American Medical Schools Research Articles

Medical student knowledge and concern regarding mental health disclosure requirements in medical licensing

ObjectiveTwo-thirds of United States medical boards require disclosure of mental health treatment or diagnosis during licensure, with negative influence on physician well-being but unknown impact on medical students. This study sought to understand whether medical students perceive mental health treatment to be a threat to their future medical license. MethodStudents at an American medical school in a state without disclosure questions completed an anonymous fourteen question survey. Analysis with univariate and multivariate statistics explored knowledge, opinion, and impact of disclosure questions. ResultsData was obtained from 327 medical students, a 53% response rate. The majority—91% (299)—were unsure or incorrect as to whether their state licensing board requires mental health disclosure. 33% (86) reported disclosure questions substantially discourage them from seeking mental health treatment. Of the 32% (105) who accessed mental health treatment during medical school, half—52% (74)—would not disclose during licensing. Those who believe that disclosure could impact their license were more likely to be discouraged from seeking care (OR, 5.23 [95% CI, 1.97–15.99]; P = 0.002). Most students—75% (245)—opposed mandatory disclosure. ConclusionsConcern about mandatory mental health disclosure discourages medical students from seeking care, despite uncertainty about disclosure questions.

“We Do Not Want Him Because He Is a Jew”: The Montreal Interns' Strike of 1934

Speeches by modern-day White supremacists often include such statements as "Jews will not replace us." In 1934, the French-speaking medical interns of Montreal's Roman Catholic hospitals went on strike because, they alleged, a Jew "replaced" a Roman Catholic French Canadian. Anti-Semitic social and economic boycotts and educational quotas were in existence in Canada from the 19th through the mid-20th century. There were particularly strong anti-immigrant and anti-Semitic feelings in the first half of the 20th century in Quebec, along with anti-Semitic pro-fascist political parties. In 1934, Montreal's Hôpital Notre-Dame (HND), a teaching hospital of the Université de Montréal (UM) medical school, was unable to hire a full complement of medical interns from among the newly graduated French-speaking Roman Catholic medical students. The hospital hired a French-speaking Jewish graduate of UM, Samuel Rabinovitch. The prospective interns at HND submitted a petition demanding that Rabinovitch be fired, stating, "We do not want him because he is a Jew." On 14 and 15 June 1934, HND's interns went on strike to prevent Rabinovitch from taking up his duties. The strike spread to multiple hospitals in Montreal. A Jewish urology trainee at the Hôtel Dieu hospital, Abram Stilman, was also targeted. Rabinovitch resigned in order to bring the strike to an end. The strike buttressed the case in the first half of the 20th century for American and Canadian Jewish hospitals and medical schools to ensure the education of Jewish physicians, reminds us of the origins of the slogans of modern White supremacists, and reinforces the historical basis of efforts to promote diversity and inclusion in medical education.

Abstract No. 97 Pediatric interventional radiology workforce in North America: a descriptive analysis of demographics, educational backgrounds, and scholarly activities

