By Emma Kappeyne van de Copello
— “On the fifth or sixth day of my GP Internship, there was the press conference, where it was announced that the Universities would close. I had just finished up with a patient and the doctor came in and said: “Tijn, the universities are closing, that’s fun for you, because you’re done. So I was sent away in the middle of my shift.” (Tijn Versteeg, second year at the Vrije Universiteit)
When Covid-19 warranted a lockdown in the Netherlands in March, Dutch medical schools were shut down. First and Second year students couldn’t attend practical classes, interns and fourth year residents were sent home, and teachers were called to work in the hospital. Because practical application is an integral element of a medical education and the entire medical sector is under pressure, medical students and universities have had to deal with a unique set of challenges since the pandemic outbreak. The continuous changes that the initial outbreak has brought about persist to influence students today as Medical Universities do their best to maintain the quality of education.
At the time of the initial coronavirus outbreak in March, student residents who were meant to orient themselves in the field for the first time were sent home, which caused a severe delay in their studies. Universities have worked hard to combat these delays by shortening residencies and creating more spaces. Undergraduates are currently also affected; They need to wait to continue their studies after graduating, as the waiting time for starting a residency in Amsterdam is now nine months to two years long, meaning that bachelor students now need to wait to continue their studies after graduating. Iris Geluk, second year at University of Utrecht, is following her junior residency next year, which has been shortened from twelve weeks to six weeks. “During your residency you learn everything about the different specialties,” says Geluk. She wonders, “if everything is shortened, then how will I find out what I really want to do?”
While many residents were sent home in March,many bachelor students volunteered to work in the hospital on the frontlines of the pandemic. Students who were already working took on new functions, such as helping Covid-19 patients with chest scans and working on the triage. Eelke Houter is a third year student at VU-Amsterdam, who works on the triage. Triage is the process of examining patients quickly to determine who should be treated first. Houter says, “The shortness of breath is very scary for people, you don’t get any air. And you’re standing there with them, telling them to breathe calmly.” He continues, “sometimes you have people that look pretty okay, and then two hours later they have to be resuscitated, and then suddenly they aren’t there anymore. That is quite heavy. I do take that with me.”
Students at the University of Utrecht express that even now, months after the initial outbreak, the pressure on the medical sector is making it so that their teachers are less available. Professors teaching classes about lungs or viruses are called to come help in the hospital. Upperclassmen who are unable to answer all questions fully now oversee the workgroups, resulting in students having to increase their amount of self study.
From March to the summer break practical classes were completely cancelled, but have now been moved online. Teacher and education coordinator at Utrecht University, T.A.P Roeling, has experienced the challenges of moving the more practical parts of the educational programme online. For his elective course on hand anatomy he had to find creative solutions to provide students an engaging experience. He says, “I asked myself: what is the essence of a dissection practicum? It is that you experience it.” He had students physically flex the muscles in their own hands and draw the muscles and ligaments on their skin to make the material come alive. For other dissecting room practicals, e-learning practicals with images of brain slices were utilized instead.
Since September, practical classes have started again, but the students aren’t allowed to touch the bodies to prevent crowding. Malou Huijsmans, a second year at Utrecht University, explains that in the second year students are usually supposed to buy their own cutting sets and operate on body parts individually, but now the bodies are prepared for them. Huismans says, “It is a shame that we don’t learn that, because it’s an important part of medical education.”
The students, however, do not seem discouraged by the virus or and increasingly determined to become doctors. “I have more motivation,” Anouk van Lent, second year at University of Utrecht says. “You see more of how rewarding your job is. Even if it is at your own expense. Now you can see even more how you can really be of value to someone”.