Education and Research During COVID-19
“What an extraordinary year this has been for our community,” said Peter Bates, dean ad interim of the School of Medicine, as he welcomed Reunion celebrants from across the country via Zoom in May. Despite—and in some cases because of—the year’s incredible challenges, Bates affirmed that the school had a year of success and growth, due to “the resolve and resilience of our faculty, our staff and our amazing students.”
Here, students and faculty share their reflections on the year, and some important questions: What is it like to be a student of medicine, public health or other health-related disciplines in the time of COVID-19? How has didactic and clinical education transformed during the pandemic? How have faculty and administrators led each of the school’s programs, and served students, in such extraordinary circumstances? What strategies and plans kept research moving forward, in and out of the labs? Finally, what lessons, losses, and celebrations will we take from this remarkable year, into the future?
Medical Education
“From 100% in-person learning, to 100% online learning in a weekend”
On the weekend of March 8, 2020, as the COVID-19 pandemic accelerated across the globe, Bates, Dean of Students Amy Kuhlik, and Dean of Educational Affairs Scott Epstein gathered for their standing dean’s team check-in. Their meeting was routine, but their agenda was not: In light of the rapidly growing pandemic, should medical education be paused, and if so, how? “We very quickly made the decision that we would be remote for the rest of that semester,” says Epstein, and “started to plan for a hybrid curriculum. We had to go from 100% in-person learning to 100% online learning in a weekend. And the faculty and students rose to the challenge.” Kuhlik describes other hurdles, such as the creation of robust surveillance testing, contact tracing and quarantine procedures. (While some medical students contracted COVID, none became seriously ill.)
Medical students in each class found ways to use “remote learning” time productively. For Christina Damon, M23, a Maine Track student, that meant spending her non-clinical time in Burlington, Vermont, where her fiancé is completing his residency. Angela Ryck, M22, balanced her studies and boosted her spirits by maintaining her life-long passions of running and playing the violin. For Robert Cerulli, M22, GBS22, time at home was a chance to keep pace with research and clinical education—and bond with his newborn son. From her bedroom/office, LeAnn Louis, M21, MG21 (MPH), attended classes, student council meetings, and residency interviews, and she learned that she’d received the 2021 Tufts Presidential Award for Civic Life.
Though online learning was an invaluable tool, says Epstein, “we tried to have as much in person education as we could safely do.” This meant adapting classes like the all-important General Anatomy course. Instead of “traditional, shoulder-to-shoulder, cadaveric dissection, where you’re in the lab for three hours,” students rotated through in small teams, wearing N95 masks and goggles, to work with cadavers prepped by faculty and fourth-year students.
“From the word ‘go’, our students did everything we’d want them to do,” he adds, and fully recognized that as future physicians “they have an essential role to play in the pandemic.” Kuhlik shares his admiration for the students, starting with first- and second-year students who found myriad ways to support physicians, health-care workers and hospital staff with food delivery, childcare, cleaning, updating patient families, and more. Zoom was the home of lectures, study groups, faculty meetings, “happy hour” socials, and residency interviews. Remote interviewing enabled fourth-year students to save time and money and accept more interviews than they could have in person. Learning the results of those interviews was also an online event.
“Not being there in person on Match Day was a little hard,” Kuhlik confesses, yet “we got to see a sliver of everyone’s life.” John Chahraban, M21, was at home in Andover, Massachusetts, when he learned that he’ll be a resident in internal medicine at Tufts Medical Center. “Match Day was incredibly fulfilling,” he says. “I got to spend it with my family—my mom, dad, younger brother and my girlfriend. That was an amazing moment to be with them.”
“Safe, gowned up, and ready to treat my patients”
“I don’t think any of us in our wildest dreams thought we’d have three highly effective vaccines within a year of the beginning of this pandemic,” says Kuhlik. Luckily for students and patients, Tufts’ teaching hospitals classified third- and fourth-year medical students as essential workers, making them among the earliest groups to qualify for vaccination in January.
“It was a difficult transition,” says Elizabeth De Jesus, M21, when clinical education went remote for much of the spring and summer, but because they were going through those challenges together, connections between classmates deepened, and remote learning gave students more time for in-depth discussions with teaching faculty. When De Jesus, who matched to a surgical residency at the University of Pennsylvania, returned to the clinical setting, patient safety was top of mind. “Tufts did a phenomenal job of surveillance testing. I cannot overemphasize how easy it was to go in for my testing, know my results, and definitely step into the clinical setting, knowing that I was safe, gowned up and ready to treat my patients.”
“I was so glad to get back into the clinical environment,” says S. Spencer Scott, M21, class president. Scott credits faculty and staff with making the year not just workable, but an opportunity to learn and grow. “I felt very safe, valued and cared for within the Tufts community.” Scott was part of a group that created a social compact of guiding principles for Tufts medical students—a student-driven project that Kuhlik says exemplifies their stellar ethics and professionalism. Like many of his peers, Scott says the pandemic has deepened his commitment to medicine. “What was amazing to me as an aspiring physician was the enormous outpouring of support by our country for medical providers from every discipline.” The reshuffling of clinical rotations afforded Scott extra time to reflect on his choice of specialty. “I really am in love with surgery,” says Scott, who matched to surgical residency at Maine Medical Center. “I can’t wait to begin.”
