Future career plans of medical students and the COVID-19 pandemic: Time to recover?

In 2019 and before the COVID-19 pandemic, about 68% of our medical students in Japan wished to engage in academic activities abroad. However, in 2020 and during the pandemic, this percentage fell to 35%. We found a significant increase in the number of students wishing to go abroad for studies/training in 2021 than in 2020, taking the percentage to the prepandemic level in 2019.

Humoral response to mRNA-based COVID-19 vaccine and booster effect of a third dose in patients with mature T cell and NK-cell neoplasms.

Patients with lymphoid malignancies have impaired humoral immunity caused by the disease itself and its treatment, placing them at risk for severe coronavirus disease-19 (COVID-19) and reduced response to vaccination. However, data for COVID-19 vaccine responses in patients with mature T cell and NK-cell neoplasms are very limited. In this study of 19 patients with mature T/NK-cell neoplasms, anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike antibodies were measured at 3 months, 6 months, and 9 months after the second mRNA-based vaccination. At the time of the second and third vaccinations, 31.6% and 15.4% of the patients were receiving active treatment. All patients received the primary vaccine dose and the third vaccination rate was 68.4%. In patients with mature T/NK-cell neoplasms, both seroconversion rate (p < 0.01) and antibody titers (p < 0.01) after the second vaccination were significantly lower than those in healthy controls (HC). In individuals who received the booster dose, patients had significantly lower antibody titers than those in HC (p < 0.01); however, the seroconversion rate in patients was 100%, which was the same as that in HC. The booster vaccine resulted in a significant increase of antibodies in elderly patients who had shown a response that was inferior to that in younger patients after two doses of vaccination. Since higher antibody titers and higher seroconversion rate reduced the incidence of infection and mortality, vaccination more than three times may have the advantage for patients with mature T/NK-cell neoplasms, especially in elderly patients. Clinical trial registration number: UMIN 000,045,267 (August 26th, 2021), 000,048,764 (August 26th, 2022).

Humoral response to mRNA-based COVID-19 vaccine in patients with immune thrombocytopenia.

Data for COVID-19 vaccine response in patients with immune thrombocytopenia (ITP) are very limited. In a study of 28 patients with ITP, anti-severe acute respiratory syndrome coronavirus 2 spike antibody titres were measured after vaccination. The seroconversion rate for ITP patients was 91.3%, comparable to that in healthy controls (HCs). However, the antibody titre in ITP patients was significantly lower than that in HCs and declined with ageing. Furthermore, the antibody titre in ITP patients who received a minimum prednisolone dose of at least 5 mg/day at any time-point at or after initial vaccination was lower than that in other patients.

Impact of COVID-19 on international medical education and the future plans of medical students in Japan.

Background: The aim of this study was to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the current study methods and future plans of medical students compared to those in the pre-pandemic period. Methods: Second-grade medical students reported their academic experiences, study methods, and future career plans before (between 2016 and 2019) and during the pandemic (2020) using a questionnaire-based survey at Hokkaido University, Japan (n = 534). Results: From 2016 to 2019, we found an increasing trend for participation in short-term international exchange programs, taking the United States Medical Licensing Examination (USMLE), clinical training, and undertaking research abroad among the students. However, these percentages significantly declined (to 35.5%) during the COVID-19 pandemic in 2020 for all the assessed future plans, including short-term exchange programs (-27.9%), taking USMLE (-19.8%), clinical training (-24.5%), and undertaking research abroad (-13.2%) compared to 2019, wherein 67.9% of the students wished to have at least one of these four above-mentioned academic activities. Conclusions: The COVID-19 pandemic adversely and significantly influenced our medical students' plans to go abroad for clinical and research training. Future studies are warranted to assess the long-term influence of this pandemic on the career planning of medical students.

Impact of COVID-19 on international medical education and the future plans of medical students in Japan [version 2;peer review: 2 approved]

Background: The aim of this study was to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the current study methods and future plans of medical students compared to those in the pre-pandemic period. Methods: Second-grade medical students reported their academic experiences, study methods, and future career plans before (between 2016 and 2019) and during the pandemic (2020) using a questionnaire-based survey at Hokkaido University, Japan (n = 534). Results: From 2016 to 2019, we found an increasing trend for participation in short-term international exchange programs, taking the United States Medical Licensing Examination (USMLE), clinical training, and undertaking research abroad among the students. However, these percentages significantly declined (to 35.5%) during the COVID-19 pandemic in 2020 for all the assessed future plans, including short-term exchange programs (-27.9%), taking USMLE (-19.8%), clinical training (-24.5%), and undertaking research abroad (-13.2%) compared to 2019, wherein 67.9% of the students wished to have at least one of these four above-mentioned academic activities. Conclusions: The COVID-19 pandemic adversely and significantly influenced our medical students’ plans to go abroad for clinical and research training. Future studies are warranted to assess the long-term influence of this pandemic on the career planning of medical students.

Humoral response to mRNA-based COVID-19 vaccine in patients with myeloid malignancies.

Data on the response to the COVID-19 vaccine in patients with myeloid malignancy, who are at severe risk in case of infection, have not emerged. In a study of 69 patients with myeloid malignancies, including 46 patients with acute myeloid leukaemia (AML) and 23 patients with myelodysplastic syndrome (MDS), anti-spike SARS-CoV-2 antibody titres were measured 3 months after the second mRNA-based vaccination. Seroconversion rates for AML and MDS were 94.7% and 100% respectively, with no significant difference from healthy controls (HCs). Patients with MDS showed a significantly lower antibody titre than that in HCs or AML patients. In AML patients, the antibody titres were comparable to those in HCs when treatment was completed, but lower in patients under maintenance therapy. The response to COVID-19 vaccine appears to be related to disease and treatment status. Patients with myeloid malignancies may be more responsive to vaccines than patients with lymphoid malignancies.