Updated: Aug 25, 2020
By Michelle Jung, Communications Editor
Michelle Jung: Introduce yourself to us.
Melanie Chen: My name is Melanie Chen. I am currently a 4th year at Tufts medical school, and I am on the MD and MPH track, which is a dual degree track. I graduated from Wellesley in 2016, and it is my last year in medical school. It has been a wild journey, to say the least, but I feel like coming from Wellesley to Tufts has been such a change and a real adjustment for me. I am glad that I had Wellesley for an undergraduate experience.
MJ: How has the pandemic affected you as a medical student?
MC: Being a medical student, COVID-19 has certainly affected me quite a bit. I actually just got back from California, as I am originally from there. When COVID-19 hit in mid-March, the administration started to talk about canceling or making adjustments to rotations because, first, the issue of student health and students potentially coming into contact with the virus, which wouldn’t be good especially at a time when we didn’t understand much about the disease. Also, the more prominent issue was PPE (personal protective equipment). Being a medical student, it is mostly experiential. The first and second year you do your classes, while third and fourth year you do rotations, which is when you get a real good sense of what clinical life is like. I think that the issue came where Residents who were working with us had to balance their actual job and getting things done with teaching us. The issue came if there was a PPE shortage, it might be that the medical students would not be prioritized because we are there to learn rather than for patient care.
I think these are the two reasons why the school decided to cut a lot of rotations short and send us home. I went home. I thought it would be a month or two, but I ended up staying in California for three months. It was crazy and I just got back last week.
MJ: When do your clinical rotations start?
MC: They wanted us to come back to Boston and self-quarantine for fourteen days. I start rotations back on Monday, which is why I came back early last week to do my self-quarantine.
MJ: How has it been like coming back to Boston and how is your self-quarantining going?
MC: I was surprised because it was really quiet and empty. I think we have just started phase two of reopening, so a lot of businesses and offices are operating at quarter capacity or a lot of their people are still working from home. But, on the airplane, for example, we have distanced a seat apart, and we were given little snack packets. I think the airlines had to adapt pretty quickly to the situation. Being back, it has been okay! Part of the reason why COVID-19 was such a big issue was that I was living in the school housing and we were kicked out telling us that we cannot get back, so it has been an adjustment to find a place and get back here.
MJ: That must have been tough!
MC: But during this time, I have been taking a lot of online courses. My MPH coursework was all moved online, which was what I was doing when I was at home, and the school even quickly adapted. Our year was originally supposed to start in May, but it got totally messed up so our school was quick to come up with virtual elective options to help us fulfill some of our requirements and get us moving. They always joke that we got an unplanned vacation, but I was like “NO! We are all quite busy.”
There have been huge shifts in how licensing exams for med school are being done, too. A lot of the testing centers got closed because of COVID-19, so like the Prometric centers got closed and they had to cancel exams. It was a scheduling nightmare. By the end of 3rd year, med students should have taken two licensing exams called Step 2. There is a multiple-choice version on the computer and then a version where you talk to a standardized patient who is a patient. They eventually decided to cancel the entire standardized patient part and we are going to have to take it during first-year residency or interns, so that has been the biggest adjustment for us. And even thinking about residency applications, the whole timeline has shifted. I never realized how important each month was until this pandemic has shed a light on the track of progression.
MJ: How does missing the standardized part of the licensing test affect your pathway as a medical professional?
MC: It is not a graduation requirement, but a licensing requirement. We cannot be licensed until we pass that part of the exam.
MJ: That must be really tough because you have already prepared for it, and then the cancelation causes you to extend your continuation of preparation.
MC: Yeah, I know people who have had their tests canceled 24 hours before they were taking it. Med students want to know what is going on and do not like uncertainty, but this is a new skill we are all learning.
MJ: Yeah, just being able to quickly adapt.
MC: Yeah. As horrible as the whole situation has been, I think it is a challenge for students to be able to thrive in this situation, but it is also a good thing as it is like growing pains, in a sense.
MJ: As a medical student, what was your role with COVID-19?
MC: As a general sentiment, we all understood why we needed to be removed from the clinical situation, but we were obviously disappointed because we felt like this would be a really good learning opportunity in case the next virus comes. As future doctors, we should be prepared for this by knowing how to handle and prepare for these situations. So, that was really frustrating for a lot of us because we felt like we were sitting at home and not necessarily contributing. As a result, medical students very quickly worked to mobilize and pooled together our knowledge and skills to address ways we could help even without physically being in the clinics.
There were a couple initiatives that came up. There is a National Health Professional Student Network that was started by a few medical students and what it does is that it is regional so it partners with different organizations. For example, in Massachusetts, it reaches out to medical professionals who need some extra support during this time. Whether that means taking care of children, running errands, getting groceries, collecting PPE, or things that do not require us to be in the clinical setting but allow us to contribute. This is what came up pretty quickly. Also, each state has their own health corps reserve and the state allowed medical students to join that. I joined the California HealthCorps Reserve in case there was a need for medical personnel to go to rural communities or in situations where they needed more people to help.
