SOM Student COVID-19 Information

Students,

Check for email announcements and regular updates on this webpage.  If you have questions or concerns, please contact either Dr. Chakraborti cchakrab@tulane.edu or Dr. LeDoux eledoux@tulane.edu directly.

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EXPOSURE AND TESTING POLICY UPDATES

 01/13/2023 - COVID Testing will continue to be available to Tulane students, faculty and staff for symptomatic, close contact exposure and travel purposes and can be found at the following times and locations:

►Downtown Tulane Living Well Occupational Health Clinic

Hutchinson Building Rm. 1810 (The Old Bookstore)
Walk-ins are welcome, no appointment necessary. 

Please use the Lasalle St. entrance and bring your Splash ID.
Hours: Monday - Friday 1:30pm-2:30pm.
Available to both Students and Employees.

 

►Uptown Student Health Center

Located on the corner of Willow St. and Newcomb Pl.
Walk-ups are welcome, no appointment necessary.

Check in with the nurse at the second door of the Health Center.
Hours: Monday - Friday 9am-noon and 1pm-4:30pm.
Available to all Students.

Please note that return to campus testing will NOT be offered at these symptomatic testing clinics. Return testing should be completed prior to arrival to campus.

Pfizer Bivalent COVID Boosters and Flu Shots are both available to Tulane students, faculty and staff at both Uptown and Downtown campuses. Appointments can be made at https://tulane.edu/covid-19/covid-19-vaccinations. For additional questions about the COVID Vaccine, please email covidvaccine@tulane.edu. 

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Testing Over the Break and Upon Return – Medical Students
Medical Students will need to complete one test prior to the start of clerkships, fourth year activities, or first/second year classes. In addition, symptomatic and exposure-based testing will be available throughout the break.

Symptomatic and Exposure-Based Testing During the Break
Drive-through symptomatic and exposure-based testing will be provided over the winter break through the Wellness Clinic. To request testing, leave a message for the clinic at 504-988-HEAL (4325) or email wellnessclinic@tulane.edu. Phones and emails will be checked regularly over the break, and testing will be available Mon – Sat except for December 25 and January 1. Testing will only be provided after an appointment is scheduled. Walk-in testing is not available for symptomatic or exposure-based tests.

Within 24-36 hours of testing, look for an email from noreply@medicat.com regarding the results. For symptomatic/exposure-based testing, if results have not been received 36 hours after testing, email mybell@tulane.edu, mlampp@tulane.edu, and spollac@tulane.edu for assistance. Between December 19 and January 3, the chtestresults@tulane.edu email will not be monitored.

Testing Upon Return to Campus for the Spring Semester
In order to protect the campus community and city residents as we return to in-person classes following Winter Recess, all new and returning students will be required to complete a return-to-campus test in January and to participate in ongoing surveillance testing throughout the spring semester.

Notices to schedule testing have been sent. Orders have been loaded in the system, and all students should have received a QR code via e-mail from no-reply@lablynx.com that will enable access to testing. To schedule a test, log in to Tulane Campus Health Patient Portal using your Tulane username and password. Click the appointment tab, and select the "Downtown" testing center location. Using the drop-down boxes, select the options for COVID-19 testing and choose from the available dates and times to schedule the test. Bring the QR code or student ID to the testing site for check-in.

If for some reason a student does not receive the scheduling email, or if additional asymptomatic testing is needed prior to January 4, they may still schedule a test through the patient portal and present their student ID at the testing site for on-site registration. Test results should be available within 24-36 hours of testing. For asymptomatic testing, if test results are not received, please return to the testing site for further information.

Asymptomatic Testing Site Hours Over the Winter Break
Downtown (LaSalle): December 14, 2020 will begin reduced hours

• Mon-Fri 7am - 3pm,
• Sat 7am - Noon,
• Closed on Sundays, Christmas Day (December 25), and New Year's Day (January 1).
• On Christmas Eve (December 24) and New Year 's eve (December 31), Lasalle will be open 7am-Noon.

