Key Words: Medical Students, CoronaVirus, Medical Students COVID19, Final Year Students, COVID19, Final Year Students COVID19, Medical Students Pandemic, UK Medical Students,
Acknowledgements:
Acknowledge the support of Dr Syed Arshad Husain (Consultant Respiratory Physician, MTW, NHS Trust):
ABSTRACT
As a result of the current outbreak of the COVID-19 pandemic, there has been an increase on the load on hospitals throughout the UK, with the introduction to more severe cases that require oxygen and ventilatory support in hospitals. Eventually, all hospitals will be rapidly experiencing an increase in hospitalisation in due time. As a result, new hospitals are being established to accommodate the shortage of beds and space, for this increasing number of patients. These hospitals will require a large amount of manpower to support the care of these patients and help them to recover swiftly and effectively.
This is an important time of national crisis where medical students can aid in serving the nation, and therefore I have tried to enumerate and enlist the ways that medical students throughout the UK, could step up and fill this gap of manpower shortage in the National Health Service. I have also begun to explore the many possibilities medical students can undertake to support the team of doctors and nurses, by also touching upon the recommendations given by the National Regulatory Bodies on the recruitment of medical students into the NHS workforce.
Introduction:
On the 30 January 2020, WHO (World Health Organization) announced the outbreak of COVID-19 as a Public Health Emergency of International Concern (1). Currently the growth of COVID-19 cases are exponentially increasing day by day reaching a total of 14,543 cases and 759 patient deaths in the UK as of the 27th March (2). This virus will lead to a detrimental impact on the NHS, having already been overworked with an increasing shortage of healthcare staff. Recently, the ‘ExCeL centre’ in East London have devoted a makeshift field hospital providing between 4,000-5000 hospital beds equipped with oxygen and ventilators (3). We must raise the question:
Who will be able to look after the patients occupying the extra beds, providing the NHS are short on staff?
This is where medical students come in and serve as the second line to helping the NHS tackle the current global crisis. Not only working for the NHS but also, they may have a role in educating and spreading awareness in local communities and volunteering in the social services.
In this article, we will explore the different ways medical students can help reduce the load on the NHS and support the local community:
HOW CAN PRE-CLINICAL STUDENTS HELP THE NHS? (Year 1-2)
Most UK Medical Students in pre-clinical years are able to take a comprehensive history and carry out basic examinations covering majority of the body systems. Some students are able to use their history taking skills to come up with a differential diagnosis and report the positive findings to the senior doctors in-charge. Although they may lack more advanced clinical skills that can be carried out by senior medical students, they are still able to offer a fair amount of support under careful supervision:
In the hospital, students are able to give updates to the patients’ relatives on the telephone. They can explain how the patient is progressing with their COVID19 infection where arrangements can be made to speak to the senior doctors in-charge, as they are not usually allowed to come in to the hospital at this time. Furthermore, they can help out with the nursing team in collecting and tabulating the blood results to present any findings from the blood results to the senior doctors. Some students can also assist the medical team in the process of clarking new patients, providing they wear the appropriate protective equipment. During the consultation, they can help out with note-taking with the doctor and relay any positive findings to the supervising clinicians. However, some patients may not be comfortable in these tasks and so it is important that if students are placed in a situation that they are not competent in or are unsure on what to do, they must discuss this with their supervisor.
Apart from the hospital, they can get involved in the current research that is taking place to find more about how the virus works and the potential treatment options we can use for COVID19 patients e.g. helping run clinical drug trials.
HOW CAN CLINICAL STUDENTS HELP THE NHS? (Year 3-5)
These students are able to take on more duties in the clinical setting as they are closer to completing their training of becoming a doctor. It has been reported that already some final year medical students at the University of Liverpool have volunteered in the hospital to lend a helping hand to the doctors in the wards (5). This could potentially mean that the more experienced doctors can focus on working in the busier wards whilst the medical students under supervision, can manage those patients that are not suffering from coronavirus-related illnesses. However, “students must be supervised to be safe, act within their competence and not undertake any duties of a doctor” (6).
In the hospital, depending on the roles they have been trained for, they can get involved in many different ways. They can see patients presenting to the emergency department and direct them to the correct areas of specialty where the specialist doctors can manage them. In addition, they can work alongside the nursing team in roles that don’t require registration such as Healthcare Assistants (HCA). HCA can help perform diagnostic investigations such as ECGs, putting up drips or taking blood (7). They can also facilitate the process of discharging patients who have recovered to free up more beds and helping out with the department reception carrying out administrative work. Students are also able to assist with the Pathology team including virus testing in the labs. Along with this, they may assist the hospital pharmacists in dispensing medication and discharging patients. Since the NHS have now received an increase in online calls as COVID19 suspected patients cannot come in, these students can volunteer in helping out with the NHS 111 call handlers’ team (8). This involves taking incoming calls from people who are suspected to have COVID19, providing them with the appropriate guidance and to arrange testing if necessary, within the short timeframe (8).