In terms of learning about it, obviously, with my MPH background, it was something that I was interested in. Within a span of a couple of weeks, the MPH faculty put together a COVID-19 curriculum and a lot of our elective classes became focused on COVID-19 and we talked a lot about it. I took a class on health communication and literacy, and we talked about how the media talks about COVID-19 and what the impact of that is on how people follow social distancing procedures and wear masks or not. Additionally, I took a public health law class and we talked about COVID-19 in terms of who has the power to say “You stay at home.” Our medical school, separate from the MPH curriculum, put together a COVID-19 curriculum that was more clinical based. We got a lot of materials and information. I think our school responded pretty robustly to something that was changing really quickly.
MJ: What was your initial reaction to the cancellation of school and clinical work?
MC: So I was, if I can be totally honest, a little relieved because I was on surgery and there were a lot of things going on. We did not really find out what would happen to our rotations until later. It was towards the end of my rotation, so that wasn’t the issue, but it was things like moving and finding a new place to live. A lot of those things made it really challenging to balance the end of rotations and preparing exams with preparing for life things like having a place to sleep. That was my initial reaction, but I did not think that they would send us home completely. I thought we would still be somewhat involved maybe through Telehealth or something like that, but I understand that early on in March, even the physicians were trying to figure out how this would affect their own practice. Being on surgery, all of the elective surgical procedures were canceled because they wanted to convert operating rooms into ICU rooms. There were no surgeries for us to watch.
MJ: How have you been communicating with your colleagues and classmates?
MC: It is an open conversation because everything is changing all the time. I live with two other roommates who are also medical students but are at different parts of the process. It is timely that you asked this because we had a conversation about like, “Hey, with everything opening up, I think we should discuss as a household we want to handle certain things.”
All of us go to clinics and are potentially exposed to COVID-19. We get a lot of guidance from the school about things we should and shouldn’t do, but a lot is still ambiguous. Restaurants are reopening where people are allowed to dine-in/sit-in, but I think a lot of the fact that I am in high-risk because I come in contact with patients, especially patients who are sick. I will be starting on my rheumatology rotation next week, and a lot of the patients in this department are on immunosuppressants for their rheumatoid disease. As a result, I feel like it is an obligation for me to be careful with where I go and who I interact with and following those guidelines as well as being mindful that it is not just me that I would impact if I somehow contracted it, it would be my roommates who then go to the clinic and see other people, the attendees I work with, and patients as well. Being in the healthcare profession and field makes it a little different from people who aren’t because they do not necessarily have to think about all of those things. And, the school and hospital are canceling the more high-risk rotations: right now some are not accepting students in the ER, ICU, Hematology/oncology departments where there are a lot of immunosuppressant patients, so the school has been doing a decent job at keeping us informed. I feel like that is where I get most of my information, but in terms of updates for treatments, we get a ton of emails every day from journals on the newest treatment updates, so we try to read a little bit of that every day and keep up our knowledge.
MJ: Ongoing changing so it is challenging.
MC: Yeah! It is ongoing and always changing. What we learned today might not be true tomorrow.
MJ: What is your current concern relating to the situation of the pandemic?
MC: I think that the possibility of getting a second wave is pretty high. Just considering the number of new cases that are happening in places like California and Florida that are at record-setting highs, I think that it is definitely possible for a second wave to come.
I think the thing that surprised me, but at the same time not really surprised me, during the first wave were the inequalities that we see between COVID pandemic and how they are treated: the racial disparities and socioeconomic disparities. I think that, again, wasn’t a surprise, but it almost seemed like we should have known that this was going to happen and maybe put some preventive measures to specifically address that. With the second wave, I think that that will be magnified, too.
Not to go off-topic, but I do think that it is related to the protests that are going on as well. That is what I am most concerned about because I don’t think it is necessarily fair for someone to choose which issue is more important: COVID or racial equality. But, when the two come together, we have to think about that more. I do not have the answers to what that would look like, but it is something that I have thought a lot about.
MJ: I recently learned about the racial disparities for maternal patients, which was shocking to hear that such practices are still occurring at a modern time like this.
MC: Exactly! That is why I say it did not surprise me when the news started to come out about COVID-19 and how it was impacting the black community more than it was than other communities. But you are completely right, black maternal health is something that a lot of my friends are passionate about that especially future OB-GYNS who I learn a lot about from. You would think it doesn’t exist, but it absolutely does, it is very real, and it is not a fabrication of data. I think that going forward, in whatever public health plan or economics stimulus plan, this is what we have to pay particular attention to. We cannot leave vulnerable lives behind, that is just not okay.
MJ: How do you think COVID-19 has set back some of your medical plans?