Uptown (Patterson): CLOSED

Exemption for Students who tested positive for COVID-19 after October 1, 2020
Any student who tested positive for COVID-19 on or after October 1, 2020, will not be required to complete a return-to-campus COVID-19 test and will not participate in surveillance testing until directed to do so by Campus Health. In order to be exempted from testing, students must email chtestresults@tulane.edu with 1) the date of their positive result and 2) note whether they were tested at a Tulane Testing Center or another location. If the result is not from a Tulane site, students must submit documentation of the test results through the COVID-19 Reporting Form.

Take care and stay safe during the Holidays!

 

 

December 14, 2020 - COVID-19 Vaccines: A Community Town Hall from Tulane University SoM (video)

December 8, 2020 - Covid-19 Town Hall for Students & Trainees (video)

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July 21, 2020, 9:06 am  Student Safety in Hospital & Clinical Activities

The School of Medicine wants to ensure that the risk of transmission of Covid-19 to medical students, (considered non-essential healthcare workers), while completing their clinical activities is as minimal as possible. The following Student Guidelines are therefore being implemented.....Read the student guidelines.

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May 26, 2020, 6:26 p.m.  Classes of 2021 and 2022 Update

USMLE has announced that Step 2CS test administrations will be suspended for the next 12-18 months.  This is no rumor, this is the real announcement, which I’ve attached.  They released this information late this afternoon and it was embargoed until now, so I’m allowed to distribute this information now.  I know this will make life much easier for the Class of 2021 and we’ll just have to see where things are for Class of 2022, no predictions from me. For more information, see Step 2CS FAQs.

Have a good evening, stay safe,
Dr. Krane

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April 29, 2020, 12:50 p.m.  Latest Updates Class of 2021:

• Away Rotations and ERAS:  To better help you plan your year, regardless of what approvals you currently have, you should plan on NO away rotations for at least through the summer, probably longer, with significant limitations on away rotations for the entire academic year.
  • The Coalition for Physician Accountability which includes all the major organizations that oversee undergraduate and graduate medical education are expected to develop guidelines regarding away rotations and to develop recommendations they will publish within the next several weeks.
  • We have confirmed that sites for students who may be holding already approved away rotations for this summer, like NYU, will NOT be having visiting students.  
  • Anticipate delays in ERAS, formal plans will be announced sometime in the next month.

• What to do in May:  You are encouraged to sign up for electives, volunteer, or study for Step 2.  
  • Actual dates are May 4-May 29, (dates on the original schedule are different).   
  • If you are interested in the Bioinformatics elective, contact Dr. Gambala (cgambal@tulane.edu) by Thursday evening so she can notify OHSU, the elective sponsor.  This online elective requires about 10hrs/wk time for 4 wks for which you will receive 2 wks credit.  The syllabus and more information are available athttps://dmice.ohsu.edu/hersh/MINF705A.html

• Make-up Clerkships from Block 6, begin June 1 and are in the process of scheduling everyone for their make-up work in June.  It is anticipated they each clerkship will be able to provide this information to you by next week. The amount of time required for make-up will vary by clerkship, and make-up time may run up to the 4th of July holiday.  Given the challenges in scheduling students during this time, please note:
  • There will be NO Acting Internships scheduled in June, regardless of your previous schedule.
  • You cannot sign up for an elective during this time.

• Acting Internships: Clerkship directors will be working hard on scheduling acting internships after the make-up activities are scheduled.  This may result in a change to your anticipated original schedule.  Contrary to current rumor, there is no plan to make all AI’s 2 wks.

• Other issues:
  • July   6 – Years 3 and 4 will begin, including acting internships, clinical electives
  • Emergency Med spots in July, August, and September will be given to students going into EM.  Previously scheduled students with 2-wk EM will be re-scheduled to a later date.  
  • The Department of Radiology is re-evaluating how best to offer the required Radiology Clerkship.  You will receive an update when plans are finalized.
  • Community Medicine is not offered in June and July but will resume in August.

• Because of the challenges in scheduling, limitations to away rotations (if any), when to take Step 2 exams when they become available, and the many changes anticipated in the residency application process, be sure to speak to your advisor.  If are not sure who to speak with, contact the Office of Student Affairs and they will advise you on who would be best for you personally, given your specialty choice.

