It has been a long time since medical students got the real taste of academic sessions. Ever since the arrival of the pandemic medical colleges stopped having classes in wards and classroom settings and eventually moved to remote learning setup. The medical colleges were soon turned into dedicated COVID treatment facilities so there was no scope for any sort of clinical training for the young medicos. Students vacated their hostels and were learning medicine from home just like any other subject.

This is the story so far and now it’s time to add a new chapter to this!

Yes, the wait is finally over! The doors of medical colleges across the country have started to open and medicos are all set to get back to their learning paths. But as we know, it’s unprecedented times and we definitely don’t have access to the ‘normal’. There’s going to be a whole lot of changes in the way medical colleges would function, all thanks to the ‘new normal’. Let’s look at how the medical colleges would resume the physical academic sessions after a very long break.

Medical Colleges Could Reopen From 1 December With Strict Physical Distancing Norms#MedStudentTwitter #MedTwitter pic.twitter.com/3ePm3EdDUt

— DailyRounds | Marrow (@DRoundsMarrow) November 25, 2020

Keeping in view of the issues and challenges that medical colleges may face after reopening the premises for academic activities, the National Medical Commission (NMC) has issued detailed guidelines on the dos and don’ts. The set of guidelines are meant to contain the spread of COVID-19 in the educational institutions, which falls under high exposure areas and to ensure continuity in the teaching-learning process.

As per the NMC, apart from following the Generic Preventive Measures or COVID-19 Appropriate Behaviour including social distancing and sanitisation, the medical colleges will have to to make their own schedule tailor-made as per the local prevailing social and medical conditions so as to effectively deal with any eventuality arising due to COVID -19/ post-COVID-19 conditions before resuming activities on campuses. 

The guidelines also spell out the issues and challenges faced by the medical colleges in reopening their campus along with the safety measures before and after the physical opening of the institutes. The commission has also laid down instructions for institutional planning, regular monitoring as well as the protocol for hostels. Furthermore, the National Medical Commission has notified about the role of various stakeholders in containing the spread of coronavirus in the medical colleges’ premises including states, UTs, top authorities at the medical institutions, parents, guardians as well as medical students.

Re-Opening the Campuses – Issues and Challenges

Our colleges are located in all kinds of terrains and assume significant diversities depending upon geographical location and government-run/ grant-in-aid colleges or colleges managed and supported by private organizations, in their size, infrastructural capacity, facilities, etc. Therefore, the issues and challenges faced by them in reopening their campus also vary considerably.

Keeping in view the uncertainties of the future due to the COVID-19 pandemic and its impact on the functioning, they may plan to reopen their campuses in a phased manner, ensuring the safety, health, and well-being of all students and staff. They should be flexible in their plan and should be ready to handle any eventuality arising due to COVID-19.

It may be difficult to comprehend all the challenges/ situations which the colleges may be required to handle while they plan to reopen. However, some of the issues which they may be required to handle instantly are given below:

• To follow the advisories/guidelines/directions issued by the Central/State Government, Ministry of Education, NMC, and UGC from time to time to prevent the spread of COVID- 19.
• Uncertainty among students regarding admissions, modes of teaching-learning, completion of courses, examinations, evaluation, declaration of results, and the academic calendar, etc.
• Anxiety, mental health, and psychological issues of students developed during the lockdown period and fear of infection after the opening of campuses.
• Safety measures including sanitisation of premises, thermal screening, ensuring physical distancing, face-cover/mask-wearing, respiratory hygiene, and hand-hygiene, etc.
• Preparation for risk assessment and subsequent actions which may be required for hostel facilities for students.
• Varied conditions of the pandemic in the state, area, and environment where the students mainly live while making risk assessment and planning to address these challenges.
• Besides students, the risk of infection will also be faced by the faculty, counsellors, and other technical and non-teaching staff who interact with the students and also among themselves regularly.

Measures Required before Re-Opening of Campuses

The union health ministry (MoHFW) and National Medical Commission (NMC), have advised all medical colleges to re-open on or before 1st December 2020 to maintain uniformity in the academic environment of the nation. However since the states/UTs are in different COVID-19 phases, colleges are likely to face a number of issues at the time of reopening. 

Hence they will be required to plan in advance and will have to take certain measures prior to reopening, as mentioned below:

Pre-requisites

The directions, instructions, guidelines, and orders issued by the Central and State /UT Government concerned regarding safety and health in view of COVID-19 must be fully complied by all colleges. However, the colleges may develop stricter provisions and guidelines, if they feel it necessary. The colleges are required to make adequate arrangements to ensure the safety and health of students, faculty and staff.

Further, the institutions should be ready with a plan for handling the inflow of students, faculty and staff in the campus, monitoring disinfecting measures, safety and health conditions, screening and detecting the infected persons, containment measures to prevent the spread of the virus in the campus, and also alternative plans, in case the campus needs to be closed again due to spread of the virus in campus or in the surrounding areas in near future.

