UPSOM Response to Covid19 Coronavirus Outbreak: 4/1/20 UPDATE
We have updated our community guidance in a few areas, which are highlighted at the top. At the bottom are previously issued but still valid recommendations, just as a reminder.
The situation continues to be rapidly changing. We will continue to post guidance as necessary, to keep our community informed. Check your e-mail frequently for updates from the school. We will post updated guidance on Navigator (bannered at the top):
In issuing guidelines, UPSOM is closely following recommendations from the CDC. We are obliged to follow guidelines from the University of Pittsburgh.
New Guidance (4/1/20):
Our leadership group has been reviewing the changing conditions related to Covid-19 and how it is affecting our clinical sites. We have been making month-to-month decisions in the hopes that things would improve to allow for a return to clinical rotations. After careful review of our current conditions and likely trends over the coming months, we are announcing today that we will extend our suspension of clinical rotations another month, through June 5. We will resume clinical rotations with Period 2, on June 8. We’re informing our community now to help clarify planning and allow people to make decisions more easily.
Although this is a hard decision, we also feel we need to be realistic. Many other schools have suspended their clinical rotations; the likelihood for us to return to clinical sites in May is so low at this point that we don’t want to delay the decision any further.
Many wonder how these are decisions are made. Briefly, UPSOM’s Strategy and Planning Committee, consisting of key deans from several offices, makes recommendations to Deans Thompson and Levine who make the final decision. Recommendations and decisions about clinical rotations have been made based on a variety of factors: hospital/clinic volume, site availability and openness, telemedicine capabilities and expertise, faculty time/availability, PPE/testing availability, guidance from national organizations (e.g., AAMC) as well as trends in peer institutions. The other factor, of course, is the news that Prometric testing centers will be closed until 4/30 at many sites, making Step 1 completion very difficult for our students. Everything is being pushed back.
It is possible that this will need to be extended through June (Period 2) at least for some clerkships or students, although based on our assessment, we’re more optimistic that most if not all clerkships and clinical electives will be able to run at that time, perhaps in modified form (e.g., utilizing telemedicine).
Instead of having clerkship/elective directors planning for May rotations that are unlikely to come to pass, we want to cancel now, so that we can work together to plan for what is likely to be a very disrupted 2020-21 academic year. We will assemble a group of administrators, faculty, and student representatives to plan for how we will manage the year given this truncation. To make this work for students, with the goal of insuring that our program learning objectives are met and that students reach their milestones to apply for residencies on time, we will be considering a variety of options:
- Expanding capacity on rotations where possible
- Shortening clinical experience duration where possible (both for clerkships and AIs)
- Offloading didactics/cases to be done remotely now with shorter clinical experiences later
- Extended the deadline for completion of clerkships
- Prioritizing rising MS4 needs for AIs and completion of missing clerkships
- Developing a process to fill dropped spots more quickly to assure full use of available spots
- Collaborating with clinical sites on using telemedicine for teaching
- Shifting dates/periods/intersessions/vacations to accommodate the changes
Just to be clear: rising MS3s and MS4s will be able to take electives remotely during the time of clinical suspension. We are working to expand our roster of such experiences for Period 12.5 and Period 1; we may be able to allow for remote “away rotations” at other schools who are all doing the same thing for their students. All non-clinical electives will continue to run remotely—research, narrative medicine, neuropharm, etc. We will try to develop a catalogue of such offerings to make it easier for students to switch in to them.
For current MS2s studying for Step 1, this means that you will have more time and flexibility to complete Step 1. You can schedule in May and take a study month then, hopefully returning for clerkships in June. But if you cannot get a testing date in time for that, you could also restart clerkships in June and take Step 1 later (by 12/31/20), using a study month later if you need.