I would like to thank all the Clerkship Directors, the Office of Student Affairs, the Office of Medical Education, and others who are working hard behind the scenes to put all these pieces together, maintain the integrity of your medical education, ensure your personal safety, and make sure that you are well prepared for the residency application process.

Take care, stay safe,
Dr. Krane

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April 26, 2020, 12:04 p.m.  Update Class of 2022: When to Take Step 1

Class of 2022:  Based on concerns raised by your Class about when is the best time to take Step 1, further discussions were held with the clerkship directors, students and others and we are providing the following information to help you in this process:

• Most students seem to have been able to arrange a Step 1 date in June.  Those students should definitely keep their date.
• About 65 students have dates scheduled for May.  None of us know if your date will be honored or canceled. I’ve attached the “official” NBME update from April 24 below, though many nationally are not certain how to interpret their comments about openings and “essential”. Therefore if you want or must re-schedule your date, we are formally endorsing that it is acceptable to schedule for July, August, or up to Sept 15.  You will be allowed 2 days off from your clerkship - the day before the exam and the day of the exam.  Several important dates to note are:
  • Avoid times around the clerkship shelf exams, which are:
    • 7/24/20:  Psych and Neuro only
    • 8/14/20:  All clerkships including Psych and Neuro
    • 9/4/20: Psych and Neuro only
  • If you have a date during the clerkship, be sure to notify the Clerkship Director/Coordinator asap so they know you will be absent those days
• I would encourage all students to speak to an advisor to ensure you are making the best decision regarding the timing of your exam.  Your advisor can be a faculty member with whom you have a relationship, Dr. LeDoux (eledoux@tulane.edu), Dr. Naquin (gnaquin@tulane.edu), Dr. Chakraborti (cchakrab@tulane.edu), or myself (kkrane@tulane.edu).
• Again, you may decide to delay taking Step 1 until after your clerkships are done, remembering there will be a significant period of study time available.

We hope this will provide more flexibility during this difficult time period.

Stay well, hope you are enjoying JazzFest Sunday #1, a perfect day for Festing whatever you are doing.

Dr. Krane

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April 20, 2020, 7:46 p.m.  Updates: Class of 2021 and 2022

Good evening:  Here are a few updates; details are being worked out on some things, which I’ll indicate, but big picture continues to fall into place, with enough information to help with your planning.  Some of this may be repetition and since there is some overlap of the Classes, I’m sending to all.  Dr. LeDoux and I will be holding open forums for each class and we’ll be happy to clarify anything at that time.
Take care,
Dr. Krane

• May block is May 4-May 29:  Available for electives, Step 2 or other activities.  Important: this period of time is shifted earlier from what was originally scheduled so that students who will be doing Block 6 clerkship make up activities can start on Monday, June 1 (also not the original date).  Be sure that you are only doing one activity at a time.
  • Electives that are completely on-line that are asynchronous with no direct faculty interaction: You are allowed a maximum of 8 wks.  They were originally designed to facilitate fourth year students while on interviews. New ones that are being posted are:
    • Pain Management and Addiction Medicine (2 wks)
    • Health Informatics (4 wks)
  • Electives that are on-line but have regular, synchronous interactions with faculty: these do not count towards the 8 wks described above.  Two, 4-week electives are being finalized and will be posted in the immediate future. If you are planning to register for either one:  If you have a Step 1 or a Step 2 date in May, there is no reason to change it, but let the course director know you will be out.
    • COVID-19: Medical and Social Impact (3rd or 4th yr students) - 4 weeks (May 4-May 29)
    • Allergy/Rheumatology/Immunology (4th yrs only) - 4 weeks (May 4-May 29)
• June 1:  Starting date is designed for Class of 2021 students to begin make up for Block 6  to complete clerkships.  Be prepared to start Monday, June 1.  However IF you have a Step 2 date in June, there is no reason to change it, but let the clerkship director/coordinator know asap so they can arrange your June schedule accordingly.  Acting Internships:  Plans are still being finalized, but some of this time may also be used by some clerkships for AI’s after clerkship activities are finished.
• Class of 2022 - June 29:  Orientation week before starting clerkships
• Class of 2022 - July 6:  Clerkships begin.  Internal Medicine, Surgery, Family Medicine, Ob/Gyn and Pediatrics will each be 6 weeks.  Pscyh and Neuro will be scheduled back to back as a 6 week block of time.   For those who will not have taken Step 1, the year will end April 2, 2021 so you will have adequate time to schedule and study for Step 1 before you begin your 4th year.  Emergency Medicine is in the process of complete reorganization and will be completed in a longitudinal fashion during year 3: some content online, other content delivered throughout the year.

