PracticalDermatology

The COVID-19 pandemic has upended many aspects of undergraduate medical education, including visiting clinical rotations, a cornerstone of the application process.

The Coalition for Physician Accountability called for the suspension of visiting or external rotations for the 2020-2021 residency application cycle, with exceptions for students without a home residency program and students needing them for graduation or accreditation requirements.

Visiting rotations are important for students as well as residency programs. For students, these programs provide expanding opportunities for advanced clinical experience, individualized mentorship, and an insight into resident life. Programs also benefit from evaluating a candidate’s fit.

To help fill this void, the GW School of Medicine and Health Sciences Dermatology Residency Program in Washington, DC created virtual rotations for interested students.

Residency and Associate Residency Program Directors, Adam Friedman, MD and Joseph Zahn, MD, in collaboration with second year residents Drs. Blair Allais and Jessica Kalen, developed a four-week virtual visiting rotation that allowed interested students to interact remotely with residents and faculty. The program was open to five rotators per month. Through videoconferencing platforms, students participated in various educational activities, such as journal club, clinicopathologic conference, grand rounds, Kodachrome review, and other resident didactics. Moreover, virtual happy hours and faculty mentoring sessions allowed for more personalized engagement. Each student was afforded one-on-one Zoom time with Drs. Friedman and Zahn. All rotators were also invited to deliver a presentation on a topic of their choice at the end of the rotation.

“While virtual rotators were not able to see patients with us, students were invited to attend any and all didactics, which are held throughout the week,” Dr. Friedman says.The program was about 10-11 hours per week. A typical in-person visiting rotation, by contrast, takes place five days a week from 8am to 5pm.

By and large, the virtual program was deemed a big success. At the conclusion of the virtual rotations, students were surveyed to evaluate their experience. The majority of the rotators were ‘‘very satisfied’’ with the clinical curriculum, learning objectives, formal didactics, ability to assess the residents, faculty advising, and diversity and inclusion initiatives. Fully 39 percent said they might not have had the traditional advantage to rotate with this program either.

The full survey results are published as a research letter in the June 1, 2021 issue of the Journal of the American Academy of Dermatology.

“It was meaningful,” Dr. Friedman says. “Across the board, students were happy they participated and learned a lot about our program.”

He admits he leaped before he looked when creating this program. “We crafted a rotation with the mindset that it was a taste,“ he recalls. “Very few dermatology programs offered such a program, so we hoped that it could serve as a template for others.”

While participating in a virtual rotation did not guarantee an interview for a coveted residency slot, one of the two available slots at GW School of Medicine and Health Sciences Dermatology Residency Program did go to virtual rotator Adam Harris Rosenfeld, MD, a medical student at University of Missouri School of Medicine in Columbus.

Dr. Rosenfeld begins his intern year this month at MacNeal Hospital in Chicago and starts his residency at GW in the summer of 2022. “Navigating the resident application cycle with COVID-19 was a challenge,” he says. Dr. Rosenfeld was interested in the GW program, so when the virtual rotation became available, he jumped at the chance. “I was able to get to know the residents and faculty even from 1,000 miles away in Columbus, MO.”

It was a great opportunity to meet with faculty and program directors and then, of course, to get a sense of program through didactics and see how the residents interact with each other and get a feel for the culture of the program,” Dr. Rosenfeld says. “It exceeded my expectations.”