Modalities for Physical Opening of Colleges

The following modalities regarding the physical opening of medical colleges, in a graded manner, may be adopted:

1. Colleges may plan to open the campuses in phases, with such activities where they can easily adhere to social distancing, use of face masks and other protective measures. This may include administrative offices, research laboratories and libraries etc.
2. Thereafter, for didactic lectures, students may also be taught on-line by using Google Classroom, Cisco Webex Meeting, YouTube streaming, OERs, SWAYAM platform (www.swayam.gov.in), etc. In those colleges, where it is feasible to hold classes, for large group or small group teaching classes, a minimum distance of 6 feet between every 2 students must strictly be adhered to. 
3. For all teaching hospitals, at least 30% of beds be allotted to teaching units and all necessary precautions must be adhered to.
4. As and when required, students may be instructed to visit their respective departments in small groups for consultation with the faculty members, after seeking prior appointments to avoid crowding, while maintaining physical distancing norms and other safety protocols.
5. Institutions should have a plan ready for students who cannot join the programme due to travel restrictions. Online teaching-learning arrangements should also be made for them.

Safety concerns

• The institutions should train their staff and students to assist and undertake the work related to safety and health to prevent an outbreak of the pandemic on their campuses. Non-resident students should be allowed on campuses only after thermal scanning, sanitization of their hands, wearing of face masks and gloves. Symptomatic persons should not be permitted to enter the campus and should be advised to contact the nearest hospital for clinical assessment.
• Regular visits of a counsellor may be arranged so that students can talk with the counsellor about their anxiety, stress, or fear.
• To avoid the risk of transmission, the students, faculty and staff should be screened and symptomatic ones are advised to get clinically assessed before allowing them entry into the campus.
• Isolation facilities for symptomatic persons and quarantine facilities for those who were in contact with the positively tested persons should be there on campus or a tie-up may be made in advance with some hospital or approved premises or as advised by the local authorities so that, in case of necessity, prompt action may be taken. Proper arrangement of safety, health, food, water, etc. should be ensured for those in quarantine and isolation facilities.
• For those who have tested positive, isolation facilities should be in place either on the campus itself or as a prior arrangement with some nearby hospitals or as advised by the local authorities.
• Colleges should prepare a policy for restricting the outside experts on campuses, study tours, field works etc., keeping in mind the situation.
• All such programmes and extracurricular activities should be avoided where physical distancing is not possible.
• Clean and hygienic conditions, as per safety and health advisories of the concerned government departments, are to be maintained at all places, including hostel kitchens, mess, washrooms, libraries, classrooms etc.

In addition to all this, every institute is asked to regularly monitor the health of its students, faculty, and staff. Also, in order to reassure the students’ community to avoid any kind of stress or panic, colleges should take necessary measures for the mental health, psychological aspects and well-being of the students.

The Role Of Students

Medicos are back to the learning path after a long break and there’s huge responsibility upon their shoulders as well as they pack their bags for the physical classes. Self-discipline is the most important key to contain the spread of the COVID-19 pandemic and students have the responsibility to adhere to this by maintaining social distancing and hygienic conditions.

According to the NMC guidelines:

• All students should wear face covers/ masks and take all preventive measures.
• May consider installing ‘Aarogya Setu App’ on the mobile.
• It is important for the students to be physically and mentally fit to handle any exigencies. By remaining fit, they can take care of others also.
• The students must inculcate activities that will increase immunity-boosting mechanisms which may include exercise, yoga, eating fresh fruits and healthy food (avoid fast food), sleep timely.
• The students must inculcate activities that will increase immunity-boosting mechanisms which may include exercise, yoga, eating fresh fruits and healthy food (avoid fast food), sleep timely.
• Discrimination of fellow students in respect of whom there is a history of COVID-19 disease in the family be avoided.
• Give support to your friends under stress due to COVID-19 pandemic.

In addition to this students should follow the guidelines, advisories, and instructions issued by the Government authorities as well as by the universities and colleges regarding health and safety measures in view of the COVID-19 pandemic.

The Role Of Teachers:

The NMC guidelines have a set of dos and don’ts for the teaching faculty as well. It states that teachers should make themselves fully aware of institutional plans and Standard Operating Procedures. Additionally, every teacher should prepare a detailed teaching plan for the subjects taught by him/her, including time table, class size, modes of delivery, assignments, theory, practical, continuous evaluation, end-semester evaluation etc.

Teachers are also asked to keep themselves updated with the latest teaching-learning methods and availability of e-resources. They are also responsible for making the students aware of the COVID-19 related situation, precautions and steps to be taken to stay safe and healthy. Teachers should also monitor and keep track of the physical and mental health of their students.

Further, the colleges are advised to make their own schedule as per the local prevailing social and medical conditions so as to effectively deal with any eventuality arising due to COVID. The reopening of colleges is expected to relieve the teaching and academic staff, as well as students from uncertainties regarding career, mode of functioning including the conduct of physical classes.

It is felt that even after the spread of coronavirus is contained, certain preventive measures will be required to be followed for quite some time to avoid its recurrence, especially in educational institutions like medical colleges.

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