AAMC Reporter: October 2009

Medical Schools Make Plans To Address Swine Flu

When swine flu appeared on the international radar this spring, health officials began making plans to handle a flu season some experts predicted could be the most severe in years. As part of the preparation, the Centers for Disease Control and Prevention (CDC) has recommended that higher learning institutions plan for a potential swine flu outbreak on campus. With swine flu cases rising, medical schools and teaching hospitals are making plans to ensure students and faculty can continue their work in the face of a pandemic.

The CDC estimates that more than 1 million Americans have contracted swine flu since April, when the virus first surfaced in the United States.

In early September, the AAMC distributed a memo outlining questions medical school administrators should consider as they develop their swine flu response plans, including whether their schools support a culture that encourages sick students to stay home and whether they have plans to communicate with students who are ill. According to AAMC Chief Academic Officer John Prescott, M.D., medical school officials should determine how they will meet the academic and medical needs of students and faculty who come down with the flu. For example, schools might need to be more flexible with attendance policies and testing dates in the event of an outbreak, and explore options for distance learning.

"Medical schools and academic medical centers are complicated organizations, and leadership at the highest level should be working to ensure continued medical care for students and faculty and continued education for students," Prescott said. "There is little doubt that H1N1 will return to the United States, and if there is more thought now, schools will be in a better situation to respond."

At the University of Toledo College of Medicine, faculty members are uploading course materials to the Web so students can access them remotely if they become sick and need to stay home. Toledo administrators also are asking faculty to consider how their classes will be taught if they get become unable to teach.

"Preparedness is the key to this. We have no idea what the severity of this is going to be," said Toledo Dean Jeffrey Gold, M.D.

Several years ago, faculty at Northeastern Ohio University Colleges of Medicine and Pharmacy (NEOUCOM) began recording lectures to prepare for a potential avian flu pandemic. The school still has those archives, which comprise all lectures for first- and second-year medical and pharmacy students and 80 percent of all clinical didactic lectures. Students can access any of these lectures online, said Mark Penn, M.D., M.B.A., NEOUCOM's senior vice president for academic affairs and executive associate dean.

NEOUCOM also assembled a pandemic flu task force, which developed a backup system for faculty who are unable to teach, and are generally tasked with making key decisions during an outbreak.

"The point is you want to have at least a couple of people backing up someone so that in the event a staff member or faculty member is ill they can continue to do their work," Penn said.

Gold said he believes medical schools should use swine flu as a learning experience for students. At Toledo, medical and nursing students, under faculty supervision, would staff a call center and handle questions from the public.Medical students also would participate in regional vaccination programs. Toledo is in the process of building six educational modules on answering public questions and helping students who are sick but unable to go home. NEOUCOM is already including special lectures on swine flu in infectious disease modules and hosting faculty talks on swine flu for the entire campus, Penn said.

"Medical students and residents are a wonderful, caring people, and it's a good educational experience for them, as well as a service to the community," Gold said.

In the event of something as unpredictable as a disease pandemic, however, even the best-laid plans can go astray. That is why Penn said schools should be prepared to change their plans if necessary.

"Just because you have great plans does not necessarily mean that things are going to work out as you planned them," Penn said. "So we need to continue to monitor the situation and adjust."

However, efforts to address swine flu at medical schools go beyond contingencies for students and faculty; there are also school applicants and test-takers to consider. Officials with the AAMC Medical College Admission Test® are working on a protocol for handling swine flu cases when 2010 testing begins in January. Among the scenarios the plan will address are regional epidemics that require testing centers to close and the need for individual students with the flu to reschedule exam dates.

"Swine flu is a very complex issue," Penn said. "There are a lot of layers to this, monitoring what's going on across the world and the nation. It really takes a concerted effort among a lot of partners to make this work well."

—By Sarah Mann

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