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April 15, 2929, 9:19 p.m. Updates: Class of 2021 and 2022

While there are still some issues that are unresolved, the following are the latest curriculum updates:
Stay well,
Dr. Krane

• The Curriculum Committee voted today to make the following changes to the curriculum for the new academic year:
  • The minimum number of weeks of required electives was reduced from 30 to 22 weeks for non-MD/MPH students and from 34 to 26 wks for MD/MPH students.  However, students may choose to complete up to 30 or 34 weeks of electives..
  • Students may delay Step 1 until the end of Year 3, but must take it before they begin Year 4.  This replaces the requirement to complete Step 1 by October of Year 3.

• We are finalizing plans to offer the following electives in May.  We will notify you when the registration process is open.
  • Covid-19:  Medical and Societal Impacts:  4 wk online course - 3rd or 4th yr students.
  • Allergy, Immunology, Rheumatology: 4 wk online course - 4th yr students only.
  • Medical Informatics: A 4wk virtual course offered through Oregon Health Sciences - 3rd or 4th yr students, counts towards 8wk limit for online courses.
  • Pain Management and Addiction: 2 wk online course, 3rd or 4th yr students, counts towards 8wk limit for online courses.

• Emergency Medicine
  • Students who plan on going into EM and are scheduled for 4 wks of EM will all be scheduled for the months of July, August, and Sept.
  • Students who are scheduled for 2 wks of EM will be scheduled beginning in Sept or October, after the 4 wk students.  

• Radiology:  This clerkship is being re-organized with the goal being to offer this clerkship in a new format beginning in July.

• Community Medicine: This clerkship is being offered in May and those students who taking this clerkship are already enrolled.  The clerkship is typically not offered in June and July and will resume again in August.  

• Other issues still being addressed:
  • Acting Internships:  A comprehensive plan to address how students can complete their AI is still being addressed.  Clerkship directors are well aware of the desire for students to complete an AI in their preferred specialty choice as early as possible in the academic year.  
  • Step 2 CK and CS:  Similarly, creating time for students to complete either part of Step 2 is challenging and we are looking at several options.
  • TOSCE:  This is likely to be moved to the latter part of the summer.
  • Away Rotations:  Expect significant restrictions; guidelines from national organizations anticipated within next several weeks.

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April 13, 202, 10:18 p.m. Class of 2021 Update

We are working on how your 4th year will lay out, anticipating significant changes due to events both locally and nationally.  There is still a lot of discussion at a national level about what the availability of “away” rotations will be, which at best are likely to be significantly limited.   ERAS and MSPE deadlines may be pushed back and there is a lot of discussion about virtual vs in-person interviewing for residencies.  It will be a very different year, but we are all committed to working with all of you to get you through the residency process and graduation.  Here are the plans for the beginning of the year and then we will work on the remainder of the year to make necessary adjustments so you can graduate as planned.

Stay well,
Dr. Krane

May:  Available activities

• Online electives in eMedley.  You are allowed a maximum of 8 wks.
• Online courses, May 4-May 29: Currently going through development and creation of registration of process.  These do not count as “online electives”.
  • Covid-19/Disaster Course:  This course will cover 4 key topics each week: Disaster Management, Leadership, Public Health Response, Covid-19 - basic and clinical science: Open to all students
  • Allergy, Immunology, Rheumatology:  Pathophysiology of common diseases and management patients with both acute and chronic varieties of common diseases in allergy/immunology and rheumatology including the pharmacotherapy and immunotherapy involved in modern allergy/immunology and rheumatology:  limited to 4th year students
  • Medical Informatics:  A virtual course offered through Oregon Health Sciences, providing a broad overview of medical informatics.  Further information is available at: https://dmice.ohsu.edu/hersh/MINF705A.html (up to 20 students).
  • Research:   Good time to do indirect clinical or other research:  Need approval forms.

