hall, were moved online in the form of either a recording from the previous year, or a livestreamed lecture. Our clinical skills were slightly altered to be more theory focused, and our end-of-year clinical skills exam, known officially as an OSCE, had been postponed. Our tests proceeded as usual except they are now held online with online proctoring so our laptop has its camera and microphone on at all times while we are writing. While it was a bit of a shift, for the most part it is “business as usual”. The big shift is for the clerks who got sent home because of the pandemic and their clerkship got paused. They were left in a bit of limbo where they did not know what was happening as the schools across Canada attempted to determine a strategy for them. As of now, it seems like schools are bringing their medical school clerks back in to the clinical setting in July and many have resumed in a fashion of “online clerkship” to maintain some of their competencies and keep them busy before they return. Their CaRMS interviews for residency positions will all be shifted online and the schedule has been slightly modified. For the 2nd year medical students that are schedule to start their clerkship in the upcoming year, as of now we are scheduled to start on time but we are having an extended “bootcamp” for us to review many of the key skills and competencies needed and complete our clinical skills exam prior to entering clerkship. There is still uncertainty if the incoming medical students and current first year students entering second year will remain online or if there will be some introduction of in-person learning. Many details are still being worked out and all of this is tentative and subject to changes based on what is going on in the world. We are ultimately left with an uncertainty we must accept.

Premed student changes

Undergraduate students transition to an online platform as well, but the variation across institutions and programs has been massive. Some schools have shifted to pass/fail for their courses, others have given students the option of having a numeric score or having a pass/fail, others have allowed students to opt-out of the exam and maintain the grade they had going into the exam and others have been “business as usual” with no shifts to their grading. With all this variation, many questions arise as to how medical schools will look at marks for their upcoming admissions in future years. Medical schools are working on deciding how to deal with this issue and ultimately will communicate this when it has been determined, but for now it is uncertain how future applications will be affected. In addition to changes in grading, the MCAT has changed. It is now in a shorter, more condensed format at a total “seated time” of 5 hours and 45 minutes, and there are now new time slots for starting the test so you could end up starting it at 6:30AM, 12:15pm or 6:00pm. For interviews, there have also been numerous changes. After the pandemic hit, all in-person interviews were cancelled. Almost all schools opted for online evaluations, either in the same format as they had for in-person or a slightly modified format. McMaster announced earlier that it was not planning on doing online interviews, but just this past week they emailed applicants explaining their selection process. They were using the pre-interview score for the top 100 applicants and to fill the Indigenous spots, but after that they would be doing a lottery for the remaining ~100 spots from the applicants that would have been offered an interview, that did not make the top 100 list. That means if you were candidate ranked number 101 based on your pre-interview score, you would be put in a completely random lottery with all other individuals who would have gotten an interview to determine if you get in or not. They also stated that all students who would have gotten an interview that do not get in will be guaranteed an interview the following cycle. An interesting approach to say the least. One thing is for sure – there is a lot of uncertainty for those in the premed community. Offers will be coming out tomorrow so that adds to the anxiety.

Keeping things in perspective

With all the uncertainty across all boards it’s hard not to be anxious in times like this. In times like this I think it’s important to keep things in perspective. Are you safe? Are you healthy? Are you being taken care of? Do you have the privilege of being able to social distance safely? Are you financially safe? Do you have to worry about where your next meal will come from? While I do not think it is fair to downplay the unique issues everyone is facing and they may very well be valid concerns to be anxious about, it is also important to keep things in perspective especially in times like this. If you have access to the essentials and you as well as your family is healthy then you are already in an extremely good place. There are people dealing with massive losses, healthcare professionals that are on the front-lines not only in Canada but across the world, including places where the pandemic is much worse like Italy and many of them are not able to see their families because of the risk of transmission. As a medical student I am seeing many of my teachers on the front-lines and they are still doing what they can to ensure we have a solid education throughout this crisis. I honestly am extremely proud of my faculty’s swift response and accommodations to us students even though they are dealing with many different issues and many of them are on the front-lines themselves.

Uncertainty is part of our lives. Sometimes, such as during a pandemic, this uncertainty is amplified. Through it all, the most important thing you should do is focus on ensuring you are taken care of and maintain your mental health. You do not need to use this time to learn new things, or be productive. If you come out of it safely without significant emotional or mental harm, then you have bettered yourself by having experienced a difficult time and built some resilience from it. My only suggestion would be to journal if you can, so you can look back on your entries in the future and think back to what you lived through, what helped you through this time so that if ever you face uncertainty again you know what works and what doesn’t.

Please stay safe during this time and remember that the most important thing above all else is your health, both physical and mental. Maintaining your health should always be a priority and remember that through this all you are not alone. We are all in this together and I hope that you are all taking the time to support one another and be there for each other. Everything you are experiencing someone else is experiencing as well, some better some worse. Call, text, and do whatever you can to remain connected and if you need help please reach out. To all those waiting on offers tomorrow, good luck, and to those reading this after offers have come out I hope that it went your way, and if it did not do not give up! There is no rush, and if you are committed to becoming a doctor it will all eventually work out if you put the work in.

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