To the Editor:
We would first like to applaud Flotte and colleagues at the University of Massachusetts Medical School 1 for ensuring that their final-year students were given the opportunity to respond to the increasing need in the health care system during these challenging times. We also commend these students for their willingness to join the workforce amidst rising fears and concerns of the COVID-19 pandemic, which shows they are ready for their lifelong call as frontline staff. The same opportunity was offered to final-year U.K. medical students through the interim Foundation Year (iFY) programme 2 before they formally started Foundation Year 1 (FY1), comparable to an internship, in August 2020. However, the accelerated graduation and deployment of the new physician cohort into the workforce has had negative consequences.
The confidence of prospective FY1 physicians has been rattled by the transition to the online delivery of lectures, as well as the cancellation of final exams, practical exams, and student electives brought on by the pandemic. In a survey carried out by 33 U.K. medical schools, respondents showed that 38.4% had their final objective structured clinical examinations canceled, while 77.3% had electives canceled. The majority of respondents were less comfortable going into their training due to the unexpected curricular changes since the COVID-19 pandemic. 3
In response to their low confidence in joining the workforce during such a demanding period, new physicians are going to require much more support than usual—including thorough psychological support. However, new physicians may not receive this help should the COVID-19 pandemic reach its highest peak and consequently overwhelm the workforce. In such a case, they may find themselves performing procedures and providing care without supervision, which may unfortunately have bad repercussions. New physicians will not quite acquire the same skills they would have in the absence of social distancing rules on wards, as well as virtual clinics and classes, therefore resulting in a difficult transition to the workforce.
1. Flotte TR, Larkin AC, Fischer MA, et al. Accelerated graduation and the deployment of new physicians during the COVID-19 pandemic. Acad Med. 2020;95:1492–1494.
2. General Medical Council. Provisional registration. https://www.gmc-uk.org/news/news-archive/coronavirus-information-and-advice/provisional-registration
. [No longer available.] Published 2020. Accessed October 5, 2020.
3. Choi B, Jegatheeswaran L, Minocha A, Alhilani M, Nakhoul M, Mutengesa E. The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: A national survey. BMC Med Educ. 2020;20:206.