To analyze the demographics, academic background, and scholarly activity of pediatric interventional radiologists (PIRs) across the United States (US) and Canada A list of all members of the Society for Pediatric Interventional Radiology was obtained, and PIRs at academic and private practice institutions in the US and Canada were included. Publicly available online sources were used to gather demographic and educational information, including online curriculum vitae, HealthGrades.com and Doximity.com websites, and Elsevier’s Scopus database. Demographic and educational data such as age, gender, education, academic rank, prior leadership positions, and metrics of scholarly activity were recorded. Fellowships in diagnostic pediatric radiology, adult interventional radiology, and/or pediatric interventional radiology were recorded. Mann-Whitney U and Kruskal-Wallis tests were used to compare the differences between groups. A total of 125 pediatric interventionalists were included, of which 24 (19.2%) were female. The mean age was 48.59 years (SD 10.58, median 45, range 36-82). There was no statistical difference between median age for male versus female PIRs (44.5 vs 45, P = 0.89). A majority of PIRs were American medical school graduates (AMG) (96, 76.8%), while 29 (23.2%) were international medical graduates (IMGs). Eighty-three percent (104) of PIRs completed diagnostic radiology residency in the US, most commonly at the University of Cincinnati (6.4%) and University of Washington at St. Louis (5.6%). Amongst fellowship training, pediatric interventionalists had completed a pediatric radiology fellowship (61.6%), adult interventional radiology fellowship (40%) and/or a dedicated PIR fellowship (57.6%). The mean (and median) publication, citations and h-index for pediatric interventionalists was 31.63 ± 44.84 (12), 668.2 ± 1316.57 (120) and 9.18 ± 10.07 (5), respectively. There was a statistically higher number of publications, citations and h-index with increasing academic rank at assistant, associate and professor levels (P< 0.001 for all groups). IMG PIRs had a higher, but not statistically significant median publication count (26 vs 11, P = 0.25), citation count (236 vs 93, P = 0.35) and h-index (9.0 vs 4.5, P = 0.24), compared to AMG PIRs. Pediatric interventionalists in North America are predominantly male, with about a quarter having graduated from international medical schools. Pediatric radiology fellowship followed by PIR fellowship was the most frequently pursued training pathway.

Nutrition in medical education in Latin America: Results of a cross-sectional survey.

The gap between the nutrition education provided to medical students and the nutrition competences and attitudes needed for doctors to provide effective nutrition care is a global concern. The goal of this study was to investigate the curricular content on nutrition education in Latin American medical schools and to evaluate the self-perceived knowledge, attitudes, and barriers to nutrition practice of final-year medical students. Eighty-five public and private medical schools from 17 Latin American countries were invited to participate in the study. Two close-ended online questionnaires consisting of 25 and 43 questions were sent to medical school directors. Quantitative variables were expressed as frequencies, percentages, mean ± standard deviation, medians, and ranges. A total of 22 (26%) medical school directors responded, of which 11 schools (50%) offered stand-alone mandatory nutrition courses in preclinical and 8 (36%) in clinical years. The mean hours dedicated to nutrition education was 47 (range: 0-150). A total of 1530 of 1630 (94%) students from 12 countries responded. Students' average age was 25 ± 3 years, and 59% were female. Most students agreed that improving patients' health through nutrition (91%) is important and that nutrition counseling and assessment should be part of routine care provided by all physicians (89%), but they lack the level of education and training required to address nutrition-related issues. Positive attitude and interest in nutrition among final-year medical students is high, but nutrition education is not perceived as sufficient to adequately prepare doctors in the field of nutrition.

Diversity in Dermatology? An Assessment of Undergraduate Medical Education.

A lack of representation of skin of color (SoC) in dermatology curricula is well-documented across North American medical schools and may present a barrier to equitable and comprehensive undergraduate medical education. This study aims to examine representation in dermatologic educational materials and appreciate a link between bias in dermatologic education and student diagnostic ability and self-rated confidence. The University of Toronto Dermatology Undergraduate Medical Education curriculum was examined for the percentage photographic representation of SoC. A survey of 10 multiple-choice questions was administered to first- and third-year medical students at the University of Toronto to assess diagnostic accuracy and self-rated confidence in diagnosis of 5 common skin lesions in Fitzpatrick skin phototypes (SPT) I-III (white skin) and VI-VI (SoC). The curriculum audit showed that <7% of all images of skin disease were in SoC. Diagnostic accuracy was fair for both first- (77.8% and 85.9%) and third-year (71.3% and 72.4%) cohorts in white skin and SoC, respectively. Students' overall self-rated confidence was significantly greater in white skin when compared to SoC, in both first- (18.75/25 and 17.78/25, respectively) and third-year students (17.75/25 and 15.79/25, respectively) (P = .0002). This preliminary assessment identified a lack of confidence in diagnosing dermatologic conditions in SoC, a finding which may impact health outcomes of patients with SoC. This project is an important first step in diversifying curricular materials to provide comprehensive medical education.

