COVID-19 vaccination telephone outreach: an analysis of the medical student experience.

INTRODUCTION: The COVID-19 pandemic diminished opportunities for medical students to gain clinical confidence and the ability to contribute to patient care. Our study sought out to understand the value of telephone outreach to schedule COVID-19 vaccines on medical student education. MATERIALS AND METHODS: Forty students engaged in telephone outreach targeting patients aged 65+ without active patient portals to schedule COVID-19 vaccines. Data consisted of a single administration retrospective pre/post survey inquiring about what students learned, expectations, other health-care processes that would benefit from outreach, and interest in a population health elective. Likert items were analyzed and open response analysis involved inductive coding and generation of thematic summaries by condensing codes into broader themes. Demographic data of patients called and subsequently received the vaccine were also collected. RESULTS: There were 33 survery respondents. There was a statistically significant increase in net comfortability for pre-clerkship students for documenting in Epic, providing telehealth care, counseling on common health-care myths, having challenging conversations, cold-calling patients, and developing an initial trusting relationship with patients. The majority called and who received the vaccine were non-Hispanic Black, within the high SVI category, and had Medicare and/or Medicaid. Qualitative data showed that students emphasized communication, the role of trusted messengers, the need to be open minded, and meeting patients where they are. DISCUSSION: Engaging students in telephone outreach early in the COVID-19 pandemic provided students the opportunity to develop their skills as physicians-in-training, contribute to combating the ongoing pandemic, and add value to the primary care team. This experience allowed students to practice patience, empathy, and vulnerability to understand why patients had not received the COVID-19 vaccine; this was an invaluable experience that helped students develop the skills to become empathetic and caring physicians, and supports the continued role of telehealth in future medical school curriculum.

Hypertensive Emergency Caused by Sexual Enhancement Supplements.

INTRODUCTION: In the United States, major depression ranks second among all diseases and injuries as a cause of disability and 40% of patients using antidepressants experience sexual dysfunction. CASE PRESENTATION: A 41-year-old woman with past history of depression and anxiety presented with hypertensive urgency after ingesting a sexual enhancement supplement-BioXgenic-for the first time. Shortly after, computed tomography showed a basal ganglia hemorrhage. After many weeks of rehabilitation, some cognitive deficits remained. DISCUSSION: The US Food and Drug Administration (FDA) does not regulate supplements. The sexual enhancement supplement ingested had monoamine oxidase inhibitor properties and precipitated a hypertensive emergency with an intracerebral hemorrhage. Reducing medication dosage, switching medication, using drug holidays, and changing the time of administration may help alleviate sexual side effects. CONCLUSION: Physicians should inquire about dietary supplements and warn about the risks, encourage patients to report adverse effects with the FDA, and refer to the FDA's Tainted Supplements database for known adulterated supplements.