Medical School 2020, Year 4, Week 33 (Residency Prep, week 1)

Six weeks until graduation. Before the last two-week elective, we have four weeks of Residency Prep (“RP”). It is March 16, 2020, and the deans are changing policies every few days, trying to stay ahead of COVID-19. M1 and M2 classes have been on Zoom for a week. Lanky Luke was facilitating an 8-student “Medical Education” elective. “Life is pretty normal for them,” Luke said. “Less than 10 percent of the class even went to lecture pre-COVID-19 so they are used to it.” He adds, “It’s odd to see people in pajamas. I don’t complain! I am too!” 

M3s are the most affected. Initially, their rotations continued, with instructions to stay out of rooms that require PPE (gowns, gloves, masks, etc.). Students are forbidden to take care of any COVID-19 patient, although our hospital has only one, a 91-year-old woman in the ICU transferred from an outside county.

This policy existed for three days.

On Tuesday, we get an email canceling all clinical rotations until further notice. Students are reassigned into non-clinical rotations. Our options: Medical Spanish via Zoom, Pathology via Zoom, Medical Education, and Advanced Anatomy (cadaver dissections; 2-3 students and one teacher in a large lab). We also have the option to take another two weeks of research or study time (a.k.a. “vacation”). Mischievous Mary is quite annoyed as she has to complete a “medical” elective before graduation so she doesn’t have the vacation option. She would have done in-person cardiology consults, but instead must do remote pathology. “FML!” she texts.

After communicating to us the critical importance of these social distancing guidelines, the administration summons us all into an auditorium to sit side-by-side and learn about a new policy for Match Day (Friday, March 20). While we breathe whatever viruses everyone else has acquired during various rotations, two deans explain that Match Day will be restricted to class members and essential staff (e.g., Deans and Chairs of Departments). University-sponsored events are now limited to 100 people.

Before the coronavirus, this would be a two-day party starting at 10:00 am with a ceremony in the auditorium. Friends and family would fly in from around the nation, with tickets capped at 10 per student. After speeches by various dignitaries, each student individually goes into a private room to open a printout of a letter  that the school would have received the night before. Students emerge to go up to the microphone and give an Oscars-style talk about how grateful they are to have matched at whatever institution. All of this is recorded on video for posterity. Everyone in the audience toasts with Champagne, followed by a catered reception. Groups of friends, accompanied by their out-of-town visiting family members, go to local restaurants for lunch. The gatherings continue into the evening in restaurant and bar private rooms and patios. There would be brunches and barbecues on Saturday and continuing into Sunday for the hardcore.

We will get none of this.

Chaos ensues as already-anxious students absorb the fact that they will not be able to open their Match letters with family and friends. Students talk over each other trying to negotiate with the deans for 2-ticket or 1-ticket allotments. Nervous Nancy quiets the room. “Some of us have loved ones that are old and vulnerable. This is serious. Let’s just have a small ceremony and leave.” Father Fred, a 30-year-old whose children are now 3 and 6-months old, asks, “Could we can pick up our letters and leave the premise to open with family instead of staying around?” The decision is that we will stay for one hour to hear shortened speeches, and then leave after we are handed our Match letters at noon to open them with loved ones outside. We’ll communicate our Match results to classmates via a group spreadsheet.

GroupMe erupts before Jane and I get to the car. 

Gigolo Giorgio: “PSA: you will get an email from NRMP at 1:00 pm, so you could just wait in bed.” 

Pinterest Penelope: “Another hour of my life wasted.”

Lanky Luke: Question- what if only significant others (perhaps fiancé and spouses or something) are allowed? It would probably be only a few individuals who are mostly local. This option would allow them to enjoy the experience with individuals who are equally impacted by this decision, while minimizing exposure. (likes and “I agree” responses accumulate)

Buff Bri: They really should cut nonessential faculty and staff. We might be able to squeeze a few more in there.

Pinterest Penelope is the camel nose under the tent: Would [Jeffrey] count? He’s not my fiancé, but we’ve been together over four years and he lives here.

Gigolo Giorgio: not opposed to the +1 idea, but still think it needs to be that everyone gets the invite or nothing. just not fair for some people to have their person there and not everyone 

Class president: The other thing we could do, which I have heard students from other schools are doing, is to take our envelopes and have our own [enormous] ceremony and opening party somewhere away from school. we could hold it in [local venue] and rent the space for longer and do everything as planned there.

Nervous Nancy: I’m not sure how great this visual would be if it got out to the public that the esteemed medical graduates are partying it up downtown while pandemic is ensuing. I wasn’t gonna ask my SO to attend cause I really really don’t like ceremonies and I’m immunocompromised [from treatment of Crohns disease]. Basically I totally get that my POV might not be the majority.

Straight-Shooter Sally: Y’all hiding behind your computers and phones acting like we didn’t meet in majority with the deans, talked it through, and decided to play our part in social distancing. We already have it better than so many people. (attaches Excel sheet from reddit with canceled Match days by medical school.)