MC: I am still graduating on time (fingers crossed). In terms of professional plans, I think the biggest impact is that after medical school, we do a residency to get trained. That whole long training still lies ahead. I don’t think that the pandemic has gotten in the way of me achieving things; it is just that we have to do things differently. All of our interviews for residency (AAMC has issued a guideline) that all interviews are conducted virtually. It typically was that you would go and fly to this program and stay there for two days, getting a real feel for whether the program fits for you or if it doesn’t. But, now that they are not doing that, everything has gone virtually, so the hardest thing for applicants and for program directors is whether you get a vibe of what a person is like and how they would fit in with the culture at a certain institution without meeting them in person. I think that is the biggest challenge that I am trying to figure out when I am in the interview season because you really want to find a place that fits and I don’t know if I can do that on Zoom.
That is the thing. In terms of setbacks, I think the administration looks out for us enough to make sure that there aren’t any huge setbacks. We are delayed, but what happened is that we are going back to this old scheduling scheme that works out fine. There were a couple of bumps in the road, but I wouldn’t say anything catastrophic to the point that it has set people back. We are learning how to be flexible and adaptive, which is most important at this moment.
MJ: Due to the pandemic, has the direction of medicine that you wanted to study changed, or are you still continuing your original interest?
MC: This pandemic has shown us the shortcomings of our healthcare system. How we are not as prepared as we think we are and how this could happen at any time. To be honest, I think we got off easy with COVID-19. Yes, there were many deaths and cases, but the virus itself isn’t as virulent or bad as it could be, so this might be a peak into preparing for the next really bad virus that comes around: what are we going to do differently? How do we make sure we have enough PPE? How do we make sure we address real information with the public and not information that furthers some political/economic motive? I think that is why we see people itching to see themselves get out of their houses. I hope that we learn from this and we take it seriously. We did not take it seriously at the beginning, which is why we got behind compared to other countries.
In terms of the direction that I want to take, I have always been interested in public health, which is why I went off into this degree track in the first place. I think this pandemic has reaffirmed that choice but has again made me think more critically about health equity. Tufts is located in ChinaTown in Boston, so it is not on the same campus as the university, and so there are a lot of projects on campus that deal with racial and health inequities because we are near different communities in the Boston area, so that is certainly where I hope to develop my career path and education.
MJ: What are some ways you are trying to improve the public health of your community?
MC: Within my household in California, I was at my parent’s home and we stuck to a strict stay-at-home policy and didn’t go out unless we had to go for groceries or something essential. Wash your hands, always wear a mask, so following CDC guidelines pretty closely. I think I was surprised by the fact that not everyone follows these guidelines, even coming back to Boston I was surprised that not everyone was wearing masks. I know it is hot, but it just shows that some people do not take this as seriously as I think it should be taken.
In terms of specifically for public health, I have been obviously trying to do as much learning about COVID-19 as possible, but I have also been in a virtual elective where we create a lot of materials because we think that a lot of the courses might go online going forward. For example, the first and second years might have a lot of their coursework online, so thinking about the materials and writing medical cases and learning cases for incoming students. And, also taking a COVID-19 class and having to write a paper about COVID-19 and global health and sort of how this was a failure. Kind of a downer, but I think it's important to talk about it.
MJ: What do you want to say to incoming freshmen or any pre-med students who want to go into medical school?
MC: Go to medical for the right reason, and what I mean about the right reason is that it is hard! It is long, it is gruesome, it is hard, so you have to understand that that is the tradeoff that you are making and it is a hard road. But, I would say reach out to fellow med students ahead of you on this path. I think that we give off the sense that we are extremely busy, which is true, but we also (at least from me) love hearing from people sort of a couple of years behind me and seeing where you are coming from. Just ask and talk to people. Ask about their experience, what they liked about it, what they did not like about it, and if this pandemic has taught us anything, it is that medicine and public health isn’t just science, we need a lot of creative thinkers from all different types of expertise and to come together and collaborate, make solutions.
When looking at mask retailers working to make masks or create hand sanitizers, this is how we get through big issues, so I think the great thing about being at a place at Wellesley is that your education is pretty expansive. It is a liberal art and you get to touch on a little bit of everything and take advantage of that. Take advantage of undergrad and take that class that you have always wanted to take even if you think it will not do anything for you, because it actually will. Take that art history class. I am an economics major actually, and people ask me why I did not study medicine, which I have my own spiel about. But, there is no limit to what you can do in medicine, and it works both ways. You do not have to be specifically focused on that. I think it is just the energy that you bring into the field, like the dedication and problem-solving and creativity.
Just do what you want and take the classes that you want because that will shine through. We are always happy to talk to people.
MJ: Where do you see yourself in five years?
MC: I am applying to internal medicine, which is a three-year residency program, so I hope that I will be finished by then.
I don’t know if I want to specialize, like you can get further training if you want to sub-specialize into something else, so I think that is sort of the crossroad decision I will be at. But, I really want to be in a community where I connect with patients and where I can bring my interests and do something with it.
It is like the Wellesley motto: Non Ministrari sed Ministrare. But it is the idea of service, and that is something that I have always wanted to uphold for five or ten years. If I am not doing that, then that is not the right job for me.