Pandemic Perspectives: Clinical Clerkship during COVID-19

Bianca Villanueva

Ateneo School of Medicine and Public Health, Philippines

Bianca is a medical clerk who finished her Master of Business Administration (MBA) course requirements in Ateneo Graduate School of Business while taking up her medical degree.

What Was Your Life Like Before COVID?

When my country went into lockdown, I was in my 3rd year of medical school. I would wake up at 4 a.m. every morning to go to school every day. Lectures would usually be in the mornings and sometimes in the afternoon, we would have labs for clinical skills. On Fridays, I would attend my MBA classes, then head to the hospital right after. After class, I’d go out with my friends or family, or go on dates. I would also spend my weekends studying out with friends in different cafés. Suffice to say, I had mastered my work-life balance to a ‘T.”

What Were Some Major Changes You Noticed Because of COVID, Compared to what your life was like before?

At first, I only noticed the little things. My bedroom became both my work and resting place, so I had to rearrange it because I don’t want to sleep in the same place I work. The Internet became one of the most important things that on some days, I’d have to ask my neighbor if I could use their Wi-Fi if mine had poor connection. But the most jarring change was the lack of skills training. So when I did get back to the hospital, I was very out of practice. It was sad, and most of my favorite restaurants closed down!

In the hospital, we had to always wear Personal Protective Equipment (PPE), not only because we could get ourselves sick, but our families as well. The fear of catching COVID was awful. Some students had to move out of their houses to continue working in the hospital. Patients were too scared to visit the hospitals and terrified of people in white coats and scrubs.

I had people stare at me and security guards stop me in public because I was wearing my white coat. What was once a symbol of healing became a source of fear.

How Were Your Studies Affected by COVID?

When the lockdown happened, my studies didn’t have a lot of direction. I felt like I studied a lot less compared to before because the feeling of being in school really gets you in the mood to study. Everything was online, which was hard to adjust to at first.

In the hospital, the number of patients coming in was reduced because people were scared of getting COVID. So, there weren’t a lot of patients to learn from. The time between the lockdown and returning to the hospital left many of us out of practice, too. A consultant once asked me to attach a cardiotocography machine transducer (a machine that helps with monitoring fetal heart rate and uterine contractions) to a patient and I had no idea how. Luckily, I had patient interns and residents to teach me how and help me learn.

What Impact Has COVID Had on Your Feeling of Being Prepared For Your Career After Medical School?

For me, the worst feeling was knowing my skills were not where I thought they would be when I became a clerk. I wasn’t that good at working the hospital equipment. Doctors would expect us to know how to suture properly, take patient history with perfection, and insert an IV on the first try. But in reality, we were just students who hadn’t seen a single patient for months. I didn’t feel ready.

But like many of my classmates, I’m determined to make the most of what I have. It may not have been the experience I wanted, but there’s merit to working in during the pandemic. Am I prepared to be a doctor? No. But eventually I will be the best doctor I can be, and this pandemic will have played a big part in it.

Which Resources and Strategies Were Most Helpful For You?

Clerkship and internship are not meant to be done online. They’re supposed to be dedicated to patient interaction and clinical skills, which you can’t do through a Zoom call. But we weren’t left with many options. So, we had to be resourceful and our creativity was put to the test. We learned to do teleconsults and teach patients how to perform Physical Exams on their own through video calls.

I had to use my family members as patients – sometimes even my dog to act as my “baby” for Obstetrics.

A lot of online resources kept me going. Without the feeling of being in school, it’s easy to lose track of what you should be studying. I had to study on my own. But there were times I would study with friends over Zoom or Discord, which kept me focused. There are also books and other resources that can give you a good direction on where to study. I even found myself binge-watching Lecturio videos before my rotations, which really helped.

What Has COVID Taught You? What Is Something You Will Take Away From Your Experience During COVID?

If there’s anything the COVID pandemic has taught me, it’s that I was capable of a lot more than I thought. Despite everything, everyone had to look out for each other. We couldn’t keep sitting on our hands. You can make a huge difference, even as a medical student. While doctors and frontliners were working overtime, it was the med students who had to step up, too. I learned to make the most of what I had, too. If I couldn’t learn from the hospital, I could learn from volunteer work. So I volunteered for various projects such as donation drives, vaccination drives, contact tracing, and paperwork for COVID patients while I wasn’t working in the hospital yet.

So, don’t think of being a student as a limit. Of course, there are some things only licensed professionals can do, but a person can help a community with the right resources and mindset. My patients may not have been from the hospital like I thought they would, but they were friends, family, and community members who asked for my help at a time when help was scarce. After everything, I know that little by little and in our own ways, we’re doing what we can to end this pandemic.