M2 - M4 Clinical Students

M3 Message from Academic Affairs

Howdy Class of 2021, 

We hope that you are doing well. Please remember that Academic Affairs is here to support you and is committed to maintaining and providing the most effective learning experiences possible in the current environment. With that in mind, OAA has coordinated the adjustment of clerkships to maximize learning opportunities without compromising safety or preparation.

Long block 2 students (IMED and SURG) started 5/4/2020 and are expected to transition to patient contact clerkship elements on 6/1/2020.

Short block 3 students (FM, OBGYN, PEDS and PSYCH) started non-patient contact clerkship elements on 5/4/2020 and will then proceed to block 4 non-patient contact clerkship elements on 5/25/2020. Short block 3 and 4 patient contact elements are expected to start on 6/15/2020 and 7/6/2020 respectively.

Clerkships are operating under a modified “front-loaded” format secondary to COVID. That means the first half of a clerkship block will be non-patient contact clerkship elements. These will mostly be online modules, Zoom lectures and didactic materials. However, some clerkships and campuses will have in-person non-patient contact elements such as simulations and telemedicine.

School of Medicine has established the following guidelines for these non-patient contact clerkship elements:

1. The proposed in-person clerkship element is necessary
2. There is no equivalent and satisfactory online/distance learning equivalent
3. There will be no patient contact
4. The conditions will comply with any and all state, local, and TAMU regulations (social distancing, masks, number of people less than 10, etc.)
5. The proposed in-person clerkship element has been discussed/vetted through the respective Executive Clerkship Director/Academic Affairs
6. Consider and plan for students with high-risk conditions that may prohibit in-person participation

Texas A&M and the School of Medicine are actively working to develop a safe and transparent pathway back into the clinical environment. Re-entry planning involves many complex and dynamic pieces, but once the policies and guidelines are finalized, they will be communicated quickly. Maintaining your safety while providing a quality education that meets objectives will be our top priority.

Finally, please work with Academic Success to determine the best study plan and date for Step 2.

USMLE Step 1 and Step 2 Contingency Plan for M2s and M3s

Tuesday, April 14, 2020

Howdy,

We know that you have many questions and concerns regarding the COVID-19 impact on Step 1 and Step 2 exams and Prometric closings. We want to assure you that we have contingency plans in place. As of today, here is what we know and what we are planning:

Step 1

• Kaplan will proceed as planned. If you were previously scheduled to take these courses, you will continue to do so. For everyone else, stick with the first 3 weeks of your schedule as mapped out by Academic Support Services.
• Plan A: If Prometric opens and you can take your test as originally scheduled, you will proceed as planned in your current clinical rotations. These will begin on July 6th.
• Plan B: If Prometric is not open by June, then you will continue with your clinical schedule. Should this occur, we will be sending additional info on how we will handle your schedule. Then, when Prometric opens, you can reschedule your test date. You will be given some dedicated preparation time prior. Work with Academic Success to reschedule your exam; however, if this affects your clinical schedule, then contact Dr. Chen directly as he is the one who does the tweaking of schedules in SA. Work with Academic Success (Hairrell, Diem, Chance, Santerre) for specific preparation time.
• Plan C: If the situation with COVID-19 leads to an extended closure of Prometric Testing Centers, your Step 1 study block will be moved to Career Explorations. Understand that this is a worst-case scenario and one that will only occur if there is an extended closure that is beyond our control. In this scenario, remember that the entire country has likely been impacted so everyone will be adjusting!

AIM students Step 1

• Please refer to the communication you received last week and today.

Step 2 CK

• If you are scheduled to end your year in back to back short clerkships, we recommend that you reschedule your exam for mid-August. There are dates available right now so we recommend you make that adjustment soon. Work with Academic Support and the Navigators to plan your adjusted schedule.
• If you end on IMED or Surgery you may be able to keep your date as scheduled. Reach out to your campus Academic Support team member to work through this planning.
• The original September 20th deadline for Step 2 CK is now Nov. 30th. The School of Medicine expectation is that it will be taken by or before Nov. 30. However, if this becomes impossible, reach out and we will work with you.

Step 2 CS

• If you must move your exam to a time that falls within an elective or clerkship, you will receive an excused absence the day before and the day of the exam for your clerkship or elective.
• Work with Academic Support Services to plan your study.
• Be precautious about things you hear about CS given there is a lot of false information being shared. Reach out to SA with any rumors you are hearing so that those rumors can be addressed.

For Health Resources (Physical & Counseling) during this time:

• https://medicine.tamu.edu/academics/students/personal-counseling-resources.html
• https://health.tamu.edu/care/student-health/index.html
• For appointments: https://medicine-tamuhsc-insight.symplicity.com
• Academic Support Services website: http://medicine.tamhsc.edu/academic-support/

THE RUMOR MILL FOR M3’S AS OF APRIL 14

Regarding Step 2CK

"Step 2CK is going to be eliminated (from the residency requirement, from being a graduation requirement)."
FALSE. We have been on many national phone calls and there has been no talk of residencies eliminating it. Regarding a School of Medicine graduation requirement, we currently have no plans to change it. Main reasons: Most residencies and medical boards require it before you start.

