Heroes on the Sidelines

It is said that when the going gets tough, the tough get going. When the COVID-19 crisis struck, Sidney Kimmel Medical College students took that old maxim to heart.

Carrie Walsh, a fourth-year about to start her residency in emergency medicine, works with an organization that coordinates food distribution to the elderly, ill, and indigent. Third-year Terry Gao is involved with an organization that finds and distributes personal protective equipment (PPE) to local hospitals. And Alexandra Leto, class of 2021, mans the phones to triage patients, walk them through telehealth appointments, and disseminate accurate information about the virus.

Although they were no longer allowed to provide direct patient care once COVID-19 emerged in the region, Walsh, Gao, and Leto—along with more than 500 other SKMC students—sprang into action to support their mentors and patients through volunteerism. They joined the approximately 2,000 health profession students across Philadelphia who have taken on a variety of activities to contribute to the health and well-being of the city in the face of unprecedented circumstances, spending hours each week supporting a multitude of efforts in addition to taking remote classes and completing virtual projects designed to continue their education.

“Sidney Kimmel Medical College attracts extremely bright and talented students who are really passionate about helping others and providing clinical care. This situation has basically sidelined them, so they have naturally gravitated to activities where they can make a difference and improve the lives of others in very creative ways,” says Charles Pohl, MD ‘87, Vice Provost of Student Affairs at Thomas Jefferson University and Vice Dean of Student Affairs and Career Counseling at SKMC. “They’ve become part of the workforce by participating in new volunteer experiences.”

The JeffMD curriculum is heavily invested in placing students with patients and in group-based learning settings. But the arrival of COVID-19—and social distancing—changed all that. Jefferson, like most medical schools across the country, followed the recommendation of the Association of American Medical Colleges and pulled its students from clinical settings and out of classrooms and lecture halls.

Pohl said the decision at Jefferson was based on three principles: patient and student safety; student wellness amidst a stressful learning environment; and proper academic oversight.

“Regarding safety: our top priority is the safety and well-being of our patients and learners, and we worried about the risk to those who have a compromised immune system or an underlying chronic medical condition—both patients and students,” says Pohl. 

“We were also very worried about the stressful clinical setting in light of the high volume of patients, acuity of their illness, and the shortage of resources such as PPE.” The biggest concern was that the students would not be prepared to handle such situations yet, and throwing them into such a medical maelstrom would put them in jeopardy both physically and emotionally.

The third consideration was that the overburdened clinical faculty couldn’t give the students proper oversight.

And, while a few medical schools allowed early graduations to put new doctors in the field, Jefferson, as with most medical schools across the country, followed the recommendation of the Accreditation Council for Graduate Medical Education (ACGME) and did not take this approach. The medical college was prepared to reverse course if the pandemic reached a dire state.

“For their safety and well-being, you have to ensure these graduates have the proper onboarding… and proper supervision,” Pohl says.

Without the ability to interact with patients, mentors, or classroom peers, the students have turned their attention, time, and desire to do good elsewhere.

“It’s pretty remarkable how our students have mobilized,” Pohl says. “Today, our students are still instrumental in assisting our healthcare teams through a myriad of volunteer activities; they still have the Jefferson spirit of giving compassionate patient care.”

Terry Gao, who is moving on to a residency in surgery at Temple University Hospital this year, admits, “All of us experienced a wave of disappointment in the beginning, but we have been really good at refocusing our energy. Medical students are very proactive and restless people; most of us are trying to find ways to be as helpful as possible. It gives us a sense of purpose.”

Gao is active in the Philadelphia Organization of Health Professionals (POHPS), a citywide group that includes students in nursing, physical and occupational therapy, podiatry, veterinary medicine, and more. Their projects include PPE2PHL, a PPE collection and distribution effort; JeffSitters, which matches student volunteers with those on the front lines in need of childcare and pet care while they are at work; and providing online tutoring for the children of healthcare workers who need help with schoolwork.

POHPS has also partnered with Feed Philly Heroes, a local nonprofit that matches young people with hospitality industry leaders for mentorship programs. POHPS collects funds so that restaurant owners and trainees can create low-cost meals to send to healthcare workers on the front lines.

Carrie Walsh, who is set to begin her residency at Massachusetts General and Brigham and Women’s Hospital this summer, wrote to the director of the emergency department offering to “help in any way—put patients on bed pans, draw labs… be an extra person on the team.” Her request was denied, so she turned to volunteering with MANNA, delivering healthy food to patients who are seriously ill or incapacitated, or just cannot get out to a store due to the virus.

“It’s hard when you know that your friends and future coworkers are on the front lines and you’re at home,” Walsh says. “So we are trying to be useful in any way we can.”

Alexandra Leto’s volunteer spirit led her to the phones to help guide patients through telehealth visits, triage those unsure whether or not to go to the hospital, and answer questions about the COVID-19 virus. She is also lending a hand in other projects, including organizing iPad donations so that patients can have remote visits with loved ones and physicians can consult with each other virtually.

“Students have been pulled (out of the hospital), but there’s still a desire to help out, and that has instilled a greater sense of community,” Leto says. “It’s not just about your personal journey; it’s about how you contribute.”

One of the biggest contributions they have made is increasing the PPE supply to keep staff on the front lines of care safe.

“They found out on a Saturday morning that (medical staff) were burning through about 350 facial shield masks a day, and needed an assemblage of about 10,000,” Pohl says. “By Monday morning, the students mobilized and assembled 10,000.” And they did it all with careful social distancing—the assembly tables were six to eight feet apart.

Another project involved refurbishing 30,000 out-of-date N95 masks that needed the elastic replaced. Within two weeks, the masks were repaired, and able to be put into use.

Some of the volunteer activities have nothing to do with hands-on healthcare. There are groups of students offering childcare and pet sitting services for doctors, nurses, and other staff members working shifts in the hospital, and providing online tutoring and homework help for the children of healthcare providers and hospital staff.

While COVID-19 has caused pain and suffering, a novel idea has grown out of the pandemic: the creation of a website to curate all of the volunteer initiatives throughout Thomas Jefferson University onto one platform. Each department can add a project so that students in search of an activity can sign up directly, thereby eliminating the “middle man” and getting help where it is needed quickly and efficiently. Leto believes the website will serve as a prototype for the future of volunteerism.

“We’re hoping to have the platform implemented for other volunteer efforts at Jefferson, such as JeffHOPE and other community service endeavors,” she says. “We want to keep this alive (after the COVID-19 crisis) so it can be a model for volunteering.”

Pohl says he is proud of the students, who are carrying on “the Jefferson way.”

“It’s roll up your sleeves; it’s being passionate about patient care,” says Pohl, a third-generation Jefferson graduate, who is also married to a Jefferson graduate.

“Through all of this, our students have maintained the Jefferson spirit of caring,” he says.“ Over the past 200 years Jefferson has had a longstanding tradition of producing future leaders of the healthcare workforce, and providing excellent patient care for our neighbors. The ongoing and unwavering altruistic actions of our students should give everyone comfort and hope for the future.”