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Having active COVID-19 within the community raises complex questions about the roles and responsibilities of medical students in a time of the global pandemic. COVID-19 has had many adverse effects on medical student learning by disrupting teaching opportunities and limiting clinical contact, particularly during the most stringent lockdowns. New Zealand's medical schools have worked hard to mitigate these problems by using online classes, assessments and innovative teaching methods. However, among these challenges, new opportunities for student engagement have emerged. There have been documented examples from around the world of senior clinical students contributing in various ways to the medical response to COVID-19.[[1,2,3]] The same has occurred in New Zealand. For example, senior students from the University of Otago Medical School (OMS) have volunteered in COVID-19 testing, screening and vaccination clinics. At Auckland Medical School (AMS), year two and three students have worked as contact tracers, while clinical students were offered an opportunity to become vaccinators. As such opportunities have emerged, both schools have needed to consider the safety of students engaged in these activities and the impact on their learning, including their professional development.

The arrival of the COVID-19 Delta variant into New Zealand meant the lockdown approach that worked so well in 2020 was less effective in containing community transmission. Achieving high levels of community vaccination rates now appears to be our best means of responding to the pandemic. Students at all levels of learning can assist by supporting public health measures and encouraging vaccination uptake. Students will often find themselves fielding questions from friends, whānau, or members of the public on health issues pertaining to COVID-19 and the vaccination response, in particular. In these situations, students have the opportunity to make a valuable contribution to the nation's response by addressing common concerns and affirming the substantial benefits of vaccination. Through these simple actions, they participate in improving the health of all members of our community, either directly or through a halo effect for more vulnerable individuals who cannot or are less likely to be vaccinated.

The Medical Council of New Zealand (MCNZ) holds a clear position on vaccination. This position has been reiterated recently in response to a small number of registered doctors who have made statements inconsistent with the weight of evidence regarding the safety and efficacy of COVID-19 vaccinations. In August 2021, Dr Curtis Walker, the Chair of the MCNZ, released the following in a media statement:

[It is the] Council's view that there is no place for anti-vaccination messages in professional practice, nor any promotion of anti-vaccination claims including on social media and advertising by health practitioners. Council expects doctors to be aware of, and comply with, its published standards of clinical and ethical practice.[[4]]

The Council's full statement on the COVID-19 vaccine and professional responsibility, published in conjunction with the Dental Council of New Zealand, states:

You have an ethical and professional obligation to protect and promote the health of patients and the public, and to participate in broader based community health efforts. Vaccination will play a critical role in protecting the health of the New Zealand public by reducing the community risk of acquiring and further transmitting COVID-19.[[5]]

These statements pertain to qualified doctors, but medical students have similar responsibilities. In addition, the community often views medical students as having access to information that is not readily available to others. Because of this, the views of a medical student are often held in high regard, irrespective of that student's level of training.

The Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago is a document that all medical students in Aotearoa New Zealand sign at the commencement of their studies. This document states:

Patients and whānau place significant trust in the medical profession and also in those learning to be a doctor. Whenever you meet people, you represent the Medical School, the University, and the medical profession. Your behaviour both within and outside of the clinical environment should uphold the reputation of the medical profession that you are joining.[[6]]

This document also states that students have an obligation to be careful about advice or information they give out. Under the heading ‘Appreciating the limits of my role’ students are required to declare that they will:

not give advice or provide information to patients, whānau or the general public, that is beyond my level of knowledge and expertise. When asked for such comment, I will direct that person to an appropriate professional.[[6]]

Navigating these requirements can be challenging for medical students. While most are aware of their own limitations, they may feel an expectation to be authoritative, and this may prompt them to express their thoughts with greater certainty than their level of expertise warrants.[[7]] Alternatively, medical students who are aware of the professional requirement to play a positive role in public health measures (such as those stated by the MCNZ), may feel hesitant about doing so because they are also aware they should not give advice “beyond their level of knowledge and expertise”. Additional tensions arise as they learn to negotiate their identities as private citizens able and entitled to comment on issues of public interest (which on medical issues is more likely to be a well-informed position consistent with the prevailing medical consensus), and as a medical student constrained by their level of training.[[7]]

These tensions will be familiar to practitioners from many health professions. For many, it requires ongoing vigilance to find the appropriate balance between the personal and the professional—a skill that all health professionals need to acquire. This crucial element of professional development is another area of immediate learning that has emerged for medical students with this pandemic.