Pediatric interventional radiology workforce in North America: a descriptive analysis of demographics, educational backgrounds and scholarly activities.

Pediatric interventional radiology has grown as an advanced subspecialty with increased demand, number and complexity of cases, and number of pediatric institutions offering a pediatric interventional radiology service. Despite the overall increase in the number of pediatric interventionalists over the past two decades, there is a heterogeneity in their academic backgrounds and a lack of uniform training pathways. To analyze the demographics, academic backgrounds and scholarly activities of pediatric interventionalists across the United States (U.S.) and Canada. A list of all members of the Society for Pediatric Interventional Radiology was obtained and pediatric interventionalists at academic and private practice institutions in the U.S. and Canada were included. Publicly available online sources were used to gather demographic and educational information about each pediatric interventionalist, which included the online curriculum vitae, the HealthGrades.com and Doximity.com websites, and Elsevier's Scopus database. Demographic and educational data including age, gender, educational background, additional degrees, academic rank, previous leadership positions, and metrics of scholarly activities were recorded. Fellowships in diagnostic pediatric radiology, adult interventional radiology and/or pediatric interventional radiology were recorded. Mann-Whitney U tests and Kruskal-Wallis tests were used to compare differences between groups. One hundred and twenty-five pediatric interventionalists were included, of whom 24 (19.2%) were female. The mean age was 48.6years (standard deviation [SD]: 10.6, median: 45years, range: 36-82years). There was no statistical difference between median age for male versus female pediatric interventionalists (44.5years vs. 45years, P=0.89). A majority of pediatric interventionalists were American medical school graduates (96, 76.8%), while 29 (23.2%) were international medical graduates. Eighty-three percent (104) of the pediatric interventionalists completed diagnostic radiology residency training in the U.S., most commonly at the University of Cincinnati in Ohio (6.4%) and Washington University in St. Louis, MO (5.6%). Among fellowship training, pediatric interventionalists completed a pediatric radiology fellowship (61.6%), adult interventional radiology fellowship (40%) and/or a dedicated pediatric interventional radiology fellowship (57.6%). The mean±SD (median) publications, citations and Hirsch index (h-index) for pediatric interventionalists were 32±45 (12), 68±1,317 (120) and 9±10 (5), respectively. There was a statistically higher number of publications, citations and h-index with increasing academic rank at the assistant, associate and professor levels (P<0.001 for all groups). International medical graduate pediatric interventionalists had a higher, but not statistically significant, median publication count (26 vs. 11, P=0.0.25), citation count (236 vs. 93, P=0.36) and h-index (9.0 vs. 5, P=0.24) compared to pediatric interventional radiologists from American medical schools. Pediatric interventionalists in North America are predominantly male, with about a quarter having graduated from international medical schools. Pediatric radiology fellowship, followed by pediatric interventional radiology fellowship, was the most frequently pursued training pathway.

Analysis of Gender Disparity in US and Canadian Radiology Residency Programs

BackgroundEquity, diversity, and inclusion in academic radiology are a work in progress and although the gender gap has decreased, there remains a paucity of studies examining female representation among radiology trainees over the past decade. ObjectiveThe aim of our undertaking was to evaluate gender parity in United States (US) and Canadian radiology residency programs and to suggest future directions to improve female representation Materials and MethodsRetrospective analysis of publicly available data on radiology residents from the US and Canada was performed from 2007to 2019. Data on diagnostic radiology residents was collected from the Accreditation Council for Graduate Medical Education for the US and the Canadian Post M.D. Education Registry for Canada. Statistical tests including regression and ANOVA were used to study the gender proportions from 2007to 2019. ResultsThere has been little progress in bridging the gender gap in the last 12 years. The proportion of female residents pursuing radiology has remained at an average of 26.74% (n = 1,238of 4,629) in US programs and 31.78% (n = 28 of88) in Canadian programs. The average change in the percentage of female residents was 0.0% per year (P = 0.0) for US programs and -2.9% per year (P = 0.3) for Canadian programs. DiscussionDespite a higher proportion of females in North American medical schools, gender disparity persists among radiology residents. More research is needed to identify barriers limiting female representation and improve gender parity across North American radiology programs.

