By: Nikki Barrington
I am a non-traditional MD/PhD student, completing three years of medical school prior to beginning my PhD in neuroscience in 2019. This meant that as I began my PhD, my close friends and colleagues applied for residency, went through the match process, and graduated. Watching from the sidelines while my cohorts moved on to residency was challenging, but I never anticipated that I would also get a front row seat to their battle against COVID-19 as freshly minted doctors, while our healthcare system grappled with the weight COVID placed on an increasingly burned-out, overburdened workforce. My sense of helplessness grew as I heard my friends’ stories, all of whom were working in emergency departments or intensive care units at the height of the pandemic. But unlike them, I wasn’t a licensed health care professional – so what could I possibly do to help?
In fall of 2020, I learned about an organization called the National Student Response Network (NSRN). Founded by medical students at Harvard and Mount Sinai Universities, the mission of this organization was “to build a network of health professionals across the US for mobilization by their respective state and local public health departments and hospitals to support them in their COVID-19 response efforts and beyond.”
Through this organization, I saw an opportunity to help despite still being a student. NSRN was able to create a network of thousands of student volunteers across the nation and worked to connect those students with COVID relief volunteer opportunities – everything from PPE collection and distribution to virtual contact tracing, to providing grocery shopping and childcare assistance to health care workers.
While working with NSRN, I served as the Director of Operations, overseeing both Regional and State Coordinators in our efforts to maintain a centralized database of volunteer opportunities at local hospitals, public health departments, and nonprofit organizations. Our team sought to connect our health professions student network with opportunities near their homes and institutions.
Though NSRN saw the massive untapped potential of health professions students to provide aid in a time of crisis, connecting those students with opportunities was not without its challenges, particularly regarding vaccine administration. Each profession and each institution had its own requirements for onboarding paperwork, training, and supervision when working with patients, even if the student wasn’t directly responsible for putting needles in patients’ arms. With licensed health care workers being incredibly taxed with patient care responsibilities, it was challenging to ensure that these requirements were met for all eligible student professions at each institution for every volunteer opportunity.
To address these challenges, NSRN worked alongside other organizations and the Biden-Harris Administration’s COVID-19 Taskforce o advocate for the expansion of the Public Readiness and Emergency Preparedness for Medical Countermeasures Against COVID-19 Act. The PREP Act formalized and expanded the ability of health professions students to administer vaccines such that students across professions – medical, nursing, pharmacy, midwife, paramedic, optometry, and veterinary students – could administer vaccines with appropriate training and supervision. Though this was certainly a needed step forward, it did not mitigate the lack of infrastructure in place to streamline onboarding, training, and supervision for students, and as such NSRN continued to face challenges connecting students with volunteer opportunities in clinical settings.
In addition to these administrative challenges, as the world returned to some semblance of normalcy and virtual work became ubiquitous, students found themselves with significantly less time to devote to volunteering as their course load returned to its pre-pandemic baseline. Many public health departments and nonprofit organizations were seeking longer term commitments from volunteers, making it difficult for NSRN to match students with volunteer opportunities that fit into their schedules. Furthermore, as students relocated back to their academic institutions, they were often geographically much further away from communities experiencing health care worker shortages, and often did not have the means nor the time to travel to the communities most in need, even if those communities had licensed health professionals that could supervise their efforts.
For a variety of reasons, the Board of Directors made the decision to dissolve the organization in April 2021; however, there is still much work to be done and health profession’s students are a valuable resource in helping to address many of our nation’s public health crises. To successfully utilize this untapped resource, there are essential barriers that need to be addressed.
1. Standardization of onboarding paperwork and training across institutions. Much like our licensed counterparts, health professions students need a standardized passport system. Such a registry would allow students to be cleared to volunteer within a network of hospitals, public health departments, and health-related nonprofit organizations. These institutions in turn would have access to all the pre-requisite paperwork for those students, and a system for ensuring said students had the same level of basic knowledge and training (blood borne pathogen training, electronic medical record training, etc.). While such a system would ideally allow volunteerism across state lines, thereby allowing for rapid mobilization in times of crisis, a more realistic approach would likely involve creating state by state registries, much as licensed health care professionals typically obtain licensure in a single state.
