Medical Students Envision Mental Health in Post-COVID World

Mohammad Adnan Nawaz (MS4 at Rutgers New Jersey Medical School)

The COVID-19 pandemic is an unprecedented, life-changing event not only for the health care industry, but for everyday citizens as well. As infection and concerns of overwhelmed health care infrastructure began to spread, lockdowns of economic activity and daily life became a necessity globally. All things that could be virtualized were virtualized, including social events, school classes, health care visits, and work meetings.

Shortly after the announcement that COVID-19 was a public health emergency, the Rutgers New Jersey Medical School (NJMS) ECHO Project began a series of video conference sessions to serve as a resource for families, clinicians, educators, and community members to learn about and discuss important topics related to mental health. In early June, the final part of the series presented a vision of the post-COVID-19 era, in which the co-authors of this article, fourth-year NJMS medical students Robert Brumer, Jacob Reep, Priya Kantesaria, and Grace Ro, were given the mic to lend our original perspectives in the form of mini-lectures. In addition to our clinical medical school experience and training, we brought to the table the perception of a generation that came of age as mobile phones, apps, and technology began to define our daily lives. We were mentored by the Rutgers NJMS Psychiatry chair, Petros Levounis, M.D., M.A.

In his presentation, “Telehealth: Global Medicine from Home,” Robert Brumer discussed ways in which the recent focus on telemedicine can be used to expand delivery of health care across the globe. With the pandemic limiting in-person contact, many physicians in the United States have had to become familiar with telehealth systems to continue meeting their patients. Global medicine programs aim to deliver health care to patients in areas of need, but many physicians are unable to commit to spending months or years in these areas to provide health care. Sub-Saharan Africa represents a particular area of need, with some countries having physician-patient ratios in excess of 1 to 5,000.

If physicians in the United States or other developed countries could be connected with these patients via telehealth, patients could be provided health care while physicians could be given an opportunity to contribute to global medicine remotely. One potential option for delivering care was discussed: delivering satellite Wi-Fi hotspots, tablets capable of video chatting, and some training to people in remote villages, allowing them to schedule remote appointments with primary care physicians in the United States. This program could expand to provide discreet health care to other vulnerable populations throughout the world, such as psychiatric care for LGBTQ populations in hostile countries or treatment of people with substance use disorder.

In his presentation, “The Normalization of Video Chatting,” Jacob Reep explored the idea that this pandemic has sparked a change in the way we go about our personal social activity, with video chatting becoming normalized—not as an inferior secondary option, but as the default way to create and maintain relationships. With the widespread advent of technological tools like smartphones and tablets and the availability of quality, low- to no-cost software, the impetus to spark this evolution came in the form of the pandemic lockdowns. This presentation also explored the ideas of future development into hologram 3D chatting and the virtualization of sexual and intimate activity in the form of teledildonics. Drawbacks discussed included the loss of the full range of human body language, the role of physical contact in building romantic intimacy, financial inequalities related to technological access, and the possibility that people may just be tired of social distancing and no longer interested in further virtualization of society.

In her presentation, “Growth of Physicians on Social Media,” Priya Kantesaria focused on the expansion of physician involvement on social media during the COVID pandemic. Traditionally, physician involvement on social media has been reactionary to the increased number of patients using the internet for health information and maintenance. However, one of the biggest paradigm shifts in regard to physicians on social media has come from the COVID-19 pandemic. The combination of a complex and rapidly evolving public health crisis highlighted the need for publicly facing health care professionals to combat coronavirus misinformation and advocate for increased physician protection through the #getmePPE campaign.

Even before some of the first case studies and articles were published, social media has served as a space for COVID-19 care updates with health care professionals from across the world connecting online to discuss emerging techniques and share personal anecdotes. Social media can be a phenomenal tool, but it is not without its limitations. The need to protect patient privacy and confidentiality and maintain a barrier between professional and personal accounts remains. As we look to the future, Kantesaria hopes that physicians take advantage of the plethora of modalities to utilize social media to educate the public, connect with one another, and advocate for issues that matter to them. Now more than ever, the public needs the collective voice of physicians.

Grace Ro began her mini-lecture “Music in the Post-COVID-19 Era” with a musical exercise in which she performed excerpts from Saint-Saëns’ “The Swan” and “Lion’s March” in an attempt to elicit unique responses from the audience members. Ro proposed her vision of more widespread inclusion of music into patient experiences—from the 30 minutes spent in the waiting room to the development of a personal playlist to be accessible during therapy sessions or recovery. One of the many discussion topics from the following Q&A session revolved around the applicability of expanding the presence of music in nonclinical settings. Ideas such as providing a quiet space at schools for students to de-stress with music, perhaps before an exam or performance, were also shared.

Brumer is applying to residencies in general surgery this fall. He hopes to continue exploring innovative ways in which the integration of technology and medicine can improve our ability to effectively deliver health care.

Reep is applying to internal medicine residencies and believes that exploring social and psychological effects of the pandemic on individuals is essential to appreciating where many of his future patients will be coming from and the context of many of their future challenges. Talks and collaborations like the NJMS ECHO Project will give him more understanding to draw upon to better empathize and assist his patients.

Kantesaria is applying to combined medicine-pediatric residencies. She is passionate about utilizing innovative advocacy methods to better patient care and physician well-being. As she progresses in her medical training, she hopes she can continue exploring the dynamic and important link between policy development and medicine.

Ro plans to apply to psychiatry residencies. With over 15 years of violin performance experience, she hopes to apply this aspect of her identity into her clinical and community-based work. She is particularly interested in the long-term impact of the arts in personal and mental development.

As rising fourth years and soon-to-be interns, what is happening now is the beginning of the future professional landscape that we will be performing in. We hope to stay open minded and continue reflecting on our ever-changing postpandemic world to best serve our future patients.  ■