HOW CAN MEDICAL STUDENTS HELP IN THE COMMUNITY?
As there are limitations into what support the medical students can offer in the hospital, there are opportunities to help out in the wider community:
Recently UCL (University College of London) and Edinburgh medical students have launched a Facebook support group to create a network of medical students that can volunteer to babysit the children of doctors and nurses who are currently working in the frontline of the NHS, providing they have the appropriate DBS checks and babysitting/tutoring experience (9). Furthermore, students can help those who fit in the high-risk criteria of catching the virus by doing their groceries or something as simple as walking their dog. For those students who have carried out paramedic training, they can then support the team in transporting patients to other hospitals, if necessary. Students can also help run the local care homes by volunteering to work at the reception or help out in the kitchen serving food and drink to patients, where the workers themselves may also be elderly and are now self-isolating.
CONCLUSION
The BMA (British Medical Association) have supported the ideas of introducing medical students into the workforce. Although they outline that students must be aware of employment that have ‘unclear arrangements’ (10). The idea of working as an ‘pre-FY1’ allowed by some medical schools still needs to be revised as BMA outline that this role may be available to take up in due time (10).
The GMC and BMA have both agreed that by moving graduation earlier for final year medical students they can work on introducing a short term F1 LAT (locum appointment for training) contract, working near their medical school (10). However, there is ‘no obligation to serve in the NHS’ because of this early provisional registration (10).
The Medical Schools Council have recently set out their guidelines on medical students volunteering to work in the NHS (11). It is important that medical students adhere to these and notify their medical school on their role.
As of 24 March 2020, Matt Hancock, UK Health Secretary, has recently called out for 250,000 volunteers to help fight the UK’s coronavirus outbreak (12). This is the time for medical students to unite and give an extra helping hand with the currently overworked NHS to fight the COVID-19 crisis.
References:
- Who.int. 2020. Coronavirus Disease (COVID-19) – Events As They Happen. [online] Available at: <https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen> [Accessed 28 March 2020].
- GOV.UK. 2020. Number Of Coronavirus (COVID-19) Cases And Risk In The UK. [online] Available at: <https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public#number-of-cases>
- BBC News. 2020. Excel Centre To Be Used As Coronavirus Hospital. [online] Available at: <https://www.bbc.co.uk/news/health-52018477>
- Modelling the impact of Covid-19 on the NHS, 2020. Edge Health. Available at: <https://www.edgehealth.co.uk/post/covid19> [Accessed 28 March 2020].
- Video Coronavirus: The med students who want to help. 2020.Directed by A. Sophia Elahi. Available at: <https://www.bbc.co.uk/news/av/uk-51952737/coronavirus-the-med-students-who-want-to-help>
- General Medical Council. 2020. Information For Medical Students. [online] Available at: <https://www.gmc-uk.org/news/news-archive/coronavirus-information-and-advice/information-for-medical-students>
- Health Europa. 2020. Covid-19: Oxford Medical Students Join Fight Against The Pandemic. [online] Available at: <https://www.healtheuropa.eu/covid-19-oxford-medical-students-join-fight-against-the-pandemic/98818/>
- Jobs.nhs.uk. 2020. NHS Jobs – NHS 111 Call Handler. [online] Available at: <https://www.jobs.nhs.uk/showvac/1/2/915924031>
- University Business. 2020. Coronavirus: Medical Students Ride To The Rescue. [online] Available at: <https://universitybusiness.co.uk/Article/coronavirus-medical-students-ride-to-the-rescue/>
- The British Medical Association. 2020. COVID-19: Early Provisional Registration For Final Year Students. [online] Available at: <https://beta.bma.org.uk/advice-and-support/covid-19/your-contract/covid-19-early-provisional-registration-for-final-year-students>
- Statement Of Expectation – Medical Student Volunteers In The NHS. [pdf] Updated – 24 March 2020: Medical Schools Council, pp.1-3. Available at: <https://www.medschools.ac.uk/media/2622/statement-of-expectation-medical-student-volunteers-in-the-nhs.pdf>
- Sky News (25 March). 2020. Coronavirus: NHS Looking For 250,000 Volunteers As New Hospital Announced. [online] Available at: <https://news.sky.com/story/coronavirus-250-000-strong-volunteer-force-sought-to-help-nhs-deal-with-crisis-11963068>