Summary

Abstract

The COVID-19 global pandemic has highlighted the potential roles and responsibilities of medical students in healthcare systems. Senior clinical students may be able to contribute practically, but all medical students, regardless of their level of training have the opportunity to assist public health measures, eg supporting vaccination uptake. Medical students may tread a difficult line in such situations. On one hand, students are advised not to act beyond their level of expertise, yet they can feel an expectation to be authoritative by the community. Navigating these spaces can be challenging for medical students and an important part of their professional development.

Aim

Method

Results

Conclusion

Author Information

Lynley Anderson: Acting Dean Dunedin School of Medicine, University of Otago, Dunedin. Simon Walker, Lecturer, Convener Professional Practice Subcommittee, Bioethics Centre, University of Otago, Dunedin. Tony Zaharic: Director Early Learning in Medicine Programme, University of Otago. Kristin Kenrick: Associate Dean Medical Education, University of Otago, Dunedin. Rathan M Subramaniam: Professor of Radiology and Nuclear Medicine, Department of Medicine, University of Otago, Dunedin.

Acknowledgements

Associate Professor Andy Wearn, Head of the Medical Programme, University of Auckland.

Correspondence

Lynley Anderson: Bioethics Centre, Dunedin School of Medicine, University of Otago. PO Box 56 Dunedin, (03) 4716132.

Correspondence Email

lynley.anderson@otago.ac.nz

Competing Interests

Nil.

1) Mitchell H, Coronelli M, Sanderson J. Medical students working as health care assistants: a letter response in the COVID-19 pandemic. Clin Teach. 2020 Oct;17(5):583-584.

2) Reddy RK, Palmer EG. Response to: 'Medical students' preference for returning to the clinical setting during the COVID-19 pandemic'. Med Educ. 2020 Dec;54(12):1192.

3) Stokes DC. Senior Medical Students in the COVID-19 Response: An Opportunity to Be Proactive. Acad Emerg Med. 2020 Apr;27(4):343-345.

4) Walker, C. (2021) Media Release-Medical Council of New Zealand https://www.mcnz.org.nz/about-us/news-and-updates/media-release/ (Accessed 6 October 2021)

5) Dental Council, Medical Council New Zealand https://www.mcnz.org.nz/assets/standards/Guidelines/30e83c27d9/Guidance-statement-COVID-19-vaccine-and-your-professional-responsibility.pdf (Accessed 6 October 2021)

6) University of Otago, University of Auckland (2020) Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago. https://www.otago.ac.nz/oms/otago614506.pdf (Accessed 6 October 2021)

7) Stubbing EA, Helmich E, Cleland J. Medical student views of and responses to expectations of professionalism. Med Educ. 2019 Oct;53(10):1025-1036.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Having active COVID-19 within the community raises complex questions about the roles and responsibilities of medical students in a time of the global pandemic. COVID-19 has had many adverse effects on medical student learning by disrupting teaching opportunities and limiting clinical contact, particularly during the most stringent lockdowns. New Zealand's medical schools have worked hard to mitigate these problems by using online classes, assessments and innovative teaching methods. However, among these challenges, new opportunities for student engagement have emerged. There have been documented examples from around the world of senior clinical students contributing in various ways to the medical response to COVID-19.[[1,2,3]] The same has occurred in New Zealand. For example, senior students from the University of Otago Medical School (OMS) have volunteered in COVID-19 testing, screening and vaccination clinics. At Auckland Medical School (AMS), year two and three students have worked as contact tracers, while clinical students were offered an opportunity to become vaccinators. As such opportunities have emerged, both schools have needed to consider the safety of students engaged in these activities and the impact on their learning, including their professional development.

The arrival of the COVID-19 Delta variant into New Zealand meant the lockdown approach that worked so well in 2020 was less effective in containing community transmission. Achieving high levels of community vaccination rates now appears to be our best means of responding to the pandemic. Students at all levels of learning can assist by supporting public health measures and encouraging vaccination uptake. Students will often find themselves fielding questions from friends, whānau, or members of the public on health issues pertaining to COVID-19 and the vaccination response, in particular. In these situations, students have the opportunity to make a valuable contribution to the nation's response by addressing common concerns and affirming the substantial benefits of vaccination. Through these simple actions, they participate in improving the health of all members of our community, either directly or through a halo effect for more vulnerable individuals who cannot or are less likely to be vaccinated.