"Step 2CK is going to pass/fail now."
FALSE. There has been no talk about this on many national calls. This is pure rumor.

"I need to take Step 2CK by July/August to match."
MOSTLY FALSE. It has been relatively common for many students to not have their Step 2CK score back by the Sept 15 ERAS opening. It has been a rare place in the past that would not process your application if you didn't have it on Sept 15. Now with large numbers not being able to complete it in a normal time frame. they will see many more without it at first. They will adjust accordingly. They won't expect you to have something that virtually no one can get done. I would agree that this does disadvantage those of you who had lower Step 1 scores than you would like, and you were hoping for a higher Step 2CK score to help a bit with that. But at this point, we just have to see when they reopen.

"I need to take Step 2CK to get an away rotation."
FALSE. Aways do like to see a score if you have it, but most don't. Normally, you apply in March/April for aways and virtually no one has a Step 2CK by then. And since everyone nationally is in the same boat, it won't matter. But honestly, it did not matter much before, either.

"If I don't have a score by Sept 15, they won't look at my application."
FALSE. While it is true that most programs would prefer to see both Step 1 and 2CK scores when you apply, different schools take 2CK at different times. It is pretty common for a significant segment to not have that score back by Sept 15. It is rare for a place to hold up your application because it doesn't have a Step 2CK score. And that was before all of this mess. As this affects all, don't worry about this.

"If centers open in other states earlier, I will be disadvantaged."
PARTIALLY TRUE. It is likely that some Prometric centers will open before others, based on local COVID conditions, shelter-in-place orders or not, etc. It is doubtful that all will open at the same time. While this could mean that it will be easier for those who live nearby to get tested sooner, it is clear that residencies realize that they will have to be dealing with partial data this year or lack of data. They will have to make changes and we hear they will if needed. I would also point out that back in the day, no licensing exam was taken until 3 weeks after you graduated. Thus, residencies had to rely on other things than these scores. In the worst-case scenario, they can do it again.

Regarding Step 2CS

"Step 2CS is going to be eliminated (from the residency requirement, from being a graduation requirement)."
FALSE. We have been on many national phone calls and there has been no talk of residencies eliminating it. Regarding a School of Medicine graduation requirement, we currently have no plans to change it. Main reasons: Most residencies require it before you start.

"Step 2CS is going to be changed to Pass/Fail."
UH SOMEWHAT FALSE. it already is PASS/FAIL!

"I can't match without Step 2CS."
PARTIALLY TRUE Most (but not all) residencies want to see a passed Step 2CS by rank order list time in later February. To get a score back by then, you have to take it by or before Dec 31, and preferably before Nov 3. HOWEVER, that assumes normal times. And these are not normal. Should Step 2CS reopening get pushed so far off that many cannot get it done by then, we fully expect residencies to drop the requirement to have it by ROL time. They likely will still want a passed test to start.

"If my Step 2CS gets pushed off too much further, I won't be able to take it because it will fall during a clerkship or elective time for me"
FALSE. Should this occur you will receive an excused absence the day before and day of your exam to allow it to be done.

Regarding ERAS, interviewing, away rotations

"ERAS won't open on Sept 15 as usual."
MAYBE. It has been suggested that it should open slightly later to give students a better chance to finish up delayed rotations. This is a topic being vigorously talked about at the national level right now. The AAMC just surveyed medical school Deans about this and most were in favor of a delay. They are getting ready to resurvey Student Affairs and Academic Affairs deans this week. We hope to have something definitive from the later this month.

"VSAS has been shutdown. "
CONDITIONALLY TRUE. It has been shut down for 2 weeks to give everyone a chance to reassess what needs to happen. We do not know what will happen at the end of that time. It is clear from national phone calls that some strongly in favor canceling all aways this year, but a large minority are not. This is being debated nationally and is also part of the poll mentioned above. Stayed tuned as this unfolds.

"Some schools are telling their students they may not do away rotations this year, or have to limit them to one".
TRUE. We know for a fact that some are, but most are not at this point. Our School of Medicine has had no discussions about requiring this, but we are waiting to see what decisions are made nationally.

"In-person interviews will not be done this year."
MOSTLY RUMOR, BUT NOT COMPLETELY. From a talk at the national level, it is clear that some places are strongly considering an option to do an online interview, as they realize that some candidates may find it easier to travel than others, depending on their local conditions. No decisions here yet, but it will not surprise us if some places offer both options.

Other

"Dr. Gibson did not pass the pediatric portion of Step 2CK."
THIS IS A VICIOUS RUMOR!

"The Cubs will win the World Series this year."
Your faith is appreciated, but will there even BE a World Series this year?

"Dr. McCord detests all kinds of seafood."
TRUE. One of the few things that are not a rumor. Dr. Chen will be happy to verify this.

"The Aggies will win the National Championship this year."
TRUE (if we are talking about Equestrian or Track and Field).

COVID-19 Electives

We have opportunities in many areas that include online electives, Zoom or modular electives, and electives that allow students to support the COVID-19 activities but do not include direct patient care.

Download or view the COVID-19 Electives

M4 Update
Monday, March 30, 2020, at 11:45 AM

Howdy M4’s,

I just wanted to touch base with you about a few things that are pertinent to your lives these days and keep you guys in the loop.