Preclerkship week will be moved from its current May 4 week to the week of June 1. While we hope to do this in-person, we acknowledge it’s very likely this will be a remote learning activity as well. [Even if hospitals and clinic sites allow for students to work, Pitt may not be ready to reopen Scaife for learning groups by then—remember, they have cancelled their on-campus summer classes and are planning remote education through until August.] If we would suspend rotations for June, which is possible, we would try to move Preclerkship Week back again, to keep it contiguous with the start of clerkships for MS2s. That also means that Humanism Day and the Pinning Ceremony will take place at the end of that week, whenever it is (currently, Friday June 5).
Students can stay where they are for now. But if you will need to travel back to Pittsburgh for June, we strongly encourage you to consider coming back two weeks early to account for the possibility of self-quarantine requirements upon your return, or other travel issues. This depends on your unique circumstances and geography of course.
Again, we know this is far from ideal. And we know that there will be many challenges and problems. But we also want to provide more schedule certainty to enable everyone to make decisions more easily.
Thanks, as always, for your understanding and flexibility in these difficult times. Stay safe and healthy.
New Guidance (3/25/20):
New Guidance for MS3 and MS4 Periods 11 and 12
As the coronavirus situation continues to evolve, we wanted to offer new guidance for UPSOM, with a focus on clinical rotations. Briefly, effective March 30 we will suspend clinical clerkships/electives for another month.
March (Period 11):
Students are completing their clinical experiences remotely, with online cases, distance didactics, and the like. Assessments this week have largely been postponed—we are not holding any SHELF or OSCE exams. The new Allegheny County stay-at-home orders as well as Pitt restrictions on building usage preclude the exams, and NBME has agreed to offer SHELF exams remotely beginning April 7. Although it isn’t ideal, we felt that to protect the safety of our students, staff, and patients, it was better to postpone the SHELF exams until they can be done remotely in two weeks.
Once assessments are completed, students will receive grades for their Period 11 rotations. Because of the difficulty in accurately assessing based on limited clinical experiences and, in some cases, absent final assessments, we will grade students Pass-Fail for these. We know some students will be disappointed, but this is what our sister institutions are largely doing, and it’s what we feel is fairest. We will be annotating MSPEs (Dean’s letters) to assure that residencies are aware of what happened—every school around the country is in the same boat and residencies, we feel, will be understanding about this.
On some rotations, depending on a student’s schedule, experiences (current/past), and competency, directors may ask students to complete additional clinical experiences later in order to successfully complete that rotation. This will be uncommon and students will be notified.
For electives/AIs, course directors are encouraged to give students a grade (H/HP/P/LP/U) if they feel they have an adequate demonstration of student performance. If not, they are allowed to switch to Pass/Fail.
April (Period 12):
For next month, we had hoped to restart at least some clinical rotations, but it has become clear that will not be possible. Clinical sites lack the ability to provide students with appropriate testing, protective equipment, adequate cases, and teaching time due to the stresses on the health system. Remote teaching is possible but does not replace clinical experiences, and our telemedicine arrangements are too chaotic right now to count on for learning. We don’t want to start a clerkship only to have to cancel later, when the “surge” hits our area. Resident and faculty educators are likely to become unavailable very quickly, even if they may be willing to teach right now.
Students currently enrolled in 8-week rotations (CAMPC, Surg/Anesth, Medicine) will be able to continue remote didactics. CAMPC students will be credited for a full experience and don’t need to register for anything else now; the others are encouraged to register for another elective experience (see below). We plan on testing most students at the end of April as planned, which gives students time to study now and allows for more focused clinical work later. Grades for all these clerkships will also be Pass-Fail, and won’t be completed until after students complete their clinical experiences later.
|CAMPC||None needed—full credit for Periods 11-12||
No OSCE or customized SHELF available
Grade based on other components
|Medicine||1mo additional to be made up later||SHELF exam at end of April|
|Surgery||1mo additional to be made up later||SHELF exam at end of April|
None needed if already doneIf not already done, will need to make up later with surgery
|If done, exam will be given at the end of April; if not, exam will be done after clinical completed|
For students taking clinical electives, these will also be cancelled, including acting internships.
