Qualitative Assessment of Medical Student Concerns About the COVID-19 Pandemic: A Multicenter Study Exploring Medical Student Perspectives

Purpose:

Medical school poses numerous stressors and challenges that can affect student well-being. ¹ Medical students are a vulnerable population within the system and may have a difficult time reporting concerns and questions to administration, particularly during the COVID-19 pandemic. ² We aimed to highlight medical student perspectives by assessing the priorities and most pressing concerns of medical students during the global pandemic via an online questionnaire.

Methods:

This is a cross-sectional qualitative study using a survey of medical students in 21 medical schools throughout the United States. Qualitative responses to open-ended questions assessing student’s concern during the pandemic were analyzed as part of a standardized iterative approach. All data were reviewed by 2 members of the research team, who independently used an inductive process to identify emergent themes. The data were analyzed and then coded by 2 authors who independently reviewed and applied codes to the 1 transcript and then met to compare code applications, resolved disagreements, and revised the codebook. The coders then independently coded designated sections of each transcript, maintaining periodic intercoder agreement at >80% on 23.8% of responses.

Results:

In total, 1,005 responses were collected. Seven core themes were identified regarding medical student concerns about the COVID-19 pandemic: medical education training, missed events not related to medical education training, financial considerations, student value and contribution, health and safety, systemic concerns, and topics not otherwise covered. COVID-19 had caused many concerns for medical students particularly as it relates to education and health and safety. One hundred one (10.05%) students expressed concern about their own personal safety, safety of direct contacts (111; 11.04%), safety of society (77; 7.66%), and access to personal protective equipment (60; 5.97%). Additionally, 481 (47.86%) respondents cited undergraduate medical training, 149 (14.82%) cited the United States Medical Licensing Examination training, 172 (17.11%) cited transition to graduate training, and 25 (2.49%) cited other educational concerns as their primary concerns during the pandemic.

Discussion:

This survey represents the most comprehensive assessment of U.S. medical students’ concerns during the first wave of COVID-19 in the United States. As key stakeholders in this evolving curriculum, it is imperative to ensure that medical students feel adequately protected and supported in their current roles through transparency in evolving educational curricula, tuition and other financial aid, community wellness initiatives, and personal health and safety measures.

Significance:

The long-lasting nature of this pandemic reinforces the need to develop interventions and strategies within medical education that are tailored to addressing the concerns and values of medical students. Programs should continue to harness the feedback from their student body to ensure their ongoing safety, welfare, and education. Student insight during these unprecedented times can help continue to guide response efforts for present and future public health crises. As the pandemic enters its second wave and conversations about vaccine distribution begin, programs can better address these emerging topics by including medical students in the conversation.

Acknowledgments:

The authors wish to thank all of the medical students and faculty who facilitated distribution of this survey across their respective institutions.