As hospital admission rates for Covid-19 rise again, medical students across the country are embarking on a very different year of learning. Clinical experiences that were once about maximising exposure, spontaneity and being able to 'come and go' onto wards have been replaced with more formalised learning and timetables to ensure safety is paramount.
Mainga Bhima has just embarked on her second year as a medical student at the University of Bristol. She talks about how she will be embracing these changes for the year ahead.
"We have all been plunged into a huge natural experiment designed to test the human tolerance limits of uncertainty. At least, that’s how it feels as I prepare to embark on my second year of medical school.
"Reflecting on my first year, I have been remembering with a sense of grim irony the presentation I gave entitled ‘Uncertainty in Medicine’. Oh, how naive we were back then. While our argument was that to practice medicine means confronting uncertainty, the reality of this confrontation felt far off in our nebulous futures - when our years of training and experience would undoubtedly provide a solid foundation for confident decision-making in complex clinical scenarios.
"At no point, as we merrily selected exactly the right stock images to illustrate our pithy talking points, did we ever consider that mere weeks into the future, we would be packing up our belongings and doing our last term of the academic year from our childhood bedrooms. This pandemic has been a rude reminder of just how illusory the concept of certainty is.
"And now we’re at the end of the beginning of Covid-19. While we know a lot more, new questions seem to arise much faster than they can be answered. A new academic year is starting as hospital admission rates are rising again and flu season is fast approaching on a raft of unknowns. In the face of all of this, it feels almost churlish to be asking about clinical education for medical students. But as an appropriately self-interested medical student, it’s impossible for me to look ahead without wondering about the ways in which learning experiences will be changed in the short, medium and long term.
"It is interesting to hear from my course mates in the years above how different their clinical experiences look this year – where once they were free to come and go to the wards as they saw fit, now their clinical exposure is strictly timetabled for obvious safety reasons. And much of the informal learning that happens beyond ward rounds in corridors, offices and canteens is, for the moment, on hold. I am due to start my clinical course this time next year – from my current vantage point, it seems unlikely that informal learning in hospitals will be back on the schedule. And I wonder to what extent my peers and I will be missing out on an essential element of medical learning if we don’t find a way to recreate such spontaneity and serendipity?
"The latter are features with which technology is notoriously ill-equipped. It’s also true that technology has afforded some brilliant learning experiences for medical students, provided free by clinicians who were working from home during the virus’ peak. Their work has changed how I think about the teaching and learning of medicine. Tuning in with other students dotted around the country (and the world) for webinars by experts whose enthusiasm managed to make its way through Zoom definitely went some way to alleviating feelings of isolation. However the future unfolds, it’s going to look different in ways we probably can’t imagine right now – some things will likely be better than they were before, while others will be worse. One thing I’ve learned is that it’s a fool’s errand to try to predict one way or the other – maybe the best we can do is to learn to embrace uncertainty as a starting point, and take it from there."
Mainga Bhima is a second-year medical student at the University of Bristol. Prior to studying medicine, Mainga studied at Edinburgh University and worked in media and publishing before deciding to change career.