All students can go home during this month. It is possible that we will restart clinical experiences next month, but it is possible the suspension will continue.
For all students who are displaced from clerkships or clinical electives, we will have several options for you to pursue during Period 12, and the registrar will work to make sure everyone is appropriately switched. Options include:
- Research elective: we will be very flexible to allow students to get credit for taking a research month during this time, although keep in mind that there are restrictions on new experiments and building access. But for students who are completing an article, working on a literature review, or analyzing a remote data set, this could be a good option.
- Clinical radiology: we have expanded capacity and students who haven’t taken this can sign up—this will be remote.
- Pandemic experience: we added a new elective on the experience of pandemics—current science as well as perspectives from medical humanities, with independent reading/writing and two group sessions weekly. Drs. Veldkamp and Thamman are leading this. This elective will count as an ILS for students (MS3 or MS4) who need one. Register for MSELCT 5401.
There are other non-clinical electives in our catalog, and students could do any other of those that are available. Kim Kirk will follow up with details on how to switch for Period 12.
Other electives/selectives will go on remotely, notably bootcamp and ILS’s.
Obviously, this is far from ideal. By postponing these clerkships, we will have to struggle later with higher than usual numbers of learners in our clinical sites. But our school is committed to doing whatever we can to insure that students meet our program learning objectives. That may mean shortening required clerkships, waiving electives when not needed, and extending the window for completion of required clerkships—all to insure that students graduate on time and having successfully met curricular goals.
We’re sure that you will have questions about these changes. Please don’t hesitate to contact Drs. Harvey, Rosenstock, or Buranosky to discuss your situation, and we will try to get back to you with more information about all this as plans become clearer. Thanks again for your flexibility, understanding, and dedication—to clinical service, to our school, and to each other.
New Guidance (3/16/20):
We hope everyone is doing OK, taking care of themselves, while we all try to get through this crisis. We want to talk about three issues in today’s guidance: clinical rotations, Step 1, and volunteering/service.
Effective immediately, we are suspending all MS3-4 clinical rotations, for a period of two weeks, until we can determine the safety and educational value of continuing. This is based on changes at UPMC and in the community that have made it increasingly difficult for students to participate effectively in clinical rotations (transportation issues, declining patient volume, shortages of personal protective equipment, etc.). Students don’t want to inadvertently infect ill patients in the hospital, and some are understandably concerned for their own safety. Given all of these factors, we feel we need to call for a pause in clinical rotations until we can determine what makes the most sense going forward.
- This includes all required clerkships and other clinical rotations. It doesn’t include non-clinical electives (e.g., a research month).
- Clerkships or clinical electives may provide you with remote learning over these next two weeks (e.g., didactics via Zoom or Team, Aquifer cases, online modules) to help fill the gap in your learning.
- Assessments at the end of Period 11 (e.g., the SHELF exam or OSCE) will be conducted as planned for March 26-27.
- Specifics on all of this will be provided for you by the clerkship/elective director.
This will enable you to complete the rotation and get credit for period 11, which is the goal. We hope that because you’ve already done two weeks (plus today) of the rotation, if you do self-study and/or other learning activities over these next two weeks, you will have earned full credit for this period.
Students taking a two-month clerkship (medicine or surgery/anesthesiology) will return in period 12 (hopefully) and pick up with the rest of their rotation; we hope that that would “count” to fulfilling the entire eight weeks as well (with the only exception being for students who miss anesthesiology, who will have to make it up in some fashion, to be determined). Specialty Care Clerkship has yet to be determined in terms of how the two week pause will affect completion
For students on a research month, there may be restrictions on lab access or initiation of new experiments. You should check with their mentor for guidance.
