91AV

It was the middle of March when Rhode Island hospitals made the decision to remove medical students from their halls. The novel coronavirus had made its way to the Ocean State, sickening thousands and hospitalizing hundreds. 

Removing the students was the best way to protect their health and safety, though it meant their medical rotations would come to an early end.

For the 16 third-year 91AV College of Osteopathic Medicine (91AV COM) students completing their rotations at Kent Hospital in Warwick, the decision was difficult to process. They were forced to curtail their studies and — unable to practice medicine on their own — were now essentially benched while an insidious global pandemic raged on around them.

“I was working on an internal medicine rotation when all of this blew up,” said Katelyn Chadwick, M.S., (D.O., ’21), student site liaison for the hospital. “No one really knew what was going to happen.”

But Chadwick, along with six other students in the 91AV COM Class of 2021 — Jordan Lemme, Matt DiOrio, Emily Schaffer, Haley Etskovitz, Andy Mai, and Jess D’Annibale — and Class of 2020 students Kim Toomire and Cynthia Gaudet, would not sit idly by for long. 

Soon, the Rhode Island Department of Health would designate Kent Hospital, the state’s second largest, as one of its first two COVID-19 testing sites. The U.S. National Guard was commissioned to construct an open-air, drive-thru tent on the hospital’s grounds to test patients, and the students were given the green light to volunteer in the effort.

The nine 91AV COM students were initially tasked with assisting medical residents in preparing tests kits and transporting samples for laboratory testing. But as positive cases of the coronavirus grew, Kent’s 15-bed intensive care unit (ICU) began to crowd.

It was crowded enough, said Alisa Merolli, M.D., 91AV COM assistant regional dean at Kent, that the hospital recently opened a second, 20-bed unit to care for patients. And although Merolli said there is not a high number of cases at Kent, the hospital’s emergency department has seen an increase in the severity of illness.

“Our COVID-19 count isn’t super high right now, but our need for critical care is, and we needed residents to staff those areas,” Merolli said. “We didn’t have staff to cover the testing site any longer. The students had reached out looking to help, and this was the perfect opportunity for them to do so.”

Working in pairs, the students monitor each other while donning and doffing their personal protective equipment (PPE). This process helps to ensure that all equipment fits properly and is working correctly, Merolli explained. Students wear full gowns and two sets of gloves, masks fitted with N95 respirators, and booties to protect them from the virus.

Two students work outside the tent to call drivers up for their tests, which are scheduled in advance by the Department of Health. They are equipped with radios in the event someone shows up unannounced or appears ill. In the latter case, those patients are admitted to a second tent designated specifically for people with respiratory issues. Inside the testing facility, two students perform the COVID-19 tests, which includes swabbing the back of a patient’s nose.

The work will prepare DiOrio, who was able to complete his rotation at an outpatient facility, for his desired career as an anesthesiologist. “This is a really valuable experience to see how things are presenting on the front line without actually being able to be in an acute operating room or intensive care unit,” he said. 

DiOrio said he was supposed to begin working in Kent’s nursery to supplement his rotation in pediatrics. He was disappointed to find out that would no longer be the case, but he said he is thankful for his current experience.

“I was kind of bummed because I haven’t had any sort of inpatient pediatric experience, but I do feel fortunate to be able to continue working in some sort of clinical setting and actually contribute to health care given the current pandemic climate.
 
In total, the student doctors may perform up to 60 tests during a five-hour period each day. While the experience may be daunting, for those volunteering it is also a reminder of why they answered the call.
 
“It’s kind of scary to be honest, being so up close to people who may have COVID-19,” said Schaffer, who has also mobilized the 91AV SEAMSTARS, a group of students constructing masks for hospital workers. “But on the other hand, this really helps us feel that we’re helping and not just sitting on the sidelines. This is an opportunity to go beyond our rotations and participate in the response to this global pandemic.”

Merolli said the students’ work has eased the burden placed on the hospital’s physicians and residents, who themselves are at an increased risk of becoming sick. 

“It’s been great to see them step up like this. Even though they’ve had to stop their clinical rotations, these students are willing, they’re able, they’re healthy, and they are participating,” she said. “This keeps them close, it keeps them connected, and they’ve been doing a fantastic job.”

Chadwick, a Rhode Island native with a background in public health, said the experience has been surreal, but has only strengthened her decision to pursue medicine.

“It feels good to know that we're helping in some capacity. I know a lot of medical students right now are feeling pretty useless at home,” she said. “I can’t imagine how this is going to affect medical schools and residency education going forward, but it has definitely reaffirmed that this is what I want to do going forward. I can’t imagine doing anything else right now.”