Summary - Mobilizing Health Professions Students
As state and local leaders develop and implement policies to expand health workforce capacity, some health leaders are looking at how health professions students could be utilized in the pandemic response. Mobilizing Health Professions Students takes a closer look at how students, particularly those near to graduation, can be mobilized to meet the increased demand for health workers. Moderator Sara Westergaard of the Mullan Institute is joined by Garrett Chan, President of HealthImpact, California’s nursing workforce and policy center, and Jo Wiederhorn, President of the Associated Medical Schools of New York (AMSNY).
Deans from medical schools in New York City’s metropolitan area expressed early interest in graduating students early as a possible avenue to help build health worker capacity, Ms. Wiederhorn begins (minute 03:30). By March of their final year of medical school, most fourth-year medical students have completed all requirements in anticipation of graduation in May. Together with AMSNY, Deans of various medical schools within New York State began to mobilize a plan.
Initial steps involved approval from the Liaison Committee on Medical Education (LCME) which provided a set of guiding principles for determining which students would be eligible for early graduation. Additional support from the State Board of Education came after some pressure from the Governor’s office, who had gotten word of the proposed plan. Per Ms. Wiederhorn, the State Board of Education has sent each school an attestation from to complete indicating that students were meeting LCME requirements for early graduation. Lastly, an executive order from Governor Cuomo waiving certain requirements in the education law and in the health law would allow these new graduates to work in the hospital.
At the same time, the Accreditation Council for Graduate Medical Education (ACGME) has also provided guidance for students and early graduates and AMSNY has been working with the medical schools and hospitals to define roles for these new graduates (minute 10:37). The new graduates would have a title of “COVID-19 specialist physician” and will be supervised by attending physicians not resident physicians as per the guidance from ACGME. These new graduates would be hired by the hospital and receive payment and benefits from the hospital including health and liability insurance. This role would end two to four weeks prior to the start of residency to allow the new graduates to quarantine if necessary and relocate to their new setting.
Ms. Wiederhorn also notes that while there is regional variation of COVID-19 prevalence in New York State, there are not currently any formal plans between schools to allow students from lower burden areas to relocate to higher needs areas. However, students who have matched in a program in the metropolitan area may relocate to that area early. “This is all voluntary on the part of the students,” she stresses. “Nobody is forcing the students to do this.”
As for nursing, Dr. Chan describes several potential roles for nursing students in the COVID-19 response (minute 16:25). Like other health professions students, the education and clinical rotations of many nursing students has been interrupted by COVID-19. Nursing leaders across the US have called for the mobilization and utilization of nursing students in the response. Dr. Chan states students can be utilized by providing both psychosocial and nursing care to patients, families, and community members at various levels of acuity.
Nursing leaders have also advocated for increased flexibility and creativity in clinical experiences for nursing students (minute 26:03) and Dr. Chan notes several waivers among state nursing boards to help move nursing students forward to maintain the educational pipeline. He reports these waivers fall into three main categories: allowing more latitude in clinical experience, increasing the amount of simulation, and suspending or creating new licensure experience.
Dr. Chan goes on to describe the work being done in California to mobilize nursing students which involves the preparation of students, faculty, and practice settings and addresses potential state and regulatory issues. In this preparation, Dr. Chan points out the importance of obtaining informed consent from the students and clearly articulating the risks, benefits, burdens, and alternatives if a student chooses to participate in the pandemic response. He also argues for the autonomy of students. “We have to recognize that students are free agents,” he says. “They have will and agency to make decisions for themselves.”
Similarly, medical schools are also developing strategies for current medical students who still have clinical rotations to complete though this is still evolving according to Ms. Wiederhorn (minute 36:40). She also notes that students in all years want to get involved to help with the response. “The students have really done some remarkable things,” she says noting that student in the metropolitan area have started a consortium of sorts to raise money for PPE and volunteer to help on phone lines. “Everyone is getting involved in their own way.”
Deans from medical schools in New York City’s metropolitan area expressed early interest in graduating students early as a possible avenue to help build health worker capacity, Ms. Wiederhorn begins (minute 03:30). By March of their final year of medical school, most fourth-year medical students have completed all requirements in anticipation of graduation in May. Together with AMSNY, Deans of various medical schools within New York State began to mobilize a plan.
Initial steps involved approval from the Liaison Committee on Medical Education (LCME) which provided a set of guiding principles for determining which students would be eligible for early graduation. Additional support from the State Board of Education came after some pressure from the Governor’s office, who had gotten word of the proposed plan. Per Ms. Wiederhorn, the State Board of Education has sent each school an attestation from to complete indicating that students were meeting LCME requirements for early graduation. Lastly, an executive order from Governor Cuomo waiving certain requirements in the education law and in the health law would allow these new graduates to work in the hospital.
At the same time, the Accreditation Council for Graduate Medical Education (ACGME) has also provided guidance for students and early graduates and AMSNY has been working with the medical schools and hospitals to define roles for these new graduates (minute 10:37). The new graduates would have a title of “COVID-19 specialist physician” and will be supervised by attending physicians not resident physicians as per the guidance from ACGME. These new graduates would be hired by the hospital and receive payment and benefits from the hospital including health and liability insurance. This role would end two to four weeks prior to the start of residency to allow the new graduates to quarantine if necessary and relocate to their new setting.
Ms. Wiederhorn also notes that while there is regional variation of COVID-19 prevalence in New York State, there are not currently any formal plans between schools to allow students from lower burden areas to relocate to higher needs areas. However, students who have matched in a program in the metropolitan area may relocate to that area early. “This is all voluntary on the part of the students,” she stresses. “Nobody is forcing the students to do this.”
As for nursing, Dr. Chan describes several potential roles for nursing students in the COVID-19 response (minute 16:25). Like other health professions students, the education and clinical rotations of many nursing students has been interrupted by COVID-19. Nursing leaders across the US have called for the mobilization and utilization of nursing students in the response. Dr. Chan states students can be utilized by providing both psychosocial and nursing care to patients, families, and community members at various levels of acuity.
Nursing leaders have also advocated for increased flexibility and creativity in clinical experiences for nursing students (minute 26:03) and Dr. Chan notes several waivers among state nursing boards to help move nursing students forward to maintain the educational pipeline. He reports these waivers fall into three main categories: allowing more latitude in clinical experience, increasing the amount of simulation, and suspending or creating new licensure experience.
Dr. Chan goes on to describe the work being done in California to mobilize nursing students which involves the preparation of students, faculty, and practice settings and addresses potential state and regulatory issues. In this preparation, Dr. Chan points out the importance of obtaining informed consent from the students and clearly articulating the risks, benefits, burdens, and alternatives if a student chooses to participate in the pandemic response. He also argues for the autonomy of students. “We have to recognize that students are free agents,” he says. “They have will and agency to make decisions for themselves.”
Similarly, medical schools are also developing strategies for current medical students who still have clinical rotations to complete though this is still evolving according to Ms. Wiederhorn (minute 36:40). She also notes that students in all years want to get involved to help with the response. “The students have really done some remarkable things,” she says noting that student in the metropolitan area have started a consortium of sorts to raise money for PPE and volunteer to help on phone lines. “Everyone is getting involved in their own way.”