The Medical Council of New Zealand (MCNZ) holds a clear position on vaccination. This position has been reiterated recently in response to a small number of registered doctors who have made statements inconsistent with the weight of evidence regarding the safety and efficacy of COVID-19 vaccinations. In August 2021, Dr Curtis Walker, the Chair of the MCNZ, released the following in a media statement:

[It is the] Council's view that there is no place for anti-vaccination messages in professional practice, nor any promotion of anti-vaccination claims including on social media and advertising by health practitioners. Council expects doctors to be aware of, and comply with, its published standards of clinical and ethical practice.[[4]]

The Council's full statement on the COVID-19 vaccine and professional responsibility, published in conjunction with the Dental Council of New Zealand, states:

You have an ethical and professional obligation to protect and promote the health of patients and the public, and to participate in broader based community health efforts. Vaccination will play a critical role in protecting the health of the New Zealand public by reducing the community risk of acquiring and further transmitting COVID-19.[[5]]

These statements pertain to qualified doctors, but medical students have similar responsibilities. In addition, the community often views medical students as having access to information that is not readily available to others. Because of this, the views of a medical student are often held in high regard, irrespective of that student's level of training.

The Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago is a document that all medical students in Aotearoa New Zealand sign at the commencement of their studies. This document states:

Patients and whānau place significant trust in the medical profession and also in those learning to be a doctor. Whenever you meet people, you represent the Medical School, the University, and the medical profession. Your behaviour both within and outside of the clinical environment should uphold the reputation of the medical profession that you are joining.[[6]]

This document also states that students have an obligation to be careful about advice or information they give out. Under the heading ‘Appreciating the limits of my role’ students are required to declare that they will:

not give advice or provide information to patients, whānau or the general public, that is beyond my level of knowledge and expertise. When asked for such comment, I will direct that person to an appropriate professional.[[6]]

Navigating these requirements can be challenging for medical students. While most are aware of their own limitations, they may feel an expectation to be authoritative, and this may prompt them to express their thoughts with greater certainty than their level of expertise warrants.[[7]] Alternatively, medical students who are aware of the professional requirement to play a positive role in public health measures (such as those stated by the MCNZ), may feel hesitant about doing so because they are also aware they should not give advice “beyond their level of knowledge and expertise”. Additional tensions arise as they learn to negotiate their identities as private citizens able and entitled to comment on issues of public interest (which on medical issues is more likely to be a well-informed position consistent with the prevailing medical consensus), and as a medical student constrained by their level of training.[[7]]

These tensions will be familiar to practitioners from many health professions. For many, it requires ongoing vigilance to find the appropriate balance between the personal and the professional—a skill that all health professionals need to acquire. This crucial element of professional development is another area of immediate learning that has emerged for medical students with this pandemic.

Summary

Abstract

The COVID-19 global pandemic has highlighted the potential roles and responsibilities of medical students in healthcare systems. Senior clinical students may be able to contribute practically, but all medical students, regardless of their level of training have the opportunity to assist public health measures, eg supporting vaccination uptake. Medical students may tread a difficult line in such situations. On one hand, students are advised not to act beyond their level of expertise, yet they can feel an expectation to be authoritative by the community. Navigating these spaces can be challenging for medical students and an important part of their professional development.

Aim

Method

Results

Conclusion

Author Information

Lynley Anderson: Acting Dean Dunedin School of Medicine, University of Otago, Dunedin. Simon Walker, Lecturer, Convener Professional Practice Subcommittee, Bioethics Centre, University of Otago, Dunedin. Tony Zaharic: Director Early Learning in Medicine Programme, University of Otago. Kristin Kenrick: Associate Dean Medical Education, University of Otago, Dunedin. Rathan M Subramaniam: Professor of Radiology and Nuclear Medicine, Department of Medicine, University of Otago, Dunedin.

Acknowledgements

Associate Professor Andy Wearn, Head of the Medical Programme, University of Auckland.

Correspondence

Lynley Anderson: Bioethics Centre, Dunedin School of Medicine, University of Otago. PO Box 56 Dunedin, (03) 4716132.

