It was Friday lunchtime when the news came that clinical training across Singapore’s healthcare system was suspended with immediate effect.
All Duke-NUS medical students on clinical postings had to be recalled to campus. The School’s education teams had the weekend to work out the first contingency plan; the first of many revisions to the School’s curricula—“75 curriculum iterations” as Vice-Dean for Education Professor Ian Curran says only half in jest—that would become necessary over the next two years.
“This really demonstrated the professionalism, determination and flexibility of the education teams both within the School and across our clinical training partners to come up with creative, imaginative and effective solutions throughout the pandemic,” reflects Curran.
These constant revisions would ensure the safety of patients, faculty and students as well as enable students’ uninterrupted progression through their training.
“Healthcare systems and the human response to disease are inherently complex adaptive systems,” Curran explains. “They’re constantly evolving. We, too, had to evolve and adapt with them to meet our educational mission.”
After they received the news, Duke-NUS educators and administrators immediately communicated to students and faculty the new Disease Outbreak Response System Condition or DORSCON Orange rules as well as the need for significant and profound changes to their curricula.
“That Friday afternoon, when we were told by the Ministry of Health, ‘That’s it; clinical training’s suspended’, we met all the classes to tell them ‘Right. Go collect your things from the hospitals, because you won’t be allowed back in for the time being,’” Curran shares candidly. “And then we had one hell of a busy weekend working out what we’re going to do.”
It was the first of many such weekends to come. Under the evolving restrictions, Duke-NUS would, over the next days, weeks and months, transition to full e-learning for classes with more than 50 students, develop virtual alternatives to clinical clerkships and work closely with the Ministry of Health and the other medical schools to return students to hospitals and clinics across the country as soon as was safe.
After sitting their final exams in March under full COVID restrictions, the final-year students would return to clinical training in April just as the country entered its national Circuit Breaker.
“This meant we had to ensure our students were fully trained in using personal protective equipment and prepared for entering a completely transformed clinical environment,” says Curran.
This group would go on to successfully complete their clinical training and graduate on time.
“We prioritised the clinical training and final exams for the fourth-year students as we were keen to demonstrate that our students had met all the required clinical, professional and academic standards that ensured they could practise as safe and competent doctors,” expands Curran.
For students in their earlier years, the education team would come up with bespoke solutions to keep their learning on track.
“We took the bold decision to bring forward the research activity for two year groups,” adds Curran. “That move allowed those cohorts to remain actively engaged and progressing through the course while the clinical settings were off-limits.”
Two classes of medical students, then, would in due course complete all components of the world-class Duke-NUS curriculum, albeit in a uniquely sequenced way, thereby cementing their place alongside the other graduated cohorts in the School’s history.