Lawrence Loh is an Adjunct Professor in the Dalla Lana School of Public Health at the University of Toronto


The rise of SARS in spring 2003 brought noticeable changes to the end of my first year of medical school at Western University. Clinical skills classes were moved out of hospitals and into repurposed labs on campus. When I started my summer job in May at a local cancer facility there was screening at entrances and signs warning me to take appropriate precautions. In comparing notes with my Toronto friends, however, it seemed that the level of disruption I experienced was minor compared to how their studies were impacted by cancellations and postponements.

Of course, none of that compares to what medical students and educators are seeing now during the COVID-19 pandemic. With classes and clerkship transitions, licencing exams and convocation, and even residency starts potentially impacted by cancellations, closures, and physical distancing directives, many medical students are asking the question: How do I continue to learn from this (hopefully) once-in-a-lifetime global infectious disease event?

In speaking with the Ontario Medical Students’ Association on April 11th, I developed a “Five As” framework that might help students and learners at any level make the most of the newfound free time they’re left with.

  1. Assist: Besides staying home and helping to slow the spread, which will help keep the healthcare system intact, medical students have volunteered to serve in many ways across various jurisdictions. Some are assisting public health’s often unseen work in trying to slow spread in the community. They’re helping to man call centres, support case and contact tracing, and test patients at assessment centres. Others have stepped up to help their mentors and faculty, for example, by doing grocery shopping and offering childcare, which always gives the possibility of wisdom imparted during a physically distant conversation near the end of a busy day or shift.
  2. Advocate: The best advocacy is usually done around issues to which the student can speak as an expert. For example, student advocacy would be essential around greater supports for students and learners or calling for alternative evaluations of competence or transitions to residency during these unusual times, to keep the next generation of physicians on the move and well.
  3. Amplify: Medical students can influence their own demographic through social media and new tech by amplifying the important messages of other leaders and advocates to self-isolate, practice physical distancing, wash hands, and so on. Medical students can mix their knowledge base and social skills to translate and code messages from authorities into something more likely to influence their audiences and peers.
  4. Articulate: This is an opportunity for learners to reflect and create work that puts a face on the pandemic. Whether it’s putting words to loss or giving voice to those who are disproportionately impacted by the implemented control measures, such work can help to build an academic portfolio and track record. Such creative reflections, if done well, enrich the overall conversation around the human cost of the pandemic.
  5. Analyze and apply: Perhaps the most important and critical thing that students can do during these times is to carefully observe. There are many physician leaders and advocates trying to make a difference on the clinical front line, in the media, and through social media. Reflecting on examples of good leadership or poor decisions and their impact on health care or policy decisions will help learners identify successful approaches. Discussing their observations with each other and with mentors will help them see the strategic pieces around why a decision was taken, or the clinical pearls around how a diagnosis was made.

Medical students can certainly make the most of this once-in-a-lifetime learning opportunity. If they can throw themselves into the response and say yes to whatever arises, while keeping eyes and ears open, there is much to be learned—about practice, leadership, and their own career aspirations. My own experience of SARS in 2003 led me to a career in public health. Where will your COVID-19 learning opportunities lead you?