Impact of the COVID-19 Pandemic on Medical Students' Perceptions of Health Care for Vulnerable Populations.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic highlighted the shortcomings of our health care delivery system for vulnerable populations and created a need to rethink health disparity education in medical training. We examined how the early COVID-19 pandemic impacted third-year medical students' attitudes, perceptions, and sense of responsibility regarding health care delivery for vulnerable populations. METHODS: Third-year family medicine clerkship students at a large, private medical school in Philadelphia, Pennsylvania responded to a reflection assignment prompt asking how the COVID-19 pandemic impacted their thoughts about health care delivery for vulnerable populations in mid-2020 (N=59). Using conventional content analysis, we identified three main themes across 24 codes. RESULTS: Students recognized homeless individuals and Black, indigenous, and persons of color (BIPOC) as vulnerable populations impacted by the pandemic. Students reported causes of vulnerability that focused heavily on social determinants of health, increased risk for contracting COVID-19 infections, and difficulty adhering to COVID-19 prevention guidelines. Notable action-oriented approaches to addressing these disparities included health care reform and community health intervention. CONCLUSIONS: Our findings describe an educational approach to care for vulnerable populations based on awareness, attitudes, and social action. Medical education must continue to teach students how to identify ways to mitigate disparities in order to achieve health equity.

A qualitative analysis of third-year medical students' reflection essays regarding the impact of COVID-19 on their education.

BACKGROUND: The COVID-19 pandemic fundamentally changed every aspect of healthcare delivery and training. Few studies have reported on the impact of these changes on the experiences, skill development, and career expectations of medical students. METHOD: Using 59 responses to a short reflection essay prompt, 3rd year medical students in Philadelphia described how the COVID-19 pandemic affected their education in mid-2020. Using conventional content analysis, six main themes were identified across 14 codes. RESULTS: Students reported concerns regarding their decreased clinical skill training and specialty exposure on their career development due to the loss of in-person experience during their family medicine clerkship. A small number felt very let down and exploited by the continued high cost of tuition while missing clinical interactions. However, many students also expressed professional pride and derived meaning from limited patient and mentorship opportunities. Many students developed a new sense of purpose and a call to become stronger public health and patient advocates. CONCLUSIONS: The medical field will need to adapt to support medical students adversely impacted by the COVID-19 pandemic, from an educational and mental health standpoint. However, there are encouraging signs that this may also galvanize many students to engage in leadership roles in their communities, to become more empathetic and thoughtful physicians, and to redesign healthcare in the future to better meet the needs of their most vulnerable patients.