POSITION PAPER Year : 2022  |  Volume : 35  |  Issue : 2  |  Page : 67-68

The “new normal” for medical education during and post-COVID-19

Fady Andraous, Ghada Essam Al-Din Amin, Mohamed Farouk Allam
Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Date of Submission06-Dec-2022Date of Decision27-Dec-2022Date of Acceptance02-Jan-2023Date of Web Publication12-Jan-2023

Correspondence Address:
Prof. Mohamed Farouk Allam
Department of Family Medicine, Faculty of Medicine, Ain Shams University, Abbasia 11566, Cairo
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/efh.efh_412_20

After outbreaks in more than 110 countries, the World Health Organization declared COVID-19 a global pandemic on the March 11, 2020, heralding unprecedented challenges in medical education. Our aim is to provide a descriptive overview of the impact of COVID-19 on medical education worldwide and to assess its future repercussions. Worldwide, medical students were removed from clerkship training. Clinical skills and practical procedure training transitioned to being online, and in some cases, postponed. Medical educators scrambled to convert the curriculum into online formats. Access to Internet, technology, and computer education posed resource allocation challenges in developing countries and further widened the disparities in medical education. Even in countries where the framework and funding were available to support the online transition, debatably, this arrangement can lead to disparities in clinical skills, bedside manner, and field experience among pre- and post-COVID-19 medical graduates. Challenges extend beyond undergraduate medical education to include the medical licensing process of international and national postgraduates. The international community of medical educators needs to collaborate to drive the future of medical education, as the world adapts to the “new normal.”

Keywords: Clerkship, clinical skills, COVID-19, medical education, online

How to cite this article:
Andraous F, Amin GE, Allam MF. The “new normal” for medical education during and post-COVID-19. Educ Health 2022;35:67-8

On the March 11, 2020, the World Health Organization declared COVID-19 as a global pandemic after outbreaks were reported in more than 110 countries.[1] This global emergency has led to unprecedented challenges in medical education. The world found itself in urgent need of physicians at the frontline combating this international crisis; at the same time, medical education has been interrupted and forced to change – arguably forever.[2],[3]

For more than a decade, medical education has been gradually shifting from didactic to problem-based and independent learning.[3],[4] Even before COVID-19, there was a drift away from the traditional lecture hall setting to small group discussions and interactive online modules. The uses of technology and simulation to enhance the teaching of various domains such as anatomy, emergency medicine, surgery, and family medicine have been ongoing for years.[5]

This transition from didactic to hands-on learning has successfully allowed early patient contact and care. Worldwide, medical students functioning as clerks have become integral members of health-care teams in the clinical fields. In response to COVID-19, medical students were removed from clerkship training. Medical educators scrambled to convert the curriculum into online formats.[3],[6] Clinical skills and practical procedure training transitioned to being online and in some cases, postponed, thus posing a real challenge for medical training and competency. After more than 6 months of fighting against COVID-19, the medical education community struggled with providing medical students the ideal path to securing the completion of their medical training and skill acquisition.

The advantages of online medical education are many; however, so are its demands.[7] Access to technology, Internet, and computer education poses resource allocation challenges in developing countries.[7],[8],[9] As countries tackle inevitable and promising changes to medical education, the reality remains that the cost of medical education in developing countries will become more expensive.[7]

Despite being at an advantage, countries that have invested in a preestablished, online medical education will still face the difficulties associated with renovating curriculum and examination processes. Even in countries where the framework and funding were available to support this transition, debatably, this arrangement can lead to disparities in clinical skills, bedside manners, and field experience among the pre- and post-COVID-19 medical graduates.[3],[6],[10]

Clinical procedures and interview performances, which have been the foundation of medical education and evaluation, are currently witnessing unprecedented changes. With the halt on in-person clerkship instruction, medical undergraduates experienced a pause on the opportunities to gain mentorship and strong letters of recommendation, which conventionally would have paved their career into residency.

Postgraduate programs faced a challenge in evaluating the performance and soft skills of medical students, as objective structured clinical examinations and multiple mini-interviews were halted.[3] Programs were transitioned to online panel interviews or abandoned totally the interview process.[2],[3] Moreover, since these changes extended beyond undergraduate and postgraduate medical education to include the medical licensing process of international and national postgraduates, registration, and licensure will also require renovation. The global need for physicians has witnessed unprecedented measures by nations such as fast-tracking of examinations, early graduation of final year medical students, and the provision of time-limited licenses for international graduates.

All these changes to medical education, evaluation, and assessment are not likely to be short-term. The international community of medical educators will need to collaborate to drive the future of medical education across the continuum of undergraduate, postgraduate, and continuing education. Reinventing the wheel is not needed for some established online curricula; however, the approach to medical teaching and assessment of clinical and practical skills will pose a bigger challenge, as the world adapts to the “new normal”.[4],[6],[10]

The reality of the COVID-19 pandemic entails that this new normal may continue for a long period of time, thus raising these questions:

What is the future of medical education post-COVID-19?How can medical schools teach and assess clinical skills?

Converting the medical curriculum and facilitating virtual evaluation will be tedious, strategic, and time-consuming. Is it time for the medical education community to collaborate internationally to develop common curricula and educational tools?

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 

  References 
1.The World Health Organization. Rolling Updates on Coronavirus Disease (COVID-19). Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen. [Last accessed on 2022 Dec 05, Last updated on 2020 Jul 31].  
    2.Young JR, NooNoo S. Education world reacts to coronavirus: The latest developments. EdSurge 2020; Available from: https://www.edsurge.com/news/2020-03-05-education-world-reacts-to-coronavirus-the-latest-developments. [Last accessed on 2022 Dec 05, Last updated on 2020 Mar 05].  
    3.Rose S. Medical student education in the time of COVID-19. JAMA 2020;323:2131-2.  
    4.Shachar M, Neumann Y. Differences between traditional and distance education academic performances: A meta-analytic approach. Int Rev Res Open Distrib Learn 2003; Available from: http://www.irrodl.org/index.php/irrodl/article/view/153/704. [Last accessed on 2020 Jul 15, Last updated on 2016 Aug 12].  
    5.Ruiz JG, Mintzer MJ, Leipzig RM. The impact of E-learning in medical education. Acad Med 2006;81:207-12.  
    6.Pettersson F, Olofsson A. Implementing distance teaching at a large scale in medical education: A struggle between dominant and non-dominant teaching activities. Educ Inf Technol 2015;20:359-80.  
    7.Africa U. UNESCO AFRICA. Retrieved from UNESCO United Nations Educational, Scientific and Cultural Organization Africa. Available from: http://www.unesco.org/new/en/africa/priority-africa/education/. [Last accessed on 2020 Jul 15, Last updated on 2014 Mar 30].  
    8.McAndrew P, Farrow R, Cooper M. Adapting online learning resources for all: Planning for professionalism in accessibility. Res Learn Technol 2012;20:20-5.  
    9.Donnay P. Challenges and Opportunity of Online Learning in Developing Countries with Specific Focus on Liberia. Bemidji, Minnesota State (USA): Bemidji State University; 2014. Available from: https://www.bemidjistate.edu/academics/departments/political-science/wp-content/uploads/sites/40/2015/05/paygar-thesis.pdf. [Last accessed on 2020 July 15, Last updated on 2020 May 21].  
    10.O'Doherty D, Dromey M, Lougheed J, Hannigan A, Last J, McGrath D. Barriers and solutions to online learning in medical education – An integrative review. BMC Med Educ 2018;18:130.