Texas STAR

You should have received a link to do the Texas STAR data. So far 70 of you have filled it out. PLEASE take the time to go online and do it. You know how helpful it was for YOU. You had it because your M4 buddies last year got on there and did it. Now it’s YOUR turn to help those behind you. Here is the link in case you lost it: https://ais.swmed.edu/redcap/surveys/?s=K7H3EF4LJM OR refer Rachel Hohlt’s email of 3/25 at 1:01 pm.

Credentialing

Work with your residency program now to start the process, and once they give you any directions or send you paperwork, don’t delay. Every senior in the country AND every resident who is finishing their residency will shortly flood state medical boards with this paperwork. And given the slow down due to COVID-19, even more so…….get going on it as soon as you can. While we are working remotely in my office, we come up a couple of times a week to check the mail, get any new credentialing that we are sent and process it, and I come in to sign it. If you have it and it can be done electronically, your Student Affairs offices can do that, too.

Graduation

Know that if the current situation were to calm enough to allow some sort of local meeting for graduation, we are certainly open to it. However, from all I am reading, the odds of this occurring are low. So we will start working over the next few weeks to come up the best alternatives we can. We will be reaching out to your class officers soon for input and ideas. So do pass on your creative ideas to them for us to consider. Some have pointed out that the Texas A&M communications said that commencement has been delayed. While this, in theory, is true—they are hoping to do a delayed university commencement late summer in July/August—the reality is that by that point in time, you guys will be in the thick of your internship. The odds you could come back for something seems low, which is why we are looking at viable alternatives now. One of you asked if it might be possible for you guys to come back and walk at the Class of 2021 Commencement to participate in the experience (in addition to whatever we do virtually now). I am sure something like this could be worked out and will be one of many things we look into as an option for those who want it.

Graduating Early

Some have asked about graduating early as they have heard of this being planned in other states to allow students to get out there and help sooner. Know that this discussion is beginning to occur at the state level as to the practicalities and possibilities. Should this go somewhere, we will keep you informed.

Schedules

Thanks to those of you who turned in your updated schedule and filled out our question form. For any who haven’t, please do so now. Most of you should be placed in something by now and/or will have instructions coming soon on how to complete an online course for things like ICU. While we are still working things out, pulling 485 off of clinicals with about 2 hours’ notice then figuring what to do is a rather daunting task! While details continue to evolve, please know the following:

• We want to get you graduated on time. There is no plan to lengthen the semester. We will likely have the latitude to reduce the number of weeks of required electives, if necessary.
• The requirement to have a certain number of patient contact weeks vs non-contact has been waived.
• We will be finding viable alternatives for those of you who have required left (ICU, AI, ER)
• WE ARE COMMITTED TO MAKING THIS WORK.

Counseling

Just a reminder that we have lifted the cap of six visits per academic year for now. We understand this has been a very stressful time for everyone, and that’s why we have counseling available. Most are doing visits via phone or Skype/FaceTime, but a few are doing in person with appropriate distancing. Late last week we called all the places we use on each campus and let them know to see you regardless of how many visits you have already used. Occasionally, a new worker may come to a practice that does not know of the setup with have with them. If for any reason you run into issues, denials or people on the other end who are confused, contact us immediately. You can call or email me directly, or ask your campus Student Affairs dean or Student Services Coordinator. Whoever you are most comfortable with is fine. We will make the call and get it straightened out. Finally, a reminder that to find one of these counselors, look in the Student Services Guide on the School of Medicine website. It’s fine to use a counselor on a different campus than your own when you are displaced elsewhere.

Health Insurance

Some of you have asked how it will work with your health insurance once you graduate if you have the A&M Student Policy. The latest info we have is that it will be in effect until May 31. It is possible to purchase an additional 3 or 6 months of coverage if desired. The link with more info is here:

https://myahpcare.com/wp-content/uploads/TAMUS_EF_Cont_19-20.pdf

Typical Timeline for Residency

Some of you have asked, “When will I have to report for duty?” The answer varies quite a bit from program to program. While July 1 is the official start date, all residencies expect you to come beforehand to go through onboarding, mask fit testing, and things like that. At least one week before July 1 is very common, and having you come 2 weeks before (i.e. mid-June) is not unusual. It has always been this way, so don’t think when you are asked to be there early that it is solely because of the pandemic. This has been pretty much standard operating procedure all the time.

Well, that’s quite enough for now! As more details become evident, we will certainly share them. Hang in there, be safe, ask for help as needed, and check up on each other. 

Dr. McCord

Urgent Update for our MS2-MS4 Students Regarding Shelter in Place
Wednesday, March 25, 2020, at 8:13 AM

Dear School of Medicine All,

As you now know, as of last night, all of our clinical campuses have shelter-in-place orders from the local governments. Yesterday, President Michael Young provided operational guidance for TAMU under these new constraints. The email clearly states that, “Students must comply with applicable local government orders. In most cases, the orders allow students to leave their residence only for essential activities, such as going to the grocery store or picking up to-go meals (on-campus or from restaurants), visiting a healthcare professional, and engaging in outdoor activity, such as walking, hiking, running, or riding a bicycle (with proper social distancing). Students may also leave to go to university-designated locations for accessing computers and internet resources as indicated on keeplearning.tamu.edu. Please consult the central COVID-19 TAMU site for facility availability and hours updates.”

