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2020 MEDICAL YEAR
IN REVIEW

COVID-19 and Pre-Clinical UME at

UIW School of Osteopathic Medicine

By Adam V. Ratner, MD, FACR

Medical school has surely changed since I was a student way
back in the last millennium. Back then, in the first two years of medical
school, we spent hours every weekday sitting in lectures while trying
not to daydream. At night and on weekends we crammed and binged,
trying to memorize the material that we would purge onto the next
test and shortly thereafter, forget.
At the University of the Incarnate Word School of Osteopathic
Medicine (UIWSOM), our case-based, team-oriented, student-di-
rected learning curriculum is built on active engagement and interac-
tion between medical students and faculty facilitators. Every Monday
through Friday morning, first and second-year medical students work
in small groups and larger teams with faculty facilitators to learn, dis-
cuss, and critically think through clinical situations, their basic science
and socioeconomic underpinnings, and humanistic consequences. Just as importantly, the lack of real person-to-person interaction
This curriculum requires the presence and active engagement of stu- adds to loneliness and isolation among medical students. Most med-
dents at a far higher level than just sitting in a classroom or watching ical students (and faculty) are able to develop strong camaraderie with
a video screen. That said, since the inception of the school we had de- colleagues. This camaraderie just isn’t quite the same on Zoom tele-
bated the merits of allowing students who were unable to attend a ses- conferences.
sion for personal reasons or mild illness to be able to join sessions From its inception, UIWSOM has always emphasized the human-
remotely. The founding leaders of UIWSOM had made the invest- ism required to be a caring and effective physician. One way we sup-
ments in the appropriate IT infrastructure to allow the use of tech- port physician humanism is this through addressing the behavioral
nologies to support remote learning. health needs of medical students and faculty. We have increased our
In early 2020, the leadership at UIWSOM began discussing the po- behavioral health resources and created new programs to address these
tential effects of a possible epidemic on our medical school. When it mental health challenges in the COVID-19 learning environment.
became apparent that the COVID-19 pandemic had reached San An- As of the time I write this (late October 2020), we are developing a
tonio by the second week of March, we were prepared. Our office of thoughtful and controlled plan to bring our pre-clinical medical stu-
Medical and Interprofessional Education trained the faculty, staff, and dents back on campus for the hands-on clinical skills training they
students in the art of Zoom teleconferencing. We converted our highly have missed in the past few months. We will continue to seek the best
interactive live curriculum into a virtual one, literally over a single possible balance to continue our mission of creating the next genera-
weekend. tion of sorely needed, primary care physicians while seeing the resur-
I remember I was most concerned about adequate bandwidth and gence of COVID-19 cases across the country and the world.
power of the Zoom servers, but my fears were unfounded. All things
considered, the transition has been astoundingly successful but, of Stay tuned.
course, not perfect.
The lack of in-person interaction has created a myriad of challenges. Adam V. Ratner, MD, FACR is Professor of Radiology,
Without in-person guidance and oversight it’s not possible to convey Health Policy, and Medical Humanities and Assistant Dean
the nuances of performing ideal history and physical examinations of Strategic Initiatives at UIWSOM. He is also Chairman of
or osteopathic manipulative techniques. The good news is that stu- The Patient Institute and 2019 President of the Bexar County
dents are learning practical telemedicine skills much earlier now than Medical Society
in the past.

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