Public Health and Professional Degree Programs
“The pandemic has been an unbelievable case study, and we’re living it.”
Aviva Must, Dean of Public Health and Professional Degree Programs and Morton A. Madoff, M.D., M.P.H., Professor and Chair of Public Health and Community Medicine, compares last spring’s unfolding health crisis to a swiftly approaching storm. “It was like rolling thunder,” she says, followed by an intensity of planning and implementation unlike any she or her colleagues had experienced before. Each program’s unique content and student body required different adaptations. “Probably the most complex and challenging were for clinical students in the Physician Assistant program,” she says. Master’s in Public Health candidates made creative adjustments to their applied learning experiences, moving much of this applied work online. “It wasn’t perfect, but we did it,” says Must, adding that one advantage was the existence of many 21st century online learning and teaching systems that could be rapidly scaled up. “If this had happened in 2005, we could have lost a year of learning.” Instead, technology made shifts to remote learning possible for students, including those in the Master’s in Biomedical Sciences (MBS) program. “The MBS faculty worked hard, the students were flexible, and together they created a wellness initiative to keep everybody engaged and motivated.” This was just one example, Must says, of the creative, flexible spirit of faculty and staff. “The students were just amazing. They did a lot of work to support each other.” She also highlights the exceptional work of support staff, including Student Services staff, and University Educational Technology and Learning Spaces. Supports were shaped by the unique circumstances of individual students. For some, living and studying at home meant negotiating crowded working/living spaces, solving childcare issues, or—for international students in particular—dealing with social isolation while removed from school, family, and friends.
“Overlaying all of these pandemic challenges were the racial justice issues that were front and center for much of the year,” observes Must. In addition to meeting academic needs, “we were trying to have a community where we could talk about these difficult issues, where students could feel there were safe spaces to process what they were experiencing, either as students of color or students who are not of color simply working to understand the magnitude of these events.”
Across public health and professional degree programs, students and faculty found ways to integrate the pandemic into their disciplines, from health communication to infectious disease. Students were actively engaged in community efforts like contact tracing and health education through social media, often in partnership with other schools. Among the unexpected lessons of this year, Must says, was that “we were forced to appreciate how resilient and adaptable we are.” Students and scholars are just beginning to unpack the year’s events. “The pandemic has been an unbelievable case study, and we’re living it. I think we’ll be digesting this and writing case studies for decades.”
Biomedical Research
“This community as a whole did really well, and everyone deserves credit for that.”
“Even for me, as an infectious disease doctor, the rapidity and scale of the pandemic were a surprise,” says Linden Hu, vice dean of research and Paul and Elaine Chervinsky Professor of Immunology. When the medical school closed, Hu and his colleagues had the monumental tasks of shutting down dozens of laboratories and research projects and supporting the faculty and students whose lives were intricately tied to those spaces. “We tried to be as transparent as possible and make the best judgments we could,” Hu says, given the limited science available. One important advantage was that “this is a scientific community, and people here listen to science.” Each area of the research enterprise responded a bit differently, Hu explains. “For the most part, people were able to find ways to be productive” while removed from their labs. “Some of us spent time writing up existing data, or writing review papers. My lab worked on building a website—these are things that we’ve always wanted to do but didn’t have time for because we’re so involved in the science.” Hu acknowledges that for some students and faculty, the loss of active research time will not be easily overcome. “I think we’ll need to find ways to support these researchers and help them get back to where they were,” Hu says.
Like his fellow deans, Hu feels that the year has revealed strengths of the school and highlighted areas for growth. “Communications are definitely better. We’re all learning about work from home—what’s possible and what’s not. Tufts has taken quite a conservative approach through the pandemic, and to its credit, that has kept people safe.” As Tufts moves toward re-opening, “we know a lot more about the science of COVID-19, what’s going to be safe in a new world where many are vaccinated and there’s a lower endemic rate in the community,” yet it will continue to be “a learning curve for everybody.”
Hu gives tremendous credit to the faculty and students for their cooperative spirit, and to Dean Bates for his outstanding leadership. “Another really good thing that came out of this is the amount of collaboration between the hospitals and universities around Boston, including Tufts. There was a lot of benefit to sharing information and sharing science. I hope that continues post pandemic, because it’s been perfect. There was a real sense of cooperation among these institutions, and that’s something we can all be proud of.”
Working together, the people of Tufts University School of Medicine have done more than survive the year of COVID-19. Drawing on resilience, creativity, and shared values, they grew stronger and supported their communities. Scott Epstein noted that students in every program and discipline have experienced one of the core elements of medicine, public health and scientific research: uncertainty. “In an unusual way it’s helped prepare our students for what lies ahead,” he says, which includes future global health events and all the daily challenges and opportunities of care, service, and discovery. “I think our students will definitely be ready to lead the way.”