CURRENT GAPS IN MEDICAL EDUCATION AS ILLUSTRATED BY THE COVID-19 PANDEMIC: INTERVIEWS WITH PHYSICIANS ACROSS VARIOUS MEDICAL SPECIALTIES

ABSTRACT

BACKGROUND: The COVID-19 pandemic brought unforeseen challenges and had many unfortunate consequences. The unprecedented uncertainty and other drastic changes that were driven by the pandemic illuminated some of the existing flaws in our healthcare system and in medical education. Numerous articles have been published discussing the impact of COVID-19;however, relatively few focus on its relation to medical education, specifically regarding communication, health equity, and uncertainty in medicine. We aim to explore these challenges as opportunities to guide improvements in medical education curriculum in these areas. METHODS: Physicians across Colorado from various medical specialties and unique practice environments were interviewed. We developed a standard set of interview questions that focused on the impact of the pandemic in the context of physicians' practices, the effect on patient care, adaptations, and the impact on trainees' education. Audio files of the interviews were transcribed, analyzed, and tallied according to a list of systematically established themes. The final data was reviewed to identify common and critical themes that could be used as an opportunity to create a positive transformation to medical education. RESULTS: Thirty-one physicians across 20 different medical specialties and sub-specialties were interviewed within the month of April 2020. Analysis of the interviews identified a number of common themes including significant mental health impact, a lack of data to drive clinical decisions, challenges in communication with patients and their families, and a disproportionate impact of the pandemic on underserved communities. Next steps include the administration and analysis of a follow-up survey of proposed innovative solutions for all interviewed physicians. CONCLUSIONS: The pandemic illuminated gaps in our healthcare system that were already present but not readily apparent. These identified themes impact all specialties, demonstrating that many of these gaps are universal in the field of medicine, and we believe that the best way to effect change is to incorporate these topics into medical education. Challenging trainees to navigate complex cases that may lack absolute answers would emphasize critical thinking and better prepare physicians for the uncertainties and complexities of medicine. As telehealth has transformed healthcare delivery, students must learn to navigate the nuances of virtual care without sacrificing the quality of care. Also, the increased prevalence of anxiety has highlighted the importance of being adequately trained to identify and address mental health disorders regardless of medical specialty. Lastly, the pandemic's disproportionate impact on underserved populations emphasizes the importance for students to be well-versed on topics such as health equity, policy reform and advocacy, and economics in ways that allow for actionable change.