June:  Priority is for students to complete Block 6 required clinical activities in all clerkships.

• Clerkship directors are making plans for students to return for a 2 wk period to complete required activities so you will need to be available to complete their clerkships.  Some clerkships may have to delay some activities like SP Center exams to an even later time.  Scheduling for June is still in progress and not yet available.
• Students cannot do concurrent academic activities and should plan on being available to focus on and complete their clerkships. Even if you are still doing volunteer work, you must be available for this 2 wk period.
•  If a student only spends 2 wks completing a clerkship during June, what to do with the other two weeks?  Options currently include:  AI, 2 wk online electives,
• AI’s:  Students who were planning on doing an AI in May or June should email the appropriate clerkship director.  AI’s that are completed in June or July may only be 2 weeks.
• Honors Surgery is being reevaluated so they can accept more students, planning for August
•  Emergency Medicine:  Availability of EM in June will depend on the clinical situation at UMC, and students will need to be available for 2 wks to complete their Block 6 clerkships.

July-May:  We will need to make significant adjustments to everyone’s schedules, knowing that everyone is trying to figure out when they can take Step 2 CK or CS, prepare for residency, and maybe get some time off.

“Off-Donut” students:  The Office of Student Affair will work with each of you individually regarding a revised schedule.

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April 8, 2020. 10:44 p.m. Class of 2021 Update

We are now able to provide more clarity to some issues that will allow you to plan and make decisions for the next few months, and then for the coming year, though there are still many uncertainties.  All of these decisions are being made with the best interest of our students in mind with input of clerkship directors, students, and educators:

• We know you are all concerned about the ERAS process, how everything will fit in your reconstructed 4th year, and getting to graduation.  I am anticipating that all typical residency preparation processes will significantly change and be delayed this year including interviews, availability of “away” rotations, and ERAS.  We will therefore all need to be very flexible in how we navigate the coming year, but we are committed to getting you through it.  We are considering several options to ensure you have the necessary time to achieve what you need, including study time for Step 2.
• Though it seems there may be “downtime” right now, it is not in the best interest of students or your education to be taking multiple courses or clerkships at the same time.  We have encountered too many conflicts to allow this.
• May will now be available to take on-line or other courses that are available (new ones are currently being developed) during this month. There will be no scheduled clinical activities/clerkships in the month of May.  
• Available online electives are posted in the “T4 electives” link in eMedley (eCurriculum in eMedley’s 2019-2020 term).  Look for the “online” electives link among all the department names listed under “categories.”  Be sure you are properly registered for these courses.  Note: Emergency Med and Radiology are clerkships that are not available as on-line courses.
• If you had an AI scheduled in May it will have to be rescheduled.
• Clerkship directors are beginning to make alternate plans for all the students who planned AI’s in May/June/July to try and ensure that everyone who had planned to complete one during this period will have the opportunity to do so during the summer.
• We are anticipating that we can use the month of June to make up required clinical activities so you should not plan or register for other activities during this time.

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April 6, 2020, 5:17 p.m. - Updates for Class of 2020

• Graduation:  Discussion is still underway concerning potential replacements to the May 16th commencement ceremony.  Issues related to regalia are being addressed and you will receive further information.
• Completion of graduation requirements:  Only a small number of students are still completing their graduation requirements.   If necessary for your graduation, plan to complete anything still required for Emergency Medicine, Radiology or other no later than  Friday, April 17, if you are currently registered, and by Friday, May 1 if you are starting April 20.
• Be sure all your IDS seminars are done - five total.
• Be sure to watch ESPN tonight, 7PM.

