Amid COVID-19 crisis, more than 30 Brown med students graduate early to begin hospital work

Fourth-year medical students at the Warren Alpert Medical School who have completed requirements and elected to graduate early will join the fight against COVID-19 both locally and in residencies nationwide.

PROVIDENCE, R.I. [Brown University] — More than 30 fourth-year medical students at Brown University will soon find themselves in the extraordinary position of joining the front lines of the fight against COVID-19 before they even receive their paper diplomas.

As the nation’s hospitals swell with patients and the demand for physicians soars, the Warren Alpert Medical School of Brown University has given fourth-year students who have completed all degree requirements the option to graduate six weeks early and begin working in hospitals immediately, including in Rhode Island.

It’s an unprecedented and historic move for the 45-year-old medical school — one that mirrors the exceptional circumstances brought about by the current global health emergency.

“Since the COVID-19 pandemic arrived in Rhode Island, our medical students have been contributing to the response in numerous ways that have had a significant impact,” said Dr. Jack A. Elias, medical school dean and Brown’s senior vice president for health affairs. “It doesn't surprise me that some who have completed their requirements are opting to graduate early to work in more hands-on roles here and in the places where they will complete their residencies. We could not be prouder of the many ways that our students have stepped up during these difficult times.”

Michael McGary
Michael McGary, right, chose to graduate early and help treat patients in a field hospital at the Rhode Island Convention Center.

Dr. Allan Tunkel, senior associate dean for medical education at the Warren Alpert Medical School, said that to date, more than 30 of the 132 students in the school’s Class of 2020 have volunteered to graduate early. Medical school leaders made soon-to-be graduates aware of the option on April 7, and on April 15 — following approval by Brown’s Faculty Executive Committee and the Corporation of Brown University’s Board of Fellows — their graduation was official. Degrees were conferred, and the new doctors were free to practice medicine.

“Medical students have expressed an eagerness to help in any way they can during this crisis,” Tunkel said. “More than 100 medical students have volunteered their time to the Rhode Island Department of Health and to local hospitals, manning call centers, managing medical records and more. Now, they have an additional opportunity to start clinical work — their presence may prove extremely valuable if we experience a surge in patients.”

Tunkel said those who make the entirely optional choice to graduate early have two potential paths: to start work in the hospitals to which they were matched for residencies earlier this spring, which span the nation; or to spend the next four to eight weeks in paid, non-accredited clinical positions in Rhode Island before beginning their medical residencies in June.

Medical students at Brown
James Scharfen, second from left, has spent the last month volunteering for the Rhode Island Department of Health alongside more than 100 other Brown medical students. Before his residency at Rhode Island Hospital begins, he plans to work at the Lifespan field hospital. Photo: Vivian Chan Li

Those who choose to stay in the state will receive temporary licenses to practice in Rhode Island and will work for Lifespan or Care New England, the state’s two largest health care systems, which operate most of the hospitals affiliated with Brown’s medical school. Some of Brown’s early graduates may begin work as soon as the week of April 20.

The decision at Brown comes on the heels of similar actions by medical schools in New York and Massachusetts, where local hospitals that needed more trained physicians began to arrange for non-accredited, temporary clinical “residencies” for any newly graduated students who were willing and able to join them. Dr. James Arrighi, director of graduate medical education at Lifespan and a professor of medicine at Brown, said he and colleagues at Brown, Lifespan and Care New England drew heavily from those early states’ arrangements as they formalized a plan for early graduates.

“Many students wanted to contribute clinically, and we wanted to capture their enthusiasm and energy,” Arrighi said. “This is a very rare opportunity for students to see firsthand how government authorities work with hospitals to create a health care infrastructure in times of crisis. And it’s a wonderful opportunity for Lifespan and Care New England to harness students’ particular expertise in, for example, managing electronic records.”

Arrighi said both hospital systems have started to establish field hospitals across the state in preparation for a potential surge in COVID-19 diagnoses. State health officials who have worked with researchers at Brown and other universities to model the disease’s likely spread in Rhode Island have predicted th­at the number of positive cases will peak between late April and late May.

Lifespan plans to send early graduates to its field hospital at the Rhode Island Convention Center, Arrighi said, where they will provide care for lower-risk patients under the supervision of attending physicians. Tunkel said that Care New England may send some graduates to field hospitals and others to regular hospital wards.

Being able to start early is just as meaningful to me as standing in front of my family and reading the Physician’s Oath, if not more.

Anastassia Gorvitovskaia M.D. Class of 2020

James Scharfen is among several newly minted doctors who will join Lifespan. Like many of his classmates, Scharfen began volunteering at the Rhode Island Department of Health in March after Brown — following guidance from the Association of American Medical Colleges and the Liaison Committee on Medical Education — pulled third- and fourth-year medical students from hospital rotations. Scharfen has spent the last four weeks notifying patients who test positive for COVID-19 and ensuring that those who had been in contact with the infected were self-isolating, among other tasks.

“I come from a military family, so I’ve always felt a sense of duty to help people who are in need,” Scharfen said. “I think the things I’m doing at the Department of Health are important, but I also know there’s a need for people with clinical expertise at hospitals right now.”

Scharfen was matched to Lifespan’s Rhode Island Hospital in March and is slated to begin an internal medicine residency there on June 11. By starting work now, he’s essentially beginning his residency two months early, albeit under unexpected circumstances.

“My thought process was: I’m going to be diving into this crisis anyway in a couple of months, so this is an opportunity to hone my skills and be better prepared,” he said. “I wanted to find a way to help my future team.”

Two other early graduates, Anastassia Gorvitovskaia and Michael McGary, will join Scharfen in the Lifespan field hospital before leaving for their emergency medicine residencies in New York and Chicago, respectively. Both say their future health care systems have kept them updated on the evolving public health situations in those cities and have notified them that their hands-on education may unfold differently than expected as the battle against COVID-19 continues.

“I feel fortunate to be someone who can provide this care going forward, but also humbled and a bit nervous,” McGary said. He said his mother, who has health conditions that elevate her risk of infection, plans to live with him in Chicago, and he’ll have to take extra precautions to protect her. For now, he is ready to contribute in Rhode Island. 

“The amount of support from the medical school, their willingness to work with us on an early graduation, has been extraordinary,” he said.

Gorvitovskaia said she feels lucky to be in a position to help. She knows many other soon-to-be graduates live with older family members or immunocompromised partners and can’t risk infecting them. Others have academic requirements to complete or need time to move to new states, as they will need to self-quarantine for two weeks before they begin work.

“All of my credits were done, and there was nothing standing in my way that would prevent me from starting to practice medicine before June,” she said. “To be able to help early feels like an immense privilege.”

For Gorvitovskaia and others who elected to graduate early, a tradition that is typically celebrated over a long weekend of pomp and circumstance was boiled down to a week of email exchanges, culminating in a final message from Tunkel on April 15: “You have now graduated.” But Gorvitovskaia, for one, doesn’t feel robbed of a celebration: She and her family still plan to attend the medical school’s virtual degree conferral on May 24.

“Being able to start early is just as meaningful to me as standing in front of my family and reading the Physician’s Oath, if not more,” she said. “At the end of the day, actions speak louder than words.”

Tags COVID-19