American Heart Association urges caution in putting med students on the frontline

The American Heart Association believes that prematurely allowing medical trainees to provide patient care during the COVID-19 pandemic could put the next generation of medical professionals at serious risk, according to a new article on the American Heart Association Presidents' Page, published today in the American Heart Association's flagship journal Circulation.

This Presidents' Page, from AHA President Robert A. Harrington, M.D., FAHA; AHA President-Elect Mitchell S.V. Elkind, M.D., M.S., FAAN, FAHA; and AHA Immediate Past-President Ivor J. Benjamin, M.D., FAHA, implores medical residency and fellowship programs to immediately abandon the trending practice of relaxing exam requirements and accelerating graduations for fourth-year medical students.

"While medical professionals of all levels of experience seek to provide care during this crisis, residents and fellows are being asked to perform patient care outside of their clinical competencies," said Harrington. "As clinicians also face a dire lack of personal protective equipment, the position of the American Heart Association is clear: protect medical trainees on the COVID-19 frontlines or do not send them in at all."

At the same time some universities are allowing doctors-in-training to perform patient care at least eight weeks early:

• China's outbreak indicated healthcare workers are at least three times as likely than the general population to contract the disease.
• 600 hospital workers in Massachusetts, both clinical and nonclinical have been infected to date (some through exposure at work, others through community spread).
• 91% of mayors polled in the U.S. reported shortages of personal protective equipment (PPE) in their cities.
• The chief of the World Health Organization recognized the chronic global shortage of PPE as one of the most urgent threats to the ability to save lives.

While the Association applauds continued efforts across the country to procure, produce and provide more protective gear for medical professionals, it also continues to urge the federal government to fully invoke the Defense Production Act to replenish the federal stockpile of PPE and get it in the hands of medical professionals. A lack of available PPE raises questions on best practices of what equipment to wear, when to wear it and which equipment is appropriate to reuse. The absence of clear and consistent guidelines during this crisis strikes fear in both experienced medical professionals and trainees.

"We will continue supporting bipartisan, coordinated, government-backed efforts and private-public initiatives that ensure this nation's frontline health care workers are protected as they labor to save lives," said Harrington. "Just as the youth embody our hopes for tomorrow, medical trainees hold the health of generations to come in their hands. We must continue to make protecting them a priority."