Stay safe,
Dr. Krane

April 6, 2020, 5:17 p.m - Updates for Class of 2021

• Chits:  Many of our students are providing remarkable service to the community through your volunteer activities.  However, your primary focus as medical students must be to your academic activities while on your clerkships.  Therefore, please be sure to plan your volunteer activities so that you are not missing clerkship or other required activities.  In the unlikely event you do need a chit, you must you must email Dr. LeDoux first with an explanation of why you need to miss a required activity prior to submitting a formal chit to Student Affairs.
• We are well aware that many of you will not be able to take USMLE Step 2 (either CK or CS) as scheduled.  Today USMLE announced that Step 2 CS testing will remain suspended through May 31, 2020, and there is no further information when Prometrics will open their centers.   We will all have to be flexible with Step 2 since we do not know when they will re-open or what activity you may be taking at that time.
• The 4th Year Schedule:  Expect changes due to the many unknowns:  what will happen with residency applications, aways, resuming clinical work, etc.  Most of these issues are likely to be addressed at a national level with input from AAMC, USMLE, GME, etc.  Currently the Office of Student Affairs is looking at how we can plan for significant disruption.  We will provide you with an official list of the requirements that will serve as your guide as to what needs to be completed to meet the graduation requirements, even if your schedule has to be changed.  There may still need to be changes from the current requirements.
• Acting Internships:  While many students were planning to do their AI in May, this seems unlikely and even June is at risk, but if we can resume then, we will.  Therefore, you should consider other options during this time.  The clerkship directors are addressing how to reorganize things, especially since the opportunity for “away” acting internships is almost certainly going to be significantly reduced, if it even remains an option.    
• Students who are “Off-Donut” needing Psych or Neuro:  The April block of Neuro is starting now and we realize that it would facilitate your schedule if you could move up your May or June Neuro block and start now.  This may work for some students.  However, if your current clerkship activities have any conflict, you cannot take Neuro at this time.   The April Psych block,  had to be delayed directly because of a difficult coronavirus issue.  Dr. Weiss will notify students as to when it  will start.
• We are hoping that we will be able to open clinical activities in the month of June to make up all the clinical activities missed during the March/April clerkships.
• If you have the time to complete them now, you can register for on-line electives.
• Now is a great time to register for and complete your 5 IDS seminars.
• Be sure to watch ESPN tonight, 7PM.

Stay safe,
Dr. Krane
 

April 6, 2020, 5:17 p.m. Updates for Class of 2022

• Chits:  Many of our students are providing remarkable service to the community through your volunteer activities.  However, your primary focus as medical students must be to your academic activities while on your clerkships.  Therefore, please be sure to plan your volunteer activities so that you are not missing clerkship or other required activities.  In the unlikely event you do need a chit, you must you must email Dr. LeDoux (eledoux@tulane.edu) first with an explanation of why you need to miss a required activity prior to submitting a formal chit to Student Affairs.
• Your clerkships will hopefully begin July 6, with an orientation scheduled to begin on June 29.  All eight week clerkships (Surgery, Peds, Medicine, Ob/Gyn) will be shortened to 6 weeks, so the academic year is expected to end about the same time as it would normally
• The 3rd Year Schedule:  Expect some changes because of the shortened clerkships and the necessity to balance some of the 6 wk clerkship time with 4 wk clerkships and 2 wk electives.  Currently the Office of Student Affairs is looking at how we can plan for the changes.
• We are well aware that many of you will not be able to take USMLE Step 1 as scheduled.  Today USMLE announced that Step 2 CS testing will remain suspended through May 31, 2020, and there is no further information when Prometrics will open their centers.   We will need to provide some options for the coming year so that you can do everything possible to avoid taking Step 1 during a clerkship.  
• We will soon provide a list of courses and on-line electives that you can register for in the month of May, even before clerkships, that do not require a clinical prerequisite.   
• We are hoping that we will be able to open clinical activities in the month of June to make up all the clinical activities missed during the March/April clerkships.
• Now is a great time to register for and complete your 5 IDS seminars, that will be required for graduation.
• Be sure to watch ESPN tonight, 7PM.

Stay safe,
Dr. Krane

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April 2, 2020, 6:08 p.m.