Throughout yesterday, the School of Medicine has considered the impact these decisions have on our current curriculum contingency plan. After receiving feedback from the campus deans, legal counsel, School of Medicine and HSC leadership, the School of Medicine has decided to continue with our current curriculum contingency plan that allows students to voluntarily participate in non-patient-care elective opportunities that require you to leave your home. Please note that if you are considered high risk (diabetes, heart disease, immunocompromised, or lung disease), I would highly discourage you from participating in these activities. As before, students should practice social distancing and enter facilities only if you do not have a fever and are feeling well, in a manner that minimizes the risk of any direct patient contact. We feel this is acceptable at this time given your unique status as a health care professional students. However, as underlined above, it is important to reiterate these electives are completely voluntary, and it is fully acceptable to participate in learning activities that can all be done from home at this time. If at any time you desire to transition to at home only elective opportunities, contact your campus Academic Navigator, or equivalent, to make this change. Also, I want to make it clear that if at any time you are asked to participate in an activity that increases the chance of patient contact, your answer must be no.

Please know your health and safety is my number one priority as your Interim Dean, followed secondly by your education. Therefore, my responsibility and duty may require to further restrict student activities within the community if the pandemic continues to worsen.

If you have further questions regarding this decision, please contact your respective Campus Dean.

Thanks,
Amy Waer

Message from Academic Affairs
Monday, March 23, 2020, 7:39 AM

Dear Students,

We are aware that many of you remain confused around your current disposition and anxious about how you will be able to proceed in the curriculum under these circumstances. While this email does not have all the answers to questions you may have, I do want to bring you up to up-to-date on some key curriculum-related decisions made by the School of Medicine last week, and what we hope will be accomplished this week.

Last week’s priority ;was to determine how the current curriculum might be delivered under current constraints that are changing daily. Unfortunately for you, all this planning required you to sit and wait for further instructions from School of Medicine.

This week’s priority is to get everybody into a learning activity. I believe this can be done, but from a student's perspective, this will still seem disorganized and inefficient. As you can imagine getting assignments for 500+ students all with different schedules is no easy task.I ask for your patience until we can get our system fully up and running under these modified parameters.

Here is a brief summary of curriculum-related decisions that have been made so far:

All:

• Please be aware that these decisions are contingency plans that are subject to change. Curriculum Committee is actively reviewing and providing feedback. The student subcommittee has already provided valuable feedback.
• School of Medicine has implemented a no-patient-contact rule in accordance with the AAMC/LCME recommendations.
• CLRC resources are very limited at this time and will impact simulation training and assessment.
• NBME customized exams for pre-clerkship are currently unavailable.
• NBME exams for clerkships will hopefully be available in early April for delivery under a modified proctoring rule.
• Campuses are in the process of developing a variety of learning activities that will be available as SIEs for M2s-M4s.

M1s:

• M1s will resume semester 2 courses
• The goal is to finish Semester 2 on the current schedule.
• Course content – the majority will be delivered online either as recorded content or zoom meetings. Each course is actively adapting to these parameters.
• CSIEs - by ZOOM will be trialed by ID block next week. If successful will be continued for subsequent blocks.
• TBLS - were successfully trialed by EnMed via ZOOM.
• CPCs - are still under discussion.
• CLRC - resources are very limited, so POM2 will be adjusting.
• Assessments
  • Modified testing will be necessary (content, delivery, proctoring)
  • NBME has suspended customized assessments so internal exams will be needed. Both BCS and EnMed are preparing for this situation.
  • The biggest hurdle encountered was proctoring exams under current constraints. The priority is to deliver exams on same calendar dates but be flexible in content, delivery, and proctoring methods. Courses will address this on an exam by exam basis and keep students informed.
  • OSCEs are not available currently. POM2 working toward solutions.
• Final Grades
  • Should a change in grading scheme be needed you will be notified by the course ASAP.
  • Incompletes can be assigned should there be further unexpected disruption to completing courses.

M2s:

• There are three groups of M2s:
  • M2s on clerkships
  • M2s on electives (after IM and Surg)
  • M2s in AIM
• The next key transition in the curriculum is April 13^th to start USMLE Step 1 self-study. Currently plan to transition to this on time.
• M2s on FM, Psych, and Radiology
  • May stay on those clerkships with modified learning activities. Clerkships will reach out to you with details.
  • Family medicine and Psychiatry reserve the right to require some additional clinical time in the future to cover what you have missed, but you will receive credit for all clinical time spent to date.
  • After Radiology is complete, you will fill time with electives until USMLE self-study time.
  • Assessments
    • Radiology hopes to give the final exam. If you are unsure if you are prepared for this exam please let the clerkship director know.
    • NBMEs will be given if they modify their proctoring rules in time for the current clerkship.
    • OSCEs will likely be delayed.
    • This means students will likely get an incomplete for the clerkships.
  • Clerkship administrators (directors and coordinators) are your primary contacts during this time.
• M2s on OB/Gyn and Pedi
  • You will receive credit for completed portions of this clerkship
  • You will need to complete 3 additional weeks of clerkship later
  • You will not be taking NBME or OSCE until completion of entire clerkship
  • Until you enter USMLE study time in April you will need to take electives and possibly Radiology if the clerkship can accommodate you.
  • Navigators will be primary contact during this time.
• M2s AIM
  • Your AIM administrators will guide you to your available learning activities at this time.

