Although we have been back in the hospital for several months now after a hiatus when COVID-19 was ramping up initially last year, there are a few things that are different about inpatient rotations in the context of COVID-19 precautions now. There are pros and cons to these precautions in light of student learning, however, I have found that generally our experience has been only slightly impacted.
Besides the donning of PPE and the elimination of white coats (for which it seems most people are grateful for!), patient interaction has certainly been reduced, particularly if they test positive for COVID-19. We have transitioned to calling many patients over the phone to gather interval history, especially on consult services where it may not be necessary to see patients in person (i.e. endocrine consults, a heavily numbers-based service where most of the management of patients is dependent on their laboratory values). As a result, the physical examination is deferred in many cases. Additionally, there are a few patients on rounds each morning whom the attending physician will not have students tag along for to prevent overcrowding in rooms; in respect of limiting persons to reduce exposure. Although we have less opportunity to practice our clinical skills and visualize, auscultate, palpate, and percuss pathology in person, I think the physical exam is really the only aspect of patient visits that we are missing out on. The advantage to rounding on fewer patients in person is that this is usually to the patient’s liking, as they are disturbed less often during the day and may be able to better keep information straight, with fewer consultants coming to see them each day.
Overall, I feel safe in the hospital and still feel as if I am getting a valuable learning experience. While we are missing out a bit on the patient interaction component, I believe schools are doing the best they can to keep patients, students, residents, and faculty physicians safe while continuing to facilitate good patient care.