T4’s:  Most of you have completed all your elective requirements, but we want to make the following clarification for 4th year students regarding elective requirements:

• Non-MD/MPH students:  Students must complete ONLY 24 weeks of electives total (4 wks have been waived from the usual requirement).
• MD/MPH students:  Students must complete ONLY 28 weeks of electives total (4 wks have been waived from the usual requirement).
• IF you have already done Outpatient Surgery, this time will be counted as elective credit towards your elective requirement.
• If you are planning or already have completed more than the above minimum number of weeks of elective, it will appear on your transcript.   In other words, if you have met the above requirements and are currently scheduled for another elective, its up to you whether you want to take it or not, but if you do, your transcript will reflect your participation in the course.
• If you have completed every on-line elective and you are concerned you still need a few more weeks and don’t know what to do, we will address your concerns on an individual basis to come up with an appropriate solution.  If this is the case, just email me directly.

Therefore, go through your own schedule and based on the above criteria, determine if you still need to complete any additional weeks of electives.  Currently, there are no clinical opportunities to do electives, they are only available online.  If you have any questions about what is available or whether you need more electives, please contact the Office of Student Affairs.   As always, feel free to contact me directly with any other questions.

Regards and stay well!
Dr. Krane

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April 1, 2020, 1:00 p.m. - Opportunities for Administrative Medical Work at the VA

To All:    Many “Opportunities for Administrative Medical Work at the VA” are available at the New Orleans Medical Center, shown below.   If you are interested in volunteering for any of these opportunities, please contact Dr. Randy Roig (rroig@tulane.edu), the Associate Chief of Staff for Education and Designated Education Officer, New Orleans Veterans Affairs Medical Center:

1. Assisting in PPE education for staff (with Dr. Boswell)
2. Assisting in creation and validation of changes in PPE guidance (Drs. Boswell and Gillette)
3. Assisting with epidemiologic modeling and forecasting (with Dr. Gillette)
4. Assisting Serg with triaging of critical values in the lab (with Dr. Widmer)
5. Literature review on various COVID topics including prevention, treatment, testing, epidemiology, equipment (all)
6. Assisting with starting up new study on Remdesivir happening at VA (with Dr. Widmer and Dr. Constans)
7. Assisting with creation of various workflows and algorithms for testing, follow-up, data management (Dr. Martin Klinger)
8. Assisting with follow-up phone calls to patients with test results (Dr. Martin Klinger, Dr. Marsh)
9. Assisting with testing and feedback/modification of various informatics solutions being built including templated notes and order sets (all)

T1’s/T2s – For Service-Learning Opportunities:
For those of you interested or are participating in COVID-19 relief efforts that do not involve direct patient care, the Service Learning Council is happy to consider providing SL credit. There are three elements:

• need a student representative for the opportunity
• need to be approved by the SL council
• students complete a reflection at the end of each academic year (not experience-specific).

To qualify for SL credit, an application should be submitted here. Students submitting requests for credit must also agree to serve as the student liaison for the project, and will track hours for participating students.    
 
Take care, thanks for all things you are doing.
Dr. Krane

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March 30, 2020, 9:03 p.m.

Classes of 2021 and 2022:  Many of you are doing incredible volunteer activities out of your strong commitment to service for our community and others, and I commend you.   We have developed the following statement and guidelines regarding volunteerism:

Tulane School of Medicine is committed to helping the community during this time of need.  We also want to ensure the safety and health of our students; therefore, we have not supported student involvement in direct patient care activities.  However, we are very supportive of Tulane medical students who are already participating in or wish to volunteer to provide indirect, non-contact patient activities and know this is an excellent opportunity for our students to provide services and help our community.  

In addition, the following provides information about ways these activities may be used towards curricular credit for the Classes of 2021 and 2022.  Students in the Class of 2023 will be addressed separately.