M3s:

• There are three groups of M3s:
  • M3s on clerkships
  • M3s on electives (Career Exploration)
  • M3s in AIM
• M3s on FM, Psych, and Radiology
  • May stay on those clerkships with modified learning activities. Clerkships will reach out to you with details.
  • Family medicine and Psychiatry reserve the right to require some additional clinical time in the future to cover what was missed, but you will receive credit for all clinical time spent to date.
  • After Radiology is complete, you will fill time with electives.
  • Assessments
    • NBMEs will be given if they modify their proctoring rules in time for the current clerkship.
    • OSCEs will likely be delayed.
  • This means students will likely get an incomplete for the clerkships.
  • Clerkship administrators (directors and coordinators) are your primary contacts during this time.
• M3s on OB/Gyn and Pedi
  • You will receive credit for completed portions of this clerkship
  • You will need to complete 3 additional weeks of clerkship later
  • You will not be taking NBME or OSCE until completion of entire clerkship
  • You will need to take electives and possibly Radiology if the clerkship can accommodate you.
  • Navigators will be primary contact during this time.
• Next key transition in the curriculum for is April 13^th for next clerkships
  • IM and Surgery are looking into the feasibility of starting at that time under the current constraints.  At most, they would be able to front-load didactics for a couple of weeks. Otherwise, students will likely need to continue in electives. More to come as they know more.
  • Other clerkships will not be able to resume under current constraints.  Electives will need to be completed during this time.
• M3s AIM
  • AIM will determine what learning activities are needed for you at this time.
  • As noted above, NBMEs and OSCES will need to be rescheduled at this time.
• Impact on 4^th year
  • Impact on USMLE Step 2 CK remains unclear at this time.
  • Hope to get as much 3^rd year requirements completed as possible.
  • Hoping to develop multidisciplinary OSCE to reduce a total number of make-up OSCEs needed.

MS4:

• The goal is to get M4s graduated as scheduled.
• Student Affairs Deans have committed to being the primary contact for you.  Navigators will be available to help as well.

• There are 3 groups of M4s:
  • M4s on electives who have met all other graduations requirements (ED, ICU, AI)
    • You will complete no-patient contact electives until graduation.
  • M4s who still have graduation requirements (AI, ICU)
    • For AIs, student affairs will work with you to review 4th-year activities to determine if something can be counted as an AI.  If not, they will help you into a learning activity to count.
    • For ICU, a task force has developed a modified curriculum for you to complete.
  • M4s on ED clerkship – ED has developed a modified curriculum for you to complete. NBME will be given once modified proctoring rules are in place.

Here is a brief summary of curriculum-related activities for next week:

Monday 23, 2020:

• M1s - will continue in POM2, ID, and MSGR. Students should follow communications from these courses closely.
• M2-M3 FM, Psych, Radio - you will be continuing in your clerkship and should follow communications from the clerkship administrators.
• M2-M3 Pedi and Ob/Gyn - please contact your navigator to secure an elective. You may also be contacted by local campus leadership with elective opportunities.
• M2-M3 on Electives - some electives have been willing to convert to non-patient contact. If not, then work with navigators to find an alternate elective.
• M4- Student Affairs Deans will be working with your schedules to ensure you will be able to graduate as planned. They may send you to navigators to plan schedules once it is clear what you need for your unique schedules.
• Several administrative meetings scheduled including campus deans and EnMed leadership.
• A CPC contingency planning meeting will be completed.

Remaining days 24-27, 2020:

• School of Medicine will continue to closely monitor the pandemic and modify the curriculum as needed.
• Continue to identify new learning opportunities within constraints of no-patient-contact.
• Dr. Waer, Academic Affairs, Student Affairs to provide daily updates and as needed. Look for ZOOM Halls for student Q&As.
• M1s- ID CSIE will be given on Wednesday via ZOOM. Follow communications/instructions from the CSIE coordinator.
• M1s - ID Exam on Friday. Follow communications from the course.
• M2-M4 - Look for communications from your Campus Administration for evolving opportunities for SIEs and how to enroll in them.

Hopefully, you will find this email helpful in understanding some of the work the School of Medicine has and is doing to take care of you during this time.

Sincerely,
Jeremy Gibson MD

Elective/Clerkship Update
Updated: Friday, March 20, 2020 8:49 PM

Good evening students,

Here is your daily update from the Office of Academic Affairs! We know this is the most exciting thing you have read all day.

Not surprisingly, we are hearing that students are anxious about taking unplanned electives. You likely have questions such as - Will these count as 3rd year or 4th-year vacation? or What does this mean for my future schedule?

We do not know all the answers right now, but please know that we are working from the mindset of minimal disruption to your education and maximal benefit of your time while dealing with the constraints imposed by the pandemic. The good news is we are seeing some amazing opportunities evolve out of these circumstances, and we want to safely get you involved in those activities.

