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CC BY 4.0 · Avicenna J Med 2024; 14(04): 194-203
DOI: 10.1055/s-0044-1795152
Original Article

Medical School Curricular Changes and Their Impact on Mental Health during the Onset of the COVID-19 Pandemic

Authors

  • Leen Al Kassab 

    1   Department of Obstetrics and Gynecology, Mass General Brigham, Harvard Medical School, Boston, Massachusetts, United States

  • Laila Fozouni

    2   Department of Internal Medicine, University of California, San Francisco School of Medicine, San Francisco, California, United States

  • Christopher Reynolds

    3   University of Michigan Medical School, Ann Arbor, Michigan, United States

  • Phuong Pham

    4   Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Harvard Humanitarian Initiative, Boston, Massachusetts, United States

  • Valerie Dobiesz

    5   Department of Emergency Medicine, STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative, Boston, Massachusetts, United States

Funding Research reported in this publication was supported by the National Institute on Aging under Award Number R38AG070171.
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Abstract

Objectives The main objectives were to identify and categorize the curricular changes that occurred in U.S. medical schools during the onset of the coronavirus disease 2019 (COVID-19) pandemic, and to identify the relationship between curricular changes and COVID-19 surges and student mental health.

Methods This Institutional Review Board-approved study consisted of a voluntary online survey of U.S. medical students. A convenience sample of students was reached through Facebook groups, medical student organizations, and administrators. The survey consisted of questions about demographics, curricular changes, and mental health. Univariate and backward stepwise multivariate linear regression were used to assess associations between mental health outcomes and demographic characteristics, curricular changes, and stressors.

Results Four-hundred and nine medical students completed the survey from 21 states between May 29, 2020, and August 29, 2020. Seventy-nine percent of respondents reported continuing their basic science curricula virtually. Forty-five percent reported that rotations continued virtually; those reported being offered virtually included internal medicine (77%), family medicine (78%), surgery (70%), obstetrics/gynecology (73%), pediatrics (74%), and psychiatry (76%). The majority of students reported that core clerkships (78%) and subinternships (86%) were not allowed, and away rotations were universally canceled. In univariate linear regression, having in-person subinternships and core clerkships allowed, as well as not relocating for coursework or residence (experienced by 35% of students), was associated with improved mental health outcomes, while experiencing graduation changes (15%) or being from the Southern region was associated with worse outcomes (p < 0.001).

Conclusion During the early COVID-19 pandemic, students reported that their medical schools adapted by converting to virtual platforms for basic science and core clerkships. Allowing in-person rotations and limiting relocation were associated with improved mental health outcomes among students. Limitations included sample size, selection bias, and student perceptions.

Keywords

medical education - curricular adaptations - mental health - COVID-19

Earlier Presentations

• Regional [poster presentation]: NERDS22; New England Regional Meeting (Society of Academic Emergency Medicine, SAEM). Worcester, MA, April 6, 2022.


• National [poster presentation]: SAEM22; Society of Academic Emergency Medicine. New Orleans, LA, May 11, 2022.


• [Oral presentation]: Syrian American Medical Society (SAMS) 11th National Conference: “Promoting Healthy Communities Through Medical Science, Policy, and Interventions.” Chicago, IL, September 4, 2022.


Note

This study was Institutional Review Board approved, and written informed consent was obtained in the survey before all individual participants voluntarily agreed to proceed in completing it.


Supplementary Material



Publication History

Article published online:
24 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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