• For non-MD/MPH students: While you may not have thought about it yet, the Community Health Clerkship is required of all students who are not in the MD/MPH program, and is typically completed in 4th yr.  The objectives of this clerkship focus on the social determinants of health, structural violence, racism in its various forms, high rates of incarceration, and other essential topics that impact the well-being of patients and populations.  It consists of a community assignment that does not involve direct patient care and a series of related seminars, all under the leadership of  Dr. Isis Smith. Dr. Smith has created a system for you to obtain credit for the community assignment portion of the clerkship. This can be done at any volunteer site. The VA Hospital is about to offer other new opportunities. A complete description of how to obtain credit is attached.   
• For MD/MPH students: Dr. Krousel-Wood is working towards developing a system that would potentially use the VA Hospital as one of the MD/MPH rotation sites and she will provide that information to your cohort.

Today, the AAMC also issued the following guidelines:  

“Unless there is a critical health care workforce (HCW) need locally, we strongly suggest that medical students not be involved in any direct patient care activities for the next two weeks, through April 14, 2020. The primary goals of this guidance are bending the curve for the public health of North America, conserving limited PPE supply to keep HCW and patients safe, and maintaining public and HCW safety given current testing availability.”

Thank you again for your commitment to everyone’s health and safety.

Dr. Krane

  ________________________________________________________________

March 26, 2020, 8:40 p.m.

T4’s needing EM to graduate:  The LCME has updated their guidelines for clinical activities required for graduation that specifically address Emergency Medicine.  We now have a way to meet your requirement and you will NOT have to physically complete clinical duties in the Emergency Department.  They will allow us to use your previous clinical activities to meet this requirement.   Here is the new plan for you to receive a passing grade for Emergency Medicine.

Emergency Medicine consists of three elements (Didactics, ACLS, Clinical) that must be completed to receive a passing grade, all of which can be completed remotely.

1. Didactics:   All students must follow the instructions below and complete the on-line didactics and take/pass the exam:

• Go here to the Handbook for the EM Rotation
• A new section has been added, called "Rotations Impacted by COVID" located at the end of the handbook which has all the asynchronous didactics requirements for the rotation. Go through JUST this section of the Handbook and complete all on-line assignments
• When you have completed all the learning modules, take the on-line exam, which should be taken as closed book, honor code system.

2. ACLS:  All students must have already completed ACLS or have completed the online Heartcode program - just provide that certificate, we are waiving the requirement for you to do the Sim Center activity.  If you need any further information regarding this program, contact the Sim Center (jcalzada@tulane.edu).

3. Clinicals:   VERY IMPORTANT:  Attached to this email is a document with the required clinical encounters for EM.  All or most of them you have certainly already done during other clerkships, and the LCME is now considering that all you need. Therefore, open this document and fill it out, telling us during which clerkships you did the respective encounter (i.e., acute abdomen, surgery, etc...)  If you have not done a specific encounter, be honest and don’t worry, we can provide you with an “alternative” which will be an on-line video, but we need to know this for documentation.  When you complete your form, email it to Ms. Rhonda Coignet, our Director of Accreditation, at rhondac@tulane.edu.

All of this can be done on-line, and the sooner you complete all these activities, the sooner you can receive a passing grade for Emergency Medicine, required for graduation.  I would like to thank Dr. Sorge for his help and support in making this happen as well.  Please let me know if you have any further questions.     

Dr. Krane

  ________________________________________________________________

March 25, 2020, 7:52 p.m.

T1s, T2s, and T3s:  I hope you are all following guidelines that unfortunately keep us socially isolated, but keep us safe.  I wanted to give you some updates.  I’m working closely with an incredible group of dedicated faculty, staff, educators, and others to provide the best support, information, and educational experience.  I hope you appreciated Dr. LeDoux’s comments last night, we will continue to send daily Dean’s remarks.  
Dr. Krane

T1s: Here’s the latest for your Class:

• Monday’s examination went well, no major problems.   Make-up exam is ready to go for Wednesday.
• Friday final exam:  We encourage all students to take this exam as it will help you gauge your understanding of the Phase 1 material; however, the majority of students may opt out of this exam.  If you do take exam, it will be graded in a way that can ONLY IMPROVE your final course grades
• Phase 2:  Ready to go for March 30.  More information to follow.
• Volunteering:  
  • We are working with our hospital partners to develop a more comprehensive volunteer policy so that students can more easily find opportunities.