Our plan is to relax our rules around electives in order to accommodate the current situation. With oversight from Student and Academic Affairs the following rules will be relaxed:

• M2/M3 Electives will be able to “count” in 4th year, especially if any 4th year time has to be used for clerkships.
• The rule about the number of online vs clinical electives will be relaxed at all levels to accommodate our current situation.
• We will allow you to take more weeks of our current online electives so you can take them as M2/M3 and still have some room to take them as an M4.
• We will adjust the number of electives and types of electives in each phase to accommodate the current situation. For example, CO 2021 will likely have a reduction in the number of selective weeks they must take.

M4:

Please contact your Academic Navigator or Student Affairs Dean (if you haven’t already been in contact), to ensure that the rest of your electives/courses have been adjusted appropriately. This process has already started, so hopefully, most of you have already been in contact and understand your next steps. See more information below from yesterday’s message about EM, ICU, and AI.

M2/M3:

There are three different situations for this group of students, if you are uncertain of what you should be doing after reading this, please reach out to your coordinators or navigators for guidance.

• If you are currently in Psychiatry, Family Medicine, or Radiology clerkships, you will proceed in your clerkship as communicated by your coordinators.
• If you are currently in Pediatrics or OBGYN, you should plan for a 1-week elective, for the time period 3/23 - 3/27. After that, there is work being done now so that you can all transition into the Radiology core clerkship for 3/30 until 4/10. Then you will proceed with Step dedicated study as planned.
• If you are currently on elective, you should proceed to choose a non-patient-contact elective that will begin on Monday 3/23. There are new options being created right now in order to accommodate all the students needing these electives, and you will find more information about these options detailed below. Your navigator is your primary point of contact, but all campus leadership is available as a resource.

Available Electives

We can identify and get you into a learning activity more quickly than we can get that updated in our system. If you have identified an opportunity for next week, please begin work on that activity and we will work out scheduling and paperwork early next week. Your navigator is your primary point of contact related to electives, but all campus leadership is available as a resource. As we go forward, if more elective time is needed, you will be able to schedule those yourself in Oasis. For right now, someone has to override your current schedule and put you in the new course.

We are currently able to offer 5 categories of electives: established non-patient contact electives, modified established electives, traditional student-initiated electives (SIEs), new School of Medicine SIEs, and COVID specific SIEs.

Established non-patient contact electives - there are a variety of no-patient contact electives that already exist within OASIS. As stated above, self-selection of these may be limited until your current schedule is overridden.

Modified established electives - Some electives have modified their current elective to be online. In these cases, the student will remain in the scheduled elective and proceed with no patient contact activities.

Students Initiated electives (SIEs) - students may continue to propose and submit their own identified learning activities using the previously established process within OASIS.

New School of Medicine provided SIEs - both faculty and students have been brainstorming about possible learning activities. As these are formalized, they will become available. If you have an idea for an elective that more students may want to take, please email Jaqueline Stoutin at jstoutin@exchange.tamu.edu. She has agreed to gather additional ideas from students so we can organize those and potentially offer them to everyone.

COVID specific SIE - Any activity in support of the pandemic, such as phone screenings, assisting with mission control, or triaging phone calls, will be captured as a COVID 999 elective. At the link below, we will be capturing these opportunities for each campus as they become available. You can reach out to the listed point of contact for availability and reporting. For scheduling, you will sign up for and SIE under the COVID 999 course in OASIS. For those who have not created an SIE before this time, there is a document that walks you through the requirements on OASIS. In terms of a sponsor, you can list a faculty member associated with A&M or a faculty member at another institution provided you can include the faculty email in order to receive an evaluation. For more assistance signing up for SIEs, you can reach out to navigators or academic success.

Thanks,
Dr. Dickey

Clerkship and Elective Updates related to COVID-19 changes
Thursday, March 19, 2020, 9:49 PM

Howdy Students,

Your health and safety are our top priority. If you are showing symptoms such as fever, cough, and/or shortness of breath, you should self-quarantine. Please refer to the TAMU website that has detailed information. If you are having symptoms, do not show up at a healthcare facility without calling first for a screening and further direction. In addition, please contact Student Affairs and let them know if you are experiencing any symptoms. We are here to help you during this time.

This will be a long email, but it’s important that you read it carefully.

We know that students have a lot of anxiety about next steps. M4’s are worried about graduation, M3’s want to finish clerkships and keep their 4th year intact, and M2’s want to be done with Step 1. We understand.  Remember that everyone in the nation is in the same position we are in, so you will not be disadvantaged in that way. School of Medicine is committed to ensuring you receive the education you deserve.

ELECTIVES

Anyone on electives, including M2-M4’s need to work with your Student Affairs Dean and Navigator to adjust your current elective or move to a no-patient-contact elective, HOPEFULLY by Monday or Tuesday if not before.  We are building opportunities in many areas that include online electives, zoom or modular electives, and electives that allow students to support the COVID-19 activities but do not include direct patient care.  We have and will modify elective requirements for each class as needed.  

