Letter to the Editor: Medical Student Concerns Relating to Neurosurgery Education During COVID-19: An African Experience

Letter:

Since the first diagnosis of 2019 novel coronavirus disease (COVID-19) in an African patient on February 14, 2020, African countries have been preparing for the outbreak. In Morocco, medical school closure was one of the drastic measures taken to withstand the healthcare system's deficiencies (lack of intensive care unit beds and medical staff). Many countries considered that suspension from clinical attachments was safer to prevent human-to-human transmission, thus risking compromise of the competency of the physicians in training.^{1 , 2} During these difficult times, most universities across the world have focused on the shifts and challenges for residency programs. Some authors highlighted the necessity to sustain not only theoretical but also clinical education of students, especially considering the eventuality that universities could not reopen.

In the era of digitalization, sharing information, and e-learning, we believe that it is our duty to ensure continuity and sustainability of medical training. In the Chinese experience, implementation of online learning techniques to complete curricula proved to be popular and efficient.¹ Therefore, Moroccan universities adapted to this unprecedented situation by quickly implementing online teaching programs using platforms where students could access classes replacing plenary lectures. In <1 week, a digital workspace was launched where students not only could receive proper medical education according to the program, but also interact with professors. As neurosurgical teachers, we were thus able to ensure the neurosurgical education required for physicians.

In addition, the Moroccan telecommunication operators offered free Internet access to digital platforms, ensuring the success of the program. Moreover, students have created alternative pathways through social media, and tutoring programs between residents and students were designed. A list of neurosurgical residents according to their city was shared on social media making the communication between the residents and students easier and reinforcing the e-learning technique.

Allowing medical students to perform clinical tasks has been beneficial to patients, outweighing the risks associated with students' involvement in a COVID-19 environment.^{2 , 3} Similar situations occurred in the past during the Spanish flu pandemic in 1918 and the polio epidemic in the late 1940s and early 1950s where medical students were actively involved in care of patients.⁴ We based the consistency of our clinical learning on volunteering. In fact, many departments were converted into COVID-19 facilities. Therefore, students felt marginalized, but they also felt the urge to attend to patients' care. An agreement was reached between administrators, professors, and medical students: according to their year of training, students are allowed some responsibilities in the care of patients under the supervision of senior residents or attending physicians, thus reducing the strain on medical staff. This program reinforces the values of solidarity, duty, patriotism, and altruism within our students' hearts.

Our experience shows that medical students are eager to be part of this historical fight.³ We should therefore not only give them the chance to commit themselves to patients' care but also continue to ensure proper medical training despite this catastrophic situation.