Medical Student Perceptions of the Learning Environment, Quality of Life, and the School of Medicine's Response to the COVID-19 Pandemic: A Single Institution Perspective.

PurposeResponding to the COVID-19 pandemic, American medical schools made swift changes to clinical education based on guidelines provided by the Association of American Medical Colleges. The purpose of this study was to collect medical student perceptions of the solely online learning environment, their quality of life (QoL), and the pandemic response by their School of Medicine (SoM) to provide suggestions to inform medical schools’ responses during the continuation of this pandemic and the next.MethodsBetween April 29, 2020 and May 16, 2020, the authors distributed a 60-item questionnaire that assessed demographics, learning environment, QoL, and the SoM response. Likert-type items were analyzed on an item-by-item basis, whereas themes were identified for open-ended questions.ResultsA total of 330 medical students (of 632; 52.2%) responded. Those who responded had positive perceptions of the online learning environment with moderate QoL disruptions to concentration and sleep. Although most students perceived being able to contribute meaningfully to the healthcare setting, they viewed themselves as underutilized. Three themes encapsulated both positive and negative perceptions of the SoM’s response—communication, learning environment, and empathy and support.ConclusionThese findings provide insight into medical student perceptions of their learning environment and QoL as they acclimated to changes resulting from the COVID-19 pandemic. Results can help inform a SoM’s response during the continuation of the COVID-19 pandemic as well as during future pandemics or crises. Follow‐up surveys of medical students at multiple institutions across the USA and abroad will be essential to better characterize student perceptions.

The Current Status of Ultrasound Education in United States Medical Schools.

Ultrasound is used by nearly every medical specialty. Medical schools are integrating ultrasound education into their curriculum but studies show this to be inconsistent. The purpose of this study was to provide an updated description of ultrasound in the curricula of United States Accredited Medical Schools (USAMS). In 2019, USAMS curricular offices were contacted. Institutions were asked about the presence of ultrasound curriculum and for contact information for faculty involved with education. Schools reporting ultrasound curriculum were surveyed regarding details of their curriculum. Two hundred USAMS were contacted with a response rate of 84%. Of 168 schools, 72.6% indicated they have an ultrasound curriculum. For schools with a curriculum, 79 (64.8%) completed our survey. The majority of survey respondents, 66 (83.5%), indicated having mandatory ultrasound. Ultrasound is primarily integrated into courses (73.8% in basic science courses, 66.2% in clinical skills courses, and 35.4% in clinical rotations). Emergency medicine physicians accounted for 54.7% of course directors. Ten or fewer faculty participate in education in 68.4% of schools and mostly as volunteers. Dedicated machines for education were reported by 78.5% of schools. Compared to prior studies, this study had a higher response rate at 84%, and more schools reported ultrasound in their curricula. Emergency medicine represents the majority of leadership in ultrasound education. Despite increased integration of ultrasound into American medical school curricula, its instruction is still inconsistent.

Three Things Schools Should Do to Make Advancement Assessment Just.

This article considers how student advancement assessment in American medical schools undermines equity. Although much attention is paid to admissions processes' capacity to diversify the physician workforce, students' advancement has been neglected as the next key step along their journeys toward graduation and residency training. This article canvasses common ways advancement undermines equity and suggests 3 areas of focus. In particular, it suggests that retention, student progression, and career advancement milestones are at least as important as admissions-based efforts to promote justice in medical education opportunity.