We hope to have a more robust list of no-patient-contact electives available in a few days, but for now, here are a few options:

• Self and Culture is now open to M2’s and M3’s.  Additionally, you can now take up to 5 weeks of this course in your School of Medicine career.  So if you take 2 weeks now, you can still use 3 weeks later.  
• Residency and Beyond is also open to M2’s and M3’s and you can now take 4 weeks of this course in your School of Medicine career.
• The USMLE Elective is open to M3’s and M4’s and can be taken for up to 4 weeks.
• There are several radiology and anesthesiology electives that are being moved online. Some of the radiology electives are available based on your career interests.
• Most campuses have COVID-19 support opportunities for elective credit.
• MORE to come! 

M2 STUDENTS

Most of you are on clerkships now and planning to move to USMLE study starting on April 13th.  Each of your clerkships are going to handle non-patient contact differently.  We will give you some brief information here, but you should work with your clerkship directly on details.  Clerkships should be reaching out to all students by the end of this week (Friday, 3/20).

FAMILY MEDICINE

FM clerkship has decided to continue the clerkship using alternative learning opportunities.  Students most likely will not be able to take their OSCE or NBME, so you may receive an “in progress” grade until all components are complete.  Your clerkship will be communicating with you soon if they have not already. Continue to study as though you are on the clerkship.

OBGYN

OBGYN has elected to continue non-patient contact elements through Friday 3/20/2020. OBGYN clerkship students will then initiate a no-patient-contact elective starting on Monday 3/23/2020.  Students will get an “in progress” grade, complete additional weeks of patient care,  and take the NBME and OSCE at a later date.  We are evaluating the Radiology Clerkship capacity. This may allow students to transition to another required course instead of an elective. More information to come on that in the next few days.

PEDIATRICS

We are meeting with the Pediatrics clerkships first thing tomorrow morning, Friday, 3/20 and will know more soon.  Watch for an email tomorrow from both OAA and your clerkship.

PSYCHIATRY

Psychiatry has decided to continue the clerkship using alternative learning opportunities and telehealth.  The clerkship is working on an option for a remote OSCE.  You may still need to get an “in progress” grade until OSCE and NBME options are decided in the next week or so.

M3 STUDENTS

Your Student Affairs Deans and Navigators have already started working with you to adjust electives as needed.  See the Elective information above.  We are working to ensure that your 4th year remains intact.  If you have to take a clerkship in your 4th year, you will have amassed enough electives to cover some of your 4th-year requirements.  The rule about 3rd-year electives counting for the 4th year will not apply to our current situation.  

For students that have IM or Surgery clerkships left, School of Medicine may flip the 4-week elective block with the clerkship if the no-patient-contact remains in effect longer than planned.

INTERNAL MEDICINE

Internal Medicine has plans to start the clerkship as scheduled on 4/13/2020. The exact approach will depend on a number of factors but maybe front-loaded to include non-patient contact elements first.

SURGERY

Surgery has plans to flip the 4-week elective and clerkship to start 5/11/20.  However, the first 2 weeks will likely be non-patient contact elements including simulation, lectures, and other educational modules.

RADIOLOGY

The radiology clerkship will continue online without patient contact.  There may be some ability for students to take the clerkship if they are not already scheduled.  Depending on capacity, it will be opened to more students as available.

M4 STUDENTS

Your Student Affairs Deans, Campus Deans, and Navigators are working diligently to ensure you have what you need to graduate.  The elective requirements have been relaxed, including the rule that you must take 10 weeks of clinical electives in the last semester.

Students in EM and ICU will get information from your course on how to proceed.  The courses are working on alternative learning opportunities to complete these required experiences. 

If you are in an Acting Internship (AI), your Student Affairs Dean is reviewing your current schedule to see if a previously completed clinical experience may meet the AI requirement.

Check with your Student Affairs Dean later next week if you have EM, ICU, or AI in the last 2 blocks.

Thanks,
Dr. Dickey

TAMU School of Medicine Latest COVID-19 Update
Wednesday, March 18, 2020, at 4:57 PM

Dear COM All,

During this time of rapidly changing dynamics, I am going to be emailing you all much more frequently in an effort to keep our lines of communication open. As of the end of business today, I have the following updates:

• Our MS4 Match Day Celebration this Friday, March 20 for all five campuses will no longer be allowed to be in person- we hope you will celebrate with us on social media using the hashtag #TAMUMatchDay-more details will be coming from Rachel Hohlt or Donna Shipp in the Office of Student Affairs tomorrow
• By this Friday, March 20 we will have met virtually with all of our clerkship leadership groups and will know whether or not each of the clerkships can continue with non-patient contact opportunities or if we need to switch over to electives
• In terms of our MS2s, MS3s, and MS4s we will have arranged by this upcoming Monday, March 23 for alternate learning activities that do not involve direct patient care-thanks to our amazing faculty and staff particularly our Campus Deans and Course Directors- everyone has been amazing during this difficult time in working hard toward getting our students back into a learning activity with minimal interruption as soon as possible
• For fourth-year courses such as Emergency Medicine, Acting Internships, and ICU we have formed task force groups working quickly to determine next steps
• Our COM graduation commencement will not be able to occur in person and we are working creatively for virtual processes to celebrate and will be asking our MS4s for ideas and suggestions on how to make this happen
• The LCME sent out the attached letter regarding the possibility of more flexibility regarding our delivery methods
• Reminder we are all supposed to be checking and documenting our temperature twice daily-if you find that you have a fever call your healthcare provider prior to going to any healthcare facility

