September 8, 2020—(BRONX, NY)—Albert Einstein College of Medicine welcomed a new class of 183 medical students to campus last month with a week of orientation activities that stressed values of community, diversity, and commitment to patient care. Just five months after the COVID-19 pandemic struck the Bronx, Einstein leaders created the nearly all-virtual orientation program and announced a streamlined and enhanced medical school curriculum for all classes.
“The pandemic has left no part of our curriculum untouched,” said Joshua Nosanchuk, M.D., senior associate dean for medical education and professor of medicine and of microbiology & immunology at Einstein and an infectious disease specialist at Montefiore Health System. “We decided early on that we were going to use this crisis as an opportunity to innovate, to improve our training and the student experience, not just muddle through. Our students, faculty, and staff have really embraced this, and we are encouraged by the feedback we have received.”
New Students on Campus
During orientation week, deans and faculty members welcomed the incoming students via Zoom video conferencing, and new class members attended a slate of virtual sessions, including a Facebook Live walk through the Bronx; interactive and small group sessions on implicit bias in medicine, mental health resources, and peer mentoring; and a virtual cooking class led by Bronx chef José DeJesus. They also observed social distancing rules and donned masks for small, in-person events and training on basic life support.
Gordon Tomaselli, M.D., the Marilyn and Stanley M. Katz Dean at Einstein and executive vice president and chief academic officer at Montefiore Medicine, acknowledged the unique circumstances faced by the Class of 2024, and took the opportunity to highlight the strong and resilient community they were joining.
“The response of our school and of our health system to the pandemic of a century has been truly remarkable,” said Dr. Tomaselli. “Despite this unprecedented situation, this is a terrific day for Einstein, as it represents a time for us to renew, as well as rededicate ourselves, to our mission to our community.”
Diversity, Tales of COVID-19 Bravery, and a New Oath
More than 8,000 prospective medical students applied to Einstein last year and more than 1,000 students were interviewed. Twenty-two percent of the class is from underrepresented groups in medicine—the highest percentage of diversity in Einstein’s history. Additionally, 53% of the class is female, 15% was born outside of the United States, and 8% will pursue a combined M.D./Ph.D. degree.
Students moved in to campus housing on a staggered schedule during the last weeks of July and the early part of August to enable appropriate social distancing and quarantine periods. The class has been divided into three communities, each consisting of 21 three-person “pods” to encourage collaboration and peer support at a time when large gatherings are prohibited.
During one orientation session, Todd Cassese, M.D., associate dean for medical education and associate professor of medicine at Einstein and an internist at Montefiore, recounted the pandemic’s severe toll on the Bronx and the large influx of patients with COVID-19 hospitalized throughout the Montefiore system. He introduced second-, third-, and fourth-year student leaders who quickly mobilized to recruit hundreds of their peers for numerous volunteer initiatives ranging from working in the hospital’s virology lab, to creating face shields and masks and making grocery runs, walking dogs, and tutoring children for front line Montefiore physicians. All told, students logged more than 10,000 hours of volunteer work during the acute period of the Bronx crisis.
Orientation leaders also arranged for a special presentation of “Bravery and Hope: 7 Days on the Front Line,” the CBS News documentary that chronicled seven days in April when Montefiore doctors, nurses, and healthcare professionals confronted the COVID-19 surge in New York. After the screening, a panel of physicians profiled in the segment shared their stories of patient care and resiliency during the pandemic’s most challenging days.
The physicians’ remarks resonated with the new students as they created their class oath, which was read aloud at a virtual ceremony attended by family, faculty, and administrators. Among its tenets:
“I will practice cultural humility as I advocate for both individuals and communities—recognizing, understanding, and dismantling disparities to create a more equitable healthcare landscape … I will adapt my method of care to address the needs of each patient’s mind, body, and soul with compassion … I will use every opportunity to educate, uplift, and support my patients with creativity, kindness, and integrity. As I embark on my career as a physician, I vow to relieve suffering where I can and bring peace where I cannot.”
Innovative Curricular Changes
The new students also learned how Einstein leaders quickly adjusted the curriculum and restrictions for in-person instruction in the face of the pandemic. Of particular note was how clinical rotations were overhauled.
“You can be innovative, as long as you meet the goals and objectives of the Liaison Committee for Medical Education—and we succeeded in doing that,” said Dr. Nosanchuk. “Usually, changes like this can take three years, but the pandemic spurred the process. We made many changes very quickly with hard work from our task forces, a lot of dialogue and consensus-building, and persistence in finding solutions that would enhance medical education at Einstein.”
A significant change affects the length and content of the clinical clerkships for the third- and fourth-years: Their rotations have been streamlined and reworked into uniform six-week blocks, resulting in greater scheduling flexibility for administrators and students as well as for thematic groupings. For example, the psychiatry rotation has been coupled with the neurology rotation, allowing for a natural interplay between the two related specialties.
Einstein has also introduced a new course, Health System Science and Health Equity, for first-years. The course addresses a range of important social issues: population health; social justice in medicine; health equity and disparities; nutrition “food deserts” and their impact on health; and community engagement. In response to feedback from a series of town halls focused on diversity, a “racism in medicine” two-hour educational activity was added to the course and is also mandatory for second-years.
Partnering with Students
“Students will remain active members of the working groups and continue identifying ways to integrate important educational themes—including the social determinants of health, professional identity formation, treatment of geriatric patients, and more—across all disciplines,” said Dr. Nosanchuk.
Several students who serve on task forces said they were pleased to participate in the process. “We really appreciated how open the deans and others were to hearing from us,” said Freddy Tadros, a fourth-year student. “They heard our feedback, worked to ensure we had options and flexibility, and wanted us to be comfortable with the changes.”
Fourth-year student Anna Bitners added: “I’m hopeful that the curricular changes that have already been made and others on the horizon will enable Einstein students to continue to engage and explore their intellectual curiosity, community orientation, and academic strengths.”