Characteristics of MD Matriculation in American Universities

Characteristics of MD matriculation in American universities lie in cooperation between Association of American Medical Colleges and Medical Schools on campus. AAMC highlights its role in three aspects, arranging Medical College Admission Test, providing American Medical College Application Service, entrusting to conduct Criminal Background Check. Medical School takes its part by proclaiming premedical courses and identifying applicants with attributes essential for medical education. The outcome of cooperation is having satisfying matriculants. The essence underlying is the professionalism permeated in medicine profession.

An evaluation of a medical student international service-learning experience in Southeast Asia.

International service-learning trips (ISLTs) are structured experiences in a different country where students interact and engage in cross-cultural dialog with others. Month-long ISLTs originating from North American or European medical schools enhance clinical acumen, cultural awareness, and global health familiarity. The impact of experiences shorter than 1 month or those that originate from Asia is unknown. We aimed to determine the impact of a short-term ISLT on medical students' clinical and cultural competence. At Duke-National University Singapore, we developed an ISLT incorporating peer-assisted learning and a 1-week on-site experience delivering supervised primary care, health screening, and health education in an underserved Southeast Asian community. Using a prospective controlled design, we assessed its impact on medical students' clinical and cultural competency using validated surveys. We compared medical students who participated in the ISTL (intervention group) to a control group of students before and after the ISTL experience. We analyzed responses using univariate analysis and the Kruskal-Wallis test. : Sixty-six students responded to the survey (100%). After the ISTL, the intervention group (n = 32) showed an increase in their ratings of clinical competency (preexperience mean = 3.39, postexperience mean = 3.81, P < 0.01) as well as an increase in their cultural competency domains (preexperience mean = 3.61, postexperience mean = 4.12, P < 0.01). Post the ISTL, students in the intervention group rated their clinical and cultural competency higher than the control group (n = 34) (clinical: intervention postexperience mean = 3.81, control postexperience mean = 3.30, P < 0.01; cultural: intervention postexperience mean = 4.12, control postexperience mean = 3.50, P < 0.01). After the ISTL, the intervention group reported increased ratings of self-efficacy (pre mean = 3.99, post mean = 4.29, P = 0.021), which were higher than the control group (pre mean = 4.29, post mean = 3.57, P < 0.01). : This short-term ISLT in an Asian medical school improved students' clinical and cultural competency and self-efficacy. Our findings suggest a positive impact of short-term ISLTs if designed and implemented with a student learning focus.

Radiation oncology education and experience in the undergraduate medical setting

ABSTRACT The goal of this study was to determine the impact and experience of radiation oncology (RO) education in the undergraduate medical experience in the USA. A list of American medical schools was complied from various sources including the Association of American Medical Colleges (AAMC) and American Association of Colleges of Osteopathic Medicine (AACOM) in the summer of 2019. Data was extracted through institution website review, individual phone calls and email distribution. A total of 198 programs (155 allopathic and 43 osteopathic medical schools) were included. Every medical school curriculum had oncology lecture during MS year 1 and 2, although a minimal amount (4%) had a RO-specific lecture during MS year 1 and 2. There were significant differences in the RO education and experience in allopathic (MD) versus osteopathic (DO) programs. Home radiation oncology programs and career advising were associated with a radiation oncology elective during year 3 and 4. Furthermore, RO career advisors and older schools were associated with having one student match into radiation oncology. RO education during the didactic portion of the undergraduate medical experience remains extremely limited. This limitation is even more pronounced in medical schools without RO mentorship and in osteopathic medical schools. This lack of RO exposure perpetuates itself by bringing less students into the field. These issues require attention both on a national and medical-school-specific level.