Thank you all for your resilience and flexibility during this time,
Amy Waer

COM Response to AAMC Recommendation for Withdrawing Medical Students from Direct Patient Care
Updated: Tuesday, March 17, 2020 at 7:14 PM

Dear COM ALL,

Per today’s AAMC/LCME recommendations (pdf), TAMU-COM has decided to immediately suspend all medical student participation in any activities that involve direct patient contact. We acknowledge the rationale by these institutions that includes: student safety, time to adopt alternative clinical education delivery methods, and conservation of personal protective equipment.  While the AAMC recommended this through March 31, we will need to be flexible regarding the endpoint. 

This decision is effective immediately, so all medical students are to refrain from direct patient care duties upon receipt of this email.  Our School of Medicine leadership team is working hard to identify alternative experiences for our students that do not involve direct patient care. M1s will continue in their current courses as instructed in yesterday’s communication, given they do not require patient care. 

M2s, M3s, and M4s will receive follow up instructions in the coming days on their assigned learning activities as the COM secures these opportunities.  In the meantime, students should proceed with self-directed learning activities related to their current clerkship or elective until otherwise directed. For example, while the ability to provide NBME exams remains unknown at this time, students on clerkships should continue to prepare for their NBME exams. Students already on non-patient contact electives may continue to participate in these activities as long as they do not require the student to access a patient care area.  If students are unsure about these guidelines they should contact their campus dean.

M4s should realize that the COM is committed to doing everything within our abilities to ensure your on-time graduation.

We appreciate your flexibility and understanding during this difficult time.  Your COM leadership team is committed to keeping you all posted as we move forward.

Thanks,
Amy Waer

Sent on behalf of the Office of Academic Affairs (OAA):

Message to M2-M4 Clinical Students - COVID-19
Updated: Monday, March 16, 2020, 5:59 PM

Howdy Clinical Students,

As you are aware things are changing rapidly in response to COVID-19. We want to keep you updated and informed. As communicated before, clinical students should continue to report to their clinical assignments although we recommend that students do NOT have direct care of patients with known or suspected cases of COVID-19.

For example, as the healthcare system becomes strained in response to the pandemic, we may see additional adjustments in your learning. There may be less patient volume in your clinics or elective procedures and surgeries may be canceled which could mean less access to patient care for you as a learner. Something else that could happen is the conservation of personal protective equipment (masks, gowns, gloves, etc) that might be used for patients that would require contact, droplet or airborne precautions. We are preparing contingency plans in case some of these events occur and student access becomes more limited.

The events around COVID-19 and what is happening within our healthcare system provides a rich learning opportunity, so even if your access to direct patient care becomes more limited, there are plenty of learning experiences.

Class of 2022 (M2)

We are working closely with the CLRC to determine plans for simulations and standardized patient activities. We will have more information in the coming days or weeks. This may mean that your mid-term simulation activities and/or mid-term OSCE schedules may be adjusted. For end-of-clerkship OSCE’s, we will know more in the coming days and weeks if we will hold those exams as planned or postpone or reschedule those. If we reschedule or postpone OSCE’s, we would set your grade as “in progress” until we can complete all the required activities.

For NBME self-assessments, your clerkship will likely direct you to take those assessments remotely at home instead of in a classroom with a proctor. Please adhere to the guidelines outlined by your clerkship (timing, closed book/notes, etc) so that assessment grade can be reflective of your knowledge. For end-of-course NBME’s, we are working on plans to administer those exams using smaller groups and social distance expectations to limit interaction. This may require COM to hold multiple NBME sessions so the groups are small enough to follow COM/University small group guidelines.

Class of 2021 (M3)

Please continue your career exploration electives as planned. If any of your electives are canceled due to COVID-19, your navigator can help you adjust your schedule. One opportunity on most campuses might include participating in COVID-19 incident management. For example, you might help with screening patients on the phone who need to return to work, or assist in a command center running information or errands. This can count for credit via an SIE.

Once your clerkships start back in April, we will know more about how things have progressed and if there will be adjustments to your clerkship.

Please see the message above to the M2’s regarding OSCE’s and NBME’s.

Class of 2020 (M4)

Many of you are finishing up your final electives and courses. If you are taking a required course like an AI, ICU, or EM, we are working on how to respond if you're unable to complete the course due to changes in the clinical setting. We want to ensure you meet graduation requirements in time to walk across the stage. We will have more information in the coming days and weeks. Emergency Medicine clerkship will be creating some adjustments and plans soon, and will communicate with anyone taking EM in the coming weeks.

If any of your electives are canceled due to COVID-19, your navigator can help you adjust your schedule. One opportunity on most campuses might include participating in COVID-19 incident management. For example, you might help with screening patients on the phone who need to return to work, or assist in a command center running information or errands. This can count for credit via an SIE.

AIM Students

While some of the above discussion will apply to the AIM track, it is important that you reach out to AIM leadership to discuss your unique circumstances.

Thank you,
Erin M. Herbrich