Fashionable Fiona: If the +1 option is pitched to [the deans] and then shut down, I’m amenable to our leadership then pitching the just SO option for the 30 or so people that have one. I get it’s not ideal or fair for everyone, but I recognize that SOs are as heavily invested in our med school experience and equally impacted by Match day. Just because I can’t have someone there, I don’t want all of you to be robbed of your SO being there. Although if they’re shooting down the +1 option, they’ll likely shoot down to the SO option for similar reasons. But still, maybe worth a shot? Desperate times. 

Gigolo Giorgio: So one student’s SO is more important than another student’s mom or dad? I don’t have any family coming either way, but it sounds like it would be unfair to do just SOs

Gigolo Giorgio: With so many other schools canceling Match day, undergrad campuses closing the campus and having online classes across the nation, and Virginia being in a state of emergency- what makes us the exception? What if the 100 limit is changed to 75 tomorrow? Or 50? I understand we’ve worked for this moment over 4 years and its a once in a lifetime opportunity to celebrate with our loved ones, but we also need to do our part to address this pandemic. Again, my family doesn’t love me enough to come so idc either way

Nervous Nancy:  Tbh y’all I’m embarrassed. The Match is supposed to demonstrate that we are almost doctors, we shouldn’t need the admin to tell us that we should respect social distancing, limit travel, etc. Come on we’re better at epidemiology than this. This a global pandemic out there y’all, people are dying. (And we bitching about our special day being less special for those with [left-home] SOs). Ton of people are not having the special moments that they worked years to earn, for be those moments Athletic or academic, we are doing it to keep people safe. Let’s not be petty, foolish. While probably having a 1+ would most likely be totally OK, imaging how dumb we’re gonna look if something does spread, and it went public that [our school] looked for a loophole with the magic # of 100…. so please pretty please, we are better than this 

Gigolo Giorgio:  “Super spreader event at local medical school: [School] overrules decision to keep Match day private and decide to invite guests! ‘F*ck the virus, I wanna be with my SO if I’m gonna die anyways,’ says a group of students. What a headline.

Ambitious Al: @Georgio you forgot the #YOLO in there 

Buff Bri: Hey everyone! Love you guys and can’t wait for us to all celebrate this next great step I spoke with [fancy restaurant with fantastic cocktails] and they said that they were ok with having 40-60 of us going to the courtyard at 1PM on March 20th. I know things are constantly changing but I think this will be an awesome chance for us to celebrate over drinks. I will keep you all updated if anything changes, but [restaurant’s] management is aware of Match Day and is very excited to host us

He follows up: Seems like we have almost the whole class who has RSVPed Yes but if anyone else wants to come, let me know!

Fashionable Fiona:: Hi all ~ Now that we *tentatively* have some plans for Match Day, we wanted to let you guys know that we have booked the basement of [local bar/club] (same place we have Halloween!) for our official match night celebration. Given that the yearly school reception has been cancelled (and with it the lovely rice krispie treats) we wanted to have an opportunity to enjoy and celebrate together with good food and drink. Things are definitely fluid right now in [our city], but I have confirmation from [the bar] that they are still allowing events to happen. Guests are also invited but obviously, please do not come/invite your guests to come if any of you are currently sick or are traveling from a high risk area. – We will have a cash bar for food and drinks and rockin’ dance floor! Hope to see you guys there! – Your Match Day Committee 

This week turns into a vacation for me. Residency Prep classes have been rescheduled for next week to allow the IT department to figure out logistics. I go in on Wednesday for individual meetings with two administrators to prepare graduation paperwork, such as NPI and documents that will be needed for state medical license applications.

GroupMe updates from classmates allow us to identify recently stocked stores for hard-to-find goods. Bri: “I found paper towels and toilet paper, but not hand sanitizer.” Jane and I grill with Luke and Sarcastic Samantha almost every evening because the weather is so nice. Samantha is still working as a hospitalist PA: “The hospital is so empty that department heads are asking physicians to take voluntary leave. This is what a hospital should look like. Finally just the actual people who should be in the hospital are here.”

Statistics for the week… Study: 0 hours. Sleep: 8 hours/night; Fun: 7 days. Example fun: Jane and I attend a Thursday party at Buff Bri’s apartment. We set up tables outside for beer pong and spike ball while drinking White Claws and cheap beer basking in the beautiful 70-degree sunshine. Jane and I left around 4:30 pm. We learned that several students went downtown to “support the bars”. Nervous Nancy scolds them over the GroupMe: “I want to thank everyone who is socially distancing and did not go downtown after [Buff Bri’s] party. We are going to be seeing a lot of each other over the next few weeks until graduation, and some of us have loved ones that are vulnerable.”

[Editor: For reference regarding the evolving thinking about social distancing and coronavirus, Li Wenliang warned colleagues about what he believed to be an outbreak of 7 SARS cases on December 30, 2019. China isolated Wuhan on January 23, 2020. On February 24, 2020, Nancy Pelosi told everyone not to avoid San Francisco’s Chinatown (“Come because precautions have been taken. The city is on top of the situation”). New York City’s mayor was inviting the public to mass events as late as March 2. Medical doctors were gathering in mass meetings until March 10. Schools in Massachusetts began to close on the afternoon of March 12. California shut down on March 19. Governor Cuomo issued a shutdown order for New York State on March 20, to take effect the evening of March 22.]

The rest of the book: http://fifthchance.com/MedicalSchool2020