DARTMOUTH MEDICAL SCHOOL IN THE USA: ESTABLISHMENT, INNOVATORS, AND INNOVATIONS (THE LATE 18TH – 19TH CENTURY)

The article reveals the peculiarities of the Dartmouth Medical School establishment. Moreover, the author appeals to American outstanding innovators and innovations from the late 18th century to the 19th century. Note that N. Smith was an innovator-organizer of American medical schools (Dartmouth Medical School, Yale School of Medicine, Bowdoin Medical School, and Jefferson Medical College in Philadelphia). Besides, N. Smith’s methods of typhus treating and certain surgical operations, as ovariotomy, staphyloraphy, were innovative in American medicine. Also, R. Mussey, D. Crosby, E. Peasley, C. Frost provided innovative activity at Dartmouth Medical School during the 19th century. Among the crucial innovations, there were new departments, implementation of new teaching methods within the educational process, use of various European practices and devices, including the X-ray apparatus, etc.

Competent to provide compassionate care? A critical discourse analysis of accreditation standards.

Medical school accreditation is recognised internationally as an important quality control process for programmes that lead to the Medical Doctor (MD) degree. Accreditation standards govern the accreditation process which in turn drives educational objectives. Given the power of these standards to shape what becomes valued in the curricula, it is therefore imperative to ensure that core values and ideals of the profession are meaningfully incorporated. As the provision of compassionate care has long been a central medical value, this value should be clearly articulated in MD programme accreditation standards. We conducted a Critical Discourse Analysis of compassionate care within Undergraduate Medical Education (UME) Accreditation Standards governing North American medical schools since 1957. We explored how and to what extent the written language of the accreditation standards incorporated compassionate care. References to compassionate care in the UME Accreditation Standards were few and far between. Historically, a statement of 'The Objectives of Undergraduate Medical Education' published by the Association of American Medical Colleges (AAMC) was referenced for the first and only time in the 1957 standards, describing the development of attributes such as the provision of compassionate care as a basic objective of UME. Thereafter, there was infrequent mention of this value. Terms that could potentially incorporate aspects of compassionate care were identified, yet these were explicated in ways that limited connection to compassion. Instead, the term 'care' has increasingly been used instrumentally (ie acute care, chronic care). The relative absence of language pertaining to compassionate care in accreditation standards is troubling as compassion is integral to good medical care. This absence is particularly important to attend to in the current era of competency-based training where we must be explicit about all important curricular objectives lest essential values and practices be unintentionally lost.

Medical Student Attitudes toward USMLE Step 1 and Health Systems Science – A Multi-Institutional Survey

Phenomenon: Because of its importance in residency selection, the United States Medical Licensing Examination Step 1 occupies a critical position in medical education, stimulating national debate about appropriate score use, equitable selection criteria, and the goals of undergraduate medical education. Yet, student perspectives on these issues and their implications for engagement with health systems science-related curricular content are relatively underexplored. Approach: We conducted an online survey of medical students at 19 American allopathic medical schools from March-July, 2019. Survey items were designed to elicit student opinions on the Step 1 examination and the impact of the examination on their engagement with new, non-test curricular content related to health systems science. Findings: A total of 2856 students participated in the survey, representing 23.5% of those invited. While 87% of students agreed that doing well on the Step 1 exam was their top priority, 56% disagreed that studying for Step 1 had a positive impact on engagement in the medical school curriculum. Eighty-two percent of students disagreed that Step 1 scores should be the top item residency programs use to offer interviews. When asked whether Step 1 results should be reported pass/fail with no numeric score, 55% of students agreed, while 33% disagreed. The majority of medical students agreed that health systems science topics were important but disagreed that studying for Step 1 helped learn this content. Students reported being more motivated to study a topic if it was on the exam, part of a course grade, prioritized by residency program directors, or if it would make them a better physician in the future. Insights: These results confirm the primacy of the United States Medical Licensing Examination Step 1 exam in preclinical medical education and demonstrate the need to balance the objectives of medical licensure and residency selection with the goals of the broader medical profession. The survey responses suggest several potential solutions to increase student engagement in health systems science curricula which may be especially important after Step 1 examination results are reported as pass/fail.