2. Collaboration among institutions and professional organizations to establish consistent interprofessional student supervision requirements. Supervision requirements should be determined by the clinical task at hand, rather than by the respective professions of the licensed health care worker and student volunteer. For example, pharmacists trained in vaccine administration should be able to supervise nursing students administering vaccines. Interprofessional supervision would not only provide increased flexibility in volunteer efforts but would also better prepare students to enter an increasingly diverse healthcare workforce.
3. Volunteer opportunities as part of the curriculum and incentives for student participation. While I would not advocate for forced volunteerism, many institutions have sought to include more interprofessional education components in their curricula, and this often includes a service-learning component. Such strategies allow students to incorporate service without taking additional time away from their demanding study schedules. Ideally, such experiences would count toward students’ clinical hours; however, further participation can easily be incentivized via awards and recognition – for example, a designation on students’ Dean’s letters when applying for residency positions and job opportunities or expanding volunteer opportunities eligible for TOUCH hours (Translating Osteopathic Understanding into Community Health) for osteopathic medical students.
4. Volunteer opportunities that are mindful of student time constraints and obligations. Given the constraints on health professions student schedules, it is essential to adapt volunteer opportunities accordingly by ensuring that the time commitment is manageable. For example, students are far more likely to participate in a single service day rather than a long-term commitment.
5. Funding and incentives to establish opportunities and transportations for student volunteers in designated Health Professions Shortage Areas (HPSAs). Many health professions students are interested in rural and underserved health, but lack the means to travel to these areas, which are often far removed from the academic institutions they attend. Dedicating greater grant funding to cover these costs would alleviate barriers to student participation.
With these lessons in mind, myself and two former NSRN student leaders – Danielle Uibel (Touro University College of Medicine, New York) and Jessica Gillespie (University of Wisconsin, Madison) – founded a new student organization called “The National Association for Health Mentorship, Education, and Service” (NAIHMES). We are dedicated to educating health professions students about public health issues and providing the appropriate mentorship and interprofessional framework to address these issues through service. NAIHMES aims to address not only COVID-relative public health issues, but also chronic, longstanding public health issues and how to be better prepared for the next acute public health crisis. NAIHMES is in the process of creating a centralized registry of existing and new student service groups across the nation, which will provide member groups with access to mentorship and education resources while laying the foundation for a passport system for student volunteers. NAIHMES is also working with Area Health Education Centers (AHEC) in multiple locations to establish service groups and volunteer opportunities while employing local institutional connections to incorporate these opportunities into curricula where possible, thereby bypassing administrative and logistical challenges. In bringing our vision to life, NAIHMES hopes to instill in students early on in their careers the importance of public health education and demonstrate how interprofessional service at all career levels can be a powerful tool in addressing population health and societal inequities.
Students and faculty wishing to get involved with NAIHMES as advisors, leaders, or volunteers should contact Nikki at firstname.lastname@example.org or reach out to @NAIHMES on Instagram, Twitter, or LinkedIn. All health professions students are welcome!
About the Author: Nikki Barrington, MPH is an MD-PhD student at Rosalind Franklin University of Medicine and Science. She received her BS from the University of California, Santa Barbara, and her MPH from the University of California, Davis. She is currently completing her PhD in neuroscience studying neuroinflammation in traumatic brain injury and plans to specialize in neurosurgery. She is co-founder and Director of Operations for the National Association for Interprofessional Health Mentorship, Education, and Service (NAIHMES), whose mission is to promote health equity by training future health care providers to address the social determinants of health utilizing an interprofessional framework.
1. Jalen Benson & Henry Berman. “How to Engage the National Student Response Network During COVID-19.” Exponent Philanthropy. 8 May 2020.
2. Madison Arnold. “National Student Response Network, created by Pensacola resident, expands during pandemic”. Pensacola News Journal. 9 August 2020.
3. “Partnership with National Student Response Network”. Harvard Medical School COVID-19 Student Response.
4. Kim Rodgers. “National Student Response Network Linking Volunteers to Health Departments”. National Association of County and City Health Officials, Preparedness Brief. 20 May 2020.
5. “Touch Program”. American Association of Colleges of Osteopathic Medicine.
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