LAUSR

The COVID-19 pandemic is the greatest challenge the National Health Service (NHS) has faced since its inception. The NHS has adapted quickly to reconfigure services in response to evolving circumstances; however, the status of undergraduate medical education in the UK remains unclear. Clinical placements were curtailed in early Spring at the peak of the UK pandemic, but are planned to restart in the new academic year (September 2020). As hospitals begin their recovery phases with the restarting of elective work and other key services, medical educators must consider how best to provide high-quality teaching to the next cohort of clinicalbased medical students. Government guidelines advise good hand hygiene and social distancing as two key methods of minimising COVID-19 infection and transmission [1]. At the time of writing, the use of facemasks in situations where social distancing cannot be maintained, such as on public transport or indoor workspaces, has also been advised. The World Health Organization (WHO) recommends social distancing at a physical distance of one metre [2], which is followed in countries such as France, Singapore and China [3]. The UK government has opted instead for a two-metre social distancing rule, or if not possible, one metre plus other precautions [4]. There may be further relaxation of these restrictions over the coming months; nonetheless, social distancing measures are likely to remain in place until the end of 2020 [5]. For close personal contact with patients where aerosol-generating procedures are taking place, full-body personal protective equipment (PPE) including respiratory protective equipment (RPE), a longsleeved disposable gown, eye protection and gloves are required [6]. For non-aerosol-generating procedures, minimum PPE consists of a disposable apron, facemask, gloves and eye protection (if required) [7]. The sourcing of vast quantities of PPE and the logistics of organising teaching to comply with social distancing regulations poses a significant challenge to undergraduate medical education for the foreseeable future and any planning must take these factors into account. The UK Medical Schools Council (UKMSC) released a statement on 1 May, acknowledging the challenge that restarting clinical placements brings, whilst emphasising the importance of students continuing to progress through medical school. This is essential to ensure continued flow of new doctors into the healthcare system. They stipulate that safe supervision of students, adequate provision of PPE and government advice on social distancing and travel must all be considered prior to restarting clinical placements [8]. A further UKMSC statement in July welcomed the decision to designate medical students as essential workers as this is key to ensuring the above criteria are met [9]. There remains, however, a degree of uncertainty for hospital trusts when planning clinical placements, due to the lack of more specific national or local guidelines. A consensus on how to ensure the safety of students on clinical placements has also not yet been reached. Although advances in digital education have been largely supported in the medical community, the actual use of these technologies as an alternative to traditional teaching methods remains limited, particularly in hospital settings where small group sessions and bedside teaching predominate [10]. However, the requirement to socially distance, as well as challenges with room booking, availability of clinicians to facilitate teaching and the increased risk of going into clinical areas, * Joshua Caplan [email protected]