Correspondence Email

lynley.anderson@otago.ac.nz

Competing Interests

Nil.

1) Mitchell H, Coronelli M, Sanderson J. Medical students working as health care assistants: a letter response in the COVID-19 pandemic. Clin Teach. 2020 Oct;17(5):583-584.

2) Reddy RK, Palmer EG. Response to: 'Medical students' preference for returning to the clinical setting during the COVID-19 pandemic'. Med Educ. 2020 Dec;54(12):1192.

3) Stokes DC. Senior Medical Students in the COVID-19 Response: An Opportunity to Be Proactive. Acad Emerg Med. 2020 Apr;27(4):343-345.

4) Walker, C. (2021) Media Release-Medical Council of New Zealand https://www.mcnz.org.nz/about-us/news-and-updates/media-release/ (Accessed 6 October 2021)

5) Dental Council, Medical Council New Zealand https://www.mcnz.org.nz/assets/standards/Guidelines/30e83c27d9/Guidance-statement-COVID-19-vaccine-and-your-professional-responsibility.pdf (Accessed 6 October 2021)

6) University of Otago, University of Auckland (2020) Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago. https://www.otago.ac.nz/oms/otago614506.pdf (Accessed 6 October 2021)

7) Stubbing EA, Helmich E, Cleland J. Medical student views of and responses to expectations of professionalism. Med Educ. 2019 Oct;53(10):1025-1036.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Having active COVID-19 within the community raises complex questions about the roles and responsibilities of medical students in a time of the global pandemic. COVID-19 has had many adverse effects on medical student learning by disrupting teaching opportunities and limiting clinical contact, particularly during the most stringent lockdowns. New Zealand's medical schools have worked hard to mitigate these problems by using online classes, assessments and innovative teaching methods. However, among these challenges, new opportunities for student engagement have emerged. There have been documented examples from around the world of senior clinical students contributing in various ways to the medical response to COVID-19.[[1,2,3]] The same has occurred in New Zealand. For example, senior students from the University of Otago Medical School (OMS) have volunteered in COVID-19 testing, screening and vaccination clinics. At Auckland Medical School (AMS), year two and three students have worked as contact tracers, while clinical students were offered an opportunity to become vaccinators. As such opportunities have emerged, both schools have needed to consider the safety of students engaged in these activities and the impact on their learning, including their professional development.

The arrival of the COVID-19 Delta variant into New Zealand meant the lockdown approach that worked so well in 2020 was less effective in containing community transmission. Achieving high levels of community vaccination rates now appears to be our best means of responding to the pandemic. Students at all levels of learning can assist by supporting public health measures and encouraging vaccination uptake. Students will often find themselves fielding questions from friends, whānau, or members of the public on health issues pertaining to COVID-19 and the vaccination response, in particular. In these situations, students have the opportunity to make a valuable contribution to the nation's response by addressing common concerns and affirming the substantial benefits of vaccination. Through these simple actions, they participate in improving the health of all members of our community, either directly or through a halo effect for more vulnerable individuals who cannot or are less likely to be vaccinated.

The Medical Council of New Zealand (MCNZ) holds a clear position on vaccination. This position has been reiterated recently in response to a small number of registered doctors who have made statements inconsistent with the weight of evidence regarding the safety and efficacy of COVID-19 vaccinations. In August 2021, Dr Curtis Walker, the Chair of the MCNZ, released the following in a media statement:

[It is the] Council's view that there is no place for anti-vaccination messages in professional practice, nor any promotion of anti-vaccination claims including on social media and advertising by health practitioners. Council expects doctors to be aware of, and comply with, its published standards of clinical and ethical practice.[[4]]

The Council's full statement on the COVID-19 vaccine and professional responsibility, published in conjunction with the Dental Council of New Zealand, states:

You have an ethical and professional obligation to protect and promote the health of patients and the public, and to participate in broader based community health efforts. Vaccination will play a critical role in protecting the health of the New Zealand public by reducing the community risk of acquiring and further transmitting COVID-19.[[5]]

These statements pertain to qualified doctors, but medical students have similar responsibilities. In addition, the community often views medical students as having access to information that is not readily available to others. Because of this, the views of a medical student are often held in high regard, irrespective of that student's level of training.

The Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago is a document that all medical students in Aotearoa New Zealand sign at the commencement of their studies. This document states:

Patients and whānau place significant trust in the medical profession and also in those learning to be a doctor. Whenever you meet people, you represent the Medical School, the University, and the medical profession. Your behaviour both within and outside of the clinical environment should uphold the reputation of the medical profession that you are joining.[[6]]

This document also states that students have an obligation to be careful about advice or information they give out. Under the heading ‘Appreciating the limits of my role’ students are required to declare that they will:

not give advice or provide information to patients, whānau or the general public, that is beyond my level of knowledge and expertise. When asked for such comment, I will direct that person to an appropriate professional.[[6]]

Navigating these requirements can be challenging for medical students. While most are aware of their own limitations, they may feel an expectation to be authoritative, and this may prompt them to express their thoughts with greater certainty than their level of expertise warrants.[[7]] Alternatively, medical students who are aware of the professional requirement to play a positive role in public health measures (such as those stated by the MCNZ), may feel hesitant about doing so because they are also aware they should not give advice “beyond their level of knowledge and expertise”. Additional tensions arise as they learn to negotiate their identities as private citizens able and entitled to comment on issues of public interest (which on medical issues is more likely to be a well-informed position consistent with the prevailing medical consensus), and as a medical student constrained by their level of training.[[7]]

These tensions will be familiar to practitioners from many health professions. For many, it requires ongoing vigilance to find the appropriate balance between the personal and the professional—a skill that all health professionals need to acquire. This crucial element of professional development is another area of immediate learning that has emerged for medical students with this pandemic.

Summary

Abstract

The COVID-19 global pandemic has highlighted the potential roles and responsibilities of medical students in healthcare systems. Senior clinical students may be able to contribute practically, but all medical students, regardless of their level of training have the opportunity to assist public health measures, eg supporting vaccination uptake. Medical students may tread a difficult line in such situations. On one hand, students are advised not to act beyond their level of expertise, yet they can feel an expectation to be authoritative by the community. Navigating these spaces can be challenging for medical students and an important part of their professional development.

Aim

Method

Results

Conclusion

Author Information

Lynley Anderson: Acting Dean Dunedin School of Medicine, University of Otago, Dunedin. Simon Walker, Lecturer, Convener Professional Practice Subcommittee, Bioethics Centre, University of Otago, Dunedin. Tony Zaharic: Director Early Learning in Medicine Programme, University of Otago. Kristin Kenrick: Associate Dean Medical Education, University of Otago, Dunedin. Rathan M Subramaniam: Professor of Radiology and Nuclear Medicine, Department of Medicine, University of Otago, Dunedin.

Acknowledgements

Associate Professor Andy Wearn, Head of the Medical Programme, University of Auckland.

Correspondence

Lynley Anderson: Bioethics Centre, Dunedin School of Medicine, University of Otago. PO Box 56 Dunedin, (03) 4716132.

Correspondence Email

lynley.anderson@otago.ac.nz

Competing Interests

Nil.

1) Mitchell H, Coronelli M, Sanderson J. Medical students working as health care assistants: a letter response in the COVID-19 pandemic. Clin Teach. 2020 Oct;17(5):583-584.

2) Reddy RK, Palmer EG. Response to: 'Medical students' preference for returning to the clinical setting during the COVID-19 pandemic'. Med Educ. 2020 Dec;54(12):1192.

3) Stokes DC. Senior Medical Students in the COVID-19 Response: An Opportunity to Be Proactive. Acad Emerg Med. 2020 Apr;27(4):343-345.

4) Walker, C. (2021) Media Release-Medical Council of New Zealand https://www.mcnz.org.nz/about-us/news-and-updates/media-release/ (Accessed 6 October 2021)

5) Dental Council, Medical Council New Zealand https://www.mcnz.org.nz/assets/standards/Guidelines/30e83c27d9/Guidance-statement-COVID-19-vaccine-and-your-professional-responsibility.pdf (Accessed 6 October 2021)

6) University of Otago, University of Auckland (2020) Code of Professional Conduct for Medical Students at the Universities of Auckland and Otago. https://www.otago.ac.nz/oms/otago614506.pdf (Accessed 6 October 2021)

7) Stubbing EA, Helmich E, Cleland J. Medical student views of and responses to expectations of professionalism. Med Educ. 2019 Oct;53(10):1025-1036.

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