Table.

Coronavirus Disease 2019 (COVID-19): Learner Risks, Rewards, Level of Consent, and “Duty to Treat”^a

Type of activities	Details	Risks	Consent or “duty to treat” rationale6	Institutional responsibility	Benefits
Risks are low to high
Medical student volunteer activities in low-risk settingsb	Call center staffing from home; telemedicine checking in with patients, making masks and other PPE; supporting research and surveillance work from home	Low	Explicit consent (to volunteer)	Ensure activities are “safe,” offer appropriate training and supervision	Provides leadership opportunity in support of frontline staff and opportunity for training in triage principles and critical resource utilization
Medical student volunteer activities in moderate-risk community settingsb	Working with community organizations and engaging in support activities in the community. These opportunities may include activities such as staffing at a call center; staffing volunteer organizations; creating items needed by health care organizations; and shopping, delivering groceries, babysitting, and doing other errands for caregivers, health care workers, patients, or families of patients	Low to moderate	Explicit consent (to volunteer)	Ensure activities are “safe,” offer appropriate training and supervision and PPE as warranted; under medical school liability	Provides leadership and team-building opportunities in support of frontline staff; provides significant psychological benefit to frontline workers; development of a sense of community that “we are all in this together”
Medical student volunteer activities in patient care settings (including volunteer activities and clinical clerkships)b	Deployment in lower-risk settings. Activities include service in traditional medical clerkship student roles and volunteer service as “scribes,” runners, clinical support, and similar activities	Low to moderate	Required component of medical student clinical education; explicit consent (to volunteer)	Offer supervision and appropriate training, including training in infection prevention and provide adequate PPE for both clinical clerkship and volunteer activities; under medical school liability	Allows students to fulfill clinical clerkship requirements; as volunteers, students support frontline staff; provides mentorship opportunities and observation of frontline personnel
Residents/fellows providing patient care activities in an educational context13,14	Provide routine care alongside fully trained physicians and staff, taking call, and taking care of all patient care and consider including aerosol-generating procedures with proper training and strict supervision	Moderate to high	Contractual agreement	Offer supervision and appropriate training, including training in infection prevention and provide adequate PPE; under hospital liability	Provides critical frontline clinical leadership growth and opportunities to learn and use principles of crisis resource management
Medical student deployment after “early graduation,” cross-deployment of residents/fellows and fellows in unsupervised practice in their core specialty3	During COVID-19 surge operations, provide care alongside fully trained physicians and staff, taking overnight call and caring for patients	Moderately high to high	Licensure for supervised practice (medical students), appointment to medical staff (fellows in unsupervised practice)	Offer just-in-time training before redeployment and provide adequate PPE; provide adequate supervision for early graduated students; ensure trainees are protected under hospital liability	Provide for added staffing to respond to clinical surge situations; educational benefits will vary by context and are not the primary rationale

^aPPE = personal protective equipment.

^bCOVID-19: Frank H. Netter MD School of Medicine, Quinnipiac University. Three tiers of medical student COVID-19 volunteer activities. Traci Marquis-Eydman, MD, written communication, March 29, 2020.