As if it were a typical Monday afternoon, my anatomy instructor asked my medical school classmates to lean in a little closer. “Do you see the left gastric artery?” He asked, as he zoomed in on a 3D online visualization of a stomach. Instead of leaning over the body of a donor, we leaned closer to our computer screens. Over the past few weeks of the COVID-19 pandemic, the format of medical school education has shifted rapidly. In an effort to minimize risks, third-year students who were about to begin clinical clerkships in hospitals are now completing online educational modules at home. For those of us in our pre-clinical years, we are learning the patient exam through theory rather than practice. And instead of completing anatomy lab dissection – a medical school rite of passage – we are making do with virtual approximations. While many aspects of our education may have been sidelined, we have not been sitting idle. Across the U.S, medical students have rallied to help mitigate the damages of COVID-19 by organizing blood drives, collecting personal protective equipment, and more. As we are organizing these efforts, however, we have also been bearing witness to the shortcomings of our healthcare system. We are seeing that our volunteer endeavors are merely temporary, band-aid solutions. COVID-19 has made it impossible for us to ignore the gross inequality and insufficiency of the healthcare system we will one day practice in. Though I, like many other medical students, am disappointed that I am currently missing out on practice-based learning, I believe that this crisis is teaching us something far more important: that our healthcare system needs radical transformation. Our nation’s abysmal response to the pandemic is clearly showing us that health care cannot be separated from politics. We are learning that our role as future physicians is not just to diagnose and to treat individual patients – it also to loudly advocate for healthcare reform. To move our country forwards, we need Medicare for all, a single-payer system that would provide health care for all. It is clear that our fragmented, market-based healthcare system was unprepared for this pandemic from the get-go. Today, the United States has more COVID-19 cases than any other country in the world, and the high cost of testing likely dissuaded many Americans from seeking care in the early stages of disease spread. Even after the passage of a bill that makes COVID-19 testing free, Americans are still responsible for co-pays and deductibles for any treatment they receive. And for the millions of Americans who are uninsured or underinsured, these medical bills pose a significant threat. In fact, they have already devastated lives. As Americans lose their jobs due to COVID-19’s economic impacts, an estimated 7.3 million will lose their health insurance, too. As a result, the pandemic has hit low-income workers and communities of color the hardest. In Chicago, for instance, legacies of structural inequities and racism have led to a higher death rate among black residents. The populations who are at most risk are those with pre-existing health conditions that stem from a lack of access to screenings and preventative care. Simply put, our profit-driven, disjointed healthcare system has failed our communities, and as medical students, COVID-19 has shown us that this system must change. In order to provide care for thousands of newly unemployed Americans, we need a single-payer system where health insurance status isn’t tied to employment. We need universal coverage so that all individuals – including many low-paid workers who are the backbone of our society – can receive acute and preventative care. We need a system that is oriented towards health over profit, and that doesn’t leave individuals with catastrophic medical bills. As future physicians, medical students must prioritize advocating for these structural and systemic changes, because this pandemic has made it clear that health care is much more than the molecular basis of disease. Even though we may not be able to engage in clinical learning right now (and even though I may not able to see the vasculature of the stomach as clearly online as in person), this pandemic must reinforce our commitment to health equity and justice. The generation of medical students trained during COVID-19 cannot solely focus our efforts on anatomy and physiology; we need to actively interrogate the structural forces that influence health outcomes, and we need to bring Medicare for all to the forefront of our efforts. Amelia Dmowska is a medical student. Source
