Considering The Impact Of COVID-19 Changes On Podiatric Student Clerkships

The ripple effect of the COVID-19 pandemic on the podiatric profession is enormous and will take substantial time to overcome. In regard to the educational training of the future of the profession, there have been many challenges including the disruption of elective surgeries and a substantial reduction in inpatient podiatric care. Many residency programs, like ours at the Ascension St. Vincent Hospital in Indianapolis, have transitioned to virtual learning experiences and a focus on research projects. Hopefully, an abundance of podiatric research is an unexpected plus that will come out of this health crisis. 

Many training programs or schools cancelled or altered schedules for clerkship rotations in April, May and June. The impact of this on podiatry students is significant. The fact is, many students end up matching at residency programs where they rotated. The number of clerkship rotations for most students ranges from six to eight. If a student had three months of cancelled rotations, then 30 to 50 percent of their rotations become affected. The reality of the situation is that their residency opportunities likely just went down by the same percentages. 

Students are scrambling to deal with this problem. The American Association of Colleges of Podiatric Medicine (AACPM) surveys residency programs regularly to update any cancellations.¹ The lost educational experience is substantial in preparation to enter residency. This is also the time when residency directors and others in the residency programs evaluate students and vice-versa. These opportunities are now significantly compromised. Some schools are requiring students to use December or the following May as a clerkship month. Most students use December to prepare for residency interviews and boards. The month of May is for graduation and preparation to move for residency. These proposed changes will help but there will likely be unintended consequences as well. 

The associated expenses with additional travel and last-minute changes are daunting for students. These unbudgeted expenses add anxiety to an already stressful period personally and academically.

I want to offer some suggestions but more than anything, I hope to open up a conversation on solutions. The student voice must be part of any discussion regarding this problem. I would ask residency programs to increase the number of students they take each month for clerkship. For example, our residency program accepts four students monthly. I am increasing that number to five. Another consideration is to make the additional monthly slots or empty slots two-week rotations, allowing more students to rotate through more programs. 

Another consideration is to move the Centralized Residency Interview Process (CRIP) from January to February. Moving CRIP back a month would open another month for rotations and allow January to be a preparation month in addition to a rotation month. Podiatry schools could also give students the option of converting a school-based didactic rotation to a clerkship rotation.

I hope all residency programs step up and work with key stakeholders in addressing the clerkship challenges third-year podiatry students face. Decisions must occur sooner rather than later, keeping the students’ interest and feedback at the forefront. Flexibility based on open, honest conversations will be key. 

We owe this to the students and our profession.

Dr. DeHeer is the Residency Director of the St. Vincent Hospital Podiatry Program in Indianapolis. He is a Fellow of the American College of Foot and Ankle Surgeons, a Fellow of the American Society of Podiatric Surgeons, a Fellow of the American College of Foot and Ankle Pediatrics, a Fellow of the Royal College of Physicians and Surgeons of Glasgow, and a Diplomate of the American Board of Podiatric Surgery.

Reference

1. American Association of Colleges of Podiatric Medicine. COVID-19 Updates: Clerkships. Available at: https://www.aacpm.org/covid19-2/#Clerkships . Accessed April 20, 2020.