Animating Primary Hemostasis for Medical Student Education

Physicians have difficulty recognizing and diagnosing disorders of primary hemostasis. The root of this may lie in their education, where students are often taught hemostasis using static graphics. We aimed to create a didactic animation on primary hemostasis for medical students to be used in North American medical schools. To promote widespread use of the animation, we surveyed hemostasis educators from Canada and the US on the animation’s learning objectives. The animation’s script and storyboard were developed using the Animation Processing Model (APM), a psychological processing model that addresses the perceptual limitations of learners. This animation is the first biomedical animation to use the APM in its design. Furthermore, this is the first didactic hemostasis animation which sought peer consensus for its learning objectives.

Promoting a More Inclusive Definition of Global Health in U.S. Medical Schools

Due to increased funding opportunities, faculty recruitment, and growing interest among medical students, global health has evolved into a mainstay in American medical education. However, medical schools continue to engage with global health through fundamentally different definitions of the term itself.1,2,3 These interpretations range widely, from emphasis on neglected tropical diseases, to health systems strengthening. This essay offers a more concise and inclusive definition of global health for academic inquiry undertaken by medical schools in this field - to interpret the word global as global in scope, rather than global in geography alone. Clarifying the definition of global health in this manner offers three distinct advantages. First, it would better align American medical schools’ global health interests to the Sustainable Development Goals passed in 2015 by the United Nations, and other consensus documents shaping the current global health agenda.4 Second, this definition would encourage researchers from non-traditional disciplines in academic medicine to collaborate with medical schools on global health projects. Finally, it would facilitate smoother translation of global health practices between developed and developing countries. Reforming the definition of global health in this nature would ultimately preserve the problem-solving ethos of this field, while streamlining its commendable efforts to improve society.

The virtualization of medical education in response to COVID-19: A Harvard and McGill pre-clerkship medical student perspective

In response to the spread of SARS-CoV-2 across North America in early March of 2020, Canadian and United States medical schools swiftly virtualized medical education for pre-clerkship students. With remote learning arrived novel challenges: barriers to students’ comprehension of course material, difficulties conveying the nuances of patient interaction, and social hardships hindering students’ continued progress. The 2020 Harvard-McGill Medical Student Exchange, a group of ten McGill University Faculty of Medicine and Harvard Medical School students, analyzed their institutions’ respective responses in the virtualization of medical education and their personal experiences with remote pre-clerkship education. The authors’ work provides insight into opportunities for mutual progress and cross-cultural exchange between Canadian and American medical schools, in the context of the COVID-19 pandemic. The authors detail potential changes to didactics, student research opportunities, support for students, and clerkship preparation that they expect would benefit pre-clerkship students in an ever-changing biomedical landscape. With gratitude toward their respective programs for their efforts in transitioning to virtual learning, the authors look toward a future of medical education increasingly interwoven with digital technology and responsive to social change.

The pre-clerkship medical student's experience during the COVID-19 pandemic: An international conversation with recommendations for progress

In response to the spread of SARS-CoV-2 across North America in early March of 2020, Canadian and United States medical schools swiftly virtualized medical education for pre-clerkship students. With remote learning arrived novel challenges: barriers to students’ comprehension of course material, difficulties conveying the nuances of patient interaction, and social hardships hindering students’ continued progress. The 2020 Harvard-McGill Medical Student Exchange, a group of ten McGill University Faculty of Medicine and Harvard Medical School students, analyzed their institutions’ respective responses in the virtualization of medical education and their personal experiences with remote pre-clerkship education. The authors’ work provides insight into opportunities for mutual progress and cross-cultural exchange between Canadian and American medical schools, in the context of the COVID-19 pandemic. The authors detail potential changes to didactics, student research opportunities, support for students, and clerkship preparation that they expect would benefit pre-clerkship students in an ever-changing biomedical landscape. With gratitude toward their respective programs for their efforts in transitioning to virtual learning, the authors look toward a future of medical education increasingly interwoven with digital technology and responsive to social change.