It is possible, just to be clear, that after the two weeks, we will determine that it remains unfeasible for students to return to clinical rotations (a decision made in conjunction with faculty, clerkship directors, and UPMC). We all need to be prepared for how missing more time on rotations will affect timelines to graduation. We want to assure you that the school will do everything possible to be flexible in terms of completion of requirements so students can graduate on time—this might include waiving certain graduation requirements, decreasing the number of required electives, giving credit for alternate experiences, allowing for later clerkships or more time off during interview season, etc.
Many MS2s have asked about what will happen with their ability to take Step 1 in the coming weeks. Some Prometric testing centers have closed (including Pittsburgh 3/16-3/31), which has raised anxiety, understandably. As you know, USMLE is closely monitoring the situation and putting updates on their websites (as is Prometric). Unfortunately, no one knows how many closures there will be, and how students will be rescheduled. Some students asked about taking the exam earlier at an open site, to avoid risking a closure—if you are ready to take it and wish to, that’s fine of course. You should discuss these decisions with Laura Jeannerette, who can help you assess based on your specific situation.
If there are closures that affect our students ability to complete the exam as expected, we will revisit the policy that students must take Step 1 prior to starting clerkships. We could, for instance, allow students to start rotations and take Step 1 later when testing centers open. If there isn’t a general closure problem, we may need to make individual decisions for students. Again, our goal is to be as flexible as possible so students can continue expected timelines as best as we can.
Many students have asked about opportunities to help in the crisis, by volunteering or providing service of some kind to the system or community. We’re thrilled and proud to have students willing to pitch in during this difficult time. MS3-4 students can sign up with Dr. Thompson to help out within the system; training will be coming soon for that. Any student can choose, if they wish, to help at any community site, with two caveats: 1) it will not count for CE-Underserved, and 2) the school cannot guarantee your health/safety at any of those sites. It’s up to you.
Again, thanks to you all for your patience and understanding. Let us know if you have any questions or concerns, and don’t forget the guidance on Navigator which has full details.
- Any student or staff member should consider themselves at risk if they have EITHER:
- recent exposure to an infected person, OR
- a fever (Temperature >100.4) and signs of lower respiratory track illness (cough, shortness of breath)
- High risk individuals should stay home and call for medical guidance.
- Exposed individuals who have been screened and cleared for return to work can do so.
- Individuals who are severely ill should go to the emergency room.
- Students and staff are encouraged to avoid exposure to symptomatic individuals or travelers returning from high-risk areas, if possible.
- Some individuals may be at higher risk than others (e.g., immunocompromised, medical conditions, age). We encourage you to have a lower threshold for social distancing to protect yourself and the community. Please consult with your health care provider (or Student Health) if you have questions about your specific situation.
- Our lecture rooms, hallways, and small group rooms in Scaife have hand sanitizers and bathrooms—wash your hands frequently! Avoid touching your face, cover your cough, and practice other routine precautions against infection. Use surface disinfectants frequently (rooms are cleaned daily).
- Practice social distancing routinely—even if you’re not infected or quarantined yourself. This means staying home as much as possible, avoiding crowds unless absolutely necessary, maintaining 6 feet of distance between individuals when you can, not shaking hands, covering coughs, washing hands, etc. You can be a role model for the community and help prevent the spread of infection!
- CDC guidelines will help inform other prevention and treatment strategies, in collaboration with UPMC Infection Control. https://www.cdc.gov/coronavirus/2019-ncov/index.html
UPSOM promises to do everything we can to ensure that students are able to get what they need from the curriculum, even during this crisis. We will work so that students aren’t held up in terms of their timeline towards graduation or other milestones. We will individualize this to provide accommodations to those who need it. Everyone needs to be understanding and flexible, recognizing that this is a very unusual situation, and the guidance may change in a short time. Communication is key—in all directions.
- Individuals should avoid any travel unless necessary. If international travel is necessary, individuals are expected to register the travel through the University of Pittsburgh International SOS Travel Registry System
- University advisories must be respected.
|Do not travel||China|
|Non-essential travel Discouraged||Iran, Italy, Japan, South Korea, Germany, Spain, France|
- Students returning from any country on the advisory list should voluntarily practice social distancing for a period of 14 days. They will be notified by the school who will assist them in arrangements, although they are still allowed to travel in the community as necessary (just not to the Pitt campus).
- Students travelling domestically won’t need to socially distance unless they’ve been exposed to cases or are ill.
- We recommend that students carefully consider their travel plans. If you travel, you should be prepared for changes in re-entry procedures that may affect your plans—make sure you have money, supplies, or other resources in case you are held up or become ill. Depending on the situation, you may not be able to return to the university community.
Curriculum Guidance (MS1-2):
- ALL students will participate in the curriculum remotely effective March 13, 2020.
- Lectures will be available on podcast (Navigator and Panopto).
- Patient panels/interviews will be cancelled or postponed.
- Small groups will be accessed remotely, utilizing Zoom to allow for both audio/video capture. Participation will still be required.
- Assessments (exams/quizzes) will either be postponed or done from home using Examsoft, depending on the course/assessment. Assessments done at home will be open-book but we ask students to complete the assessments on their own unless otherwise specified.
- Laboratories or other course requirements/activities will be reconfigured or cancelled.
- Advanced Physical Exam (APE) and Clinical Procedures (CP) sessions will be postponed and made up later.
- Students may be asked to complete some activities in the summer to make up lost curriculum.
- There will be no printed syllabi for Neuroscience or Psychiatry.
- OMED and course directors will provide more specific details moving forward.
- Research and laboratory work will continue as usual, including the summer research program.
Many MS2s have asked about Step 1 and the closure of testing centers. We do not have any clear information about what will happen, and thus can’t offer any real guidance on what you should do. Laura Jeannerette can help you decide if you are considering moving up your exam or finding a different testing center.
Students are encouraged to go home, wherever that is, to stay safe, but of course you will be allowed to remain in the dorm at Darragh, and you can study at Scaife if you wish (the building will still remain open).
Curriculum Guidance (MS3-4):
- Clinical rotations (clerkships/electives) will be suspended from March 17-26, with assessments (including SHELF, OSCE) allowed on March 27 for clerkships were that is relevant. Some remote curriculum may be provided. Most students will get credit for completing the full month; a few may require make-up activities.
- We will follow guidelines from UPMC; students returning from travel or who had exposure will require UPMC clearance before returning to clinical sites—this will be done at MyHealth@Work 412-647-3695, Kaufmann Medical Bldg (3471 5th Ave Suite 1111).
- For students engaging in voluntary social distancing, classroom-based activities (e.g., bootcamp, ILS, Assessment Week) would be postponed or done asynchronously/remotely, depending on the activity.
- Bootcamp/ILS sessions will be delivered remotely, although some simulation/SP sessions and dissections may continue. The CSCS trip to Washington has been cancelled. CCAs, however, will go on as planned.
- All international electives will be put on hold.
- Staff should follow guidance from the University of Pittsburgh.
- Individuals engaging in voluntary social distancing may be given the opportunity to work remotely. Human Resources may help in guidance for specific situations.
- Staff deemed “non-essential” will be given every opportunity to work remotely.
- Most school-sanctioned gatherings are being cancelled/postponed. This includes the large Match Day ceremony with all students, faculty, and families attending.
- If you are sick, you are advised to stay home and contact the school for further instructions.
- If you are not sick but are concerned about attending, it is absolutely fine for you to opt out. Contact the school.
- Scaife Hall will remain open. The library will remain open. Students can use the building to study if you wish. However, we are strongly recommend that you maximize the distance between you and others, to protect yourself and them.
Important websites to monitor:
- CDC: https://www.cdc.gov/coronavirus/2019-ncov/index.html
- Pitt: https://www.emergency.pitt.edu/covid19
- Prepare your home: https://www.wesa.fm/post/guide-how-prepare-your-home-coronavirus
Please see bottem of page for previous updates