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Aspiring doctors train for resilience amid the COVID-19 pandemic

St. Luke's Covid
St. Luke's ICU Nurse Kristen Connelly
St. Luke's Health System
A coronavirus patient is treated after going into cardiac arrest on Thanksgiving in the ICU at St. Luke’s in Boise.

Kiefer Starks distinctly remembers the smell of his N95 mask and the constant beeping from his recent rotation in the emergency room at West Valley Medical Center in Caldwell.

“The monitors are always going off because the oxygen is always low and there’s always chaos because the EMS team is always arriving with three or four patients and we don’t have any beds for them,” Starks said.

Starks is a 27-year-old medical student in his fourth year at the Idaho College of Osteopathic Medicine, or ICOM.

As part of his clinical rotations, he recently spent a month at the West Valley emergency room just as the delta variant spread across Canyon County and the rest of Idaho.

Starks said patients reacted in all kinds of ways when they were told they had COVID.

“We had patients who refused to believe COVID is real and then we had patients asking for the vaccine when it was already time to be intubated,” he said.

Some family members went to go get vaccinated themselves, but others demanded doctors treat their loved ones with unproven drugs.

The constant second-guessing gets to him.

Kiefer Starks.jpg
Leap Photography
Leap Photography
Kiefer Starks, a 27-year-old medical student, said he already feels like he's burned out from seeing waves of COVID-19 patients during his rotations. Medical schools are trying to teach students resilience skills so they can cope with difficult days on the job.

“I joke about it a lot,” he said. “I’m like, ‘Man, I haven’t even gotten to residency yet and I’m already burned out.’”

While the COVID-19 pandemic has exacerbated how overwhelming medical school can be for aspiring physicians, professors said they try to prepare students to handle tough situations every day.

ICOM brings in actors so students can practice delivering bad news or de-escalating tense situations with a patient.

“There was very little communications training when I was in medical school,” said Dr. Nicole Moses, laughing when asked how she was trained.

Moses now teaches these skills at ICOM.

She said she had to pick up those tools by watching other physicians care for patients instead of getting to practice in the classroom.

“This is really light years forward in education.”

Dr. Dustin Worth had a similar experience when he was a med school student.

“Historically, it’s like we just beat the empathy out of them,” Worth said.

He’s the clinical medicine coordinator for the WWAMI program at University of Idaho. The program gives medical students their first two years of education locally at schools across the northwest. They can then choose to undertake their clinical rotations there, or at other locations across the program's five states.

Like at ICOM, Worth said WWAMI hasn’t specifically trained students how to handle the strain of crisis standards of care, but helping a student brace themselves before telling a patient they have a terminal illness helps them be more resilient.

“That can be as challenging and difficult emotionally for a young physician as watching a patient die,” he said.

Back at ICOM, Jake Price works as the school’s counselor.

Price said he’s heard the same types of issues from students in the pandemic as he had before — anxiety, feeling overwhelmed — they’re just more common now.

Price tries to get students to regularly check in with themselves.

“How are you doing mentally, emotionally and socially? How is your body? How are you eating well? Are you sleeping well? Are you doing things that remind you of who you are?”

Ignoring your own emotions, he said, is a recipe for burnout — and can lead to worse health outcomes for patients down the road.

“If they’re not constantly caring for themselves then it slowly erodes that moral connection that they have,” Price said.

Dr. Moses agrees. She said she gets pushback all the time from other physicians for focusing so much on teaching self-care skills that weren’t always prioritized in the industry.

Nicole Moses teaches communications skills to aspiring doctors at the Idaho College of Osteopathic Medicine.
Idaho College of Osteopathic Medicine
Nicole Moses teaches communications skills to aspiring doctors at the Idaho College of Osteopathic Medicine.

That includes recognizing when a member of their team might be struggling.

“I think we’re really starting to see that we have to listen to each other in order to be able to help protect each other from the negative effects of the profession overall,” Moses said.

Despite feeling burned out from his stint this summer in the ER, Starks said the experience didn’t turn him off from becoming a doctor.

It did make him rethink his plans after his residency, though.

“Idaho’s done such a poor job at kind of managing this whole pandemic,” Starks said.

Since January 2020, Idaho ranks 17th in the nation for cases per capita and 33rd for deaths per capita, according to the CDC.

The Twin Falls native thought he’d eventually come back to work in Idaho, which ranks among the bottom of all states in physicians per capita.

Starks said that’s still a possibility, but for now, he’s looking elsewhere.

Correction: This story previously stated WWAMI students transferred to University of Washington in Seattle to perform their clinical rotations. That used to be the case, but students now may undertake clinical rotations in any of the five states served by WWAMI.

Follow James Dawson on Twitter @RadioDawson for more local news.

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I cover politics and a bit of everything else for Boise State Public Radio. Outside of public meetings, you can find me fly fishing, making cool things out of leather or watching the Seattle Mariners' latest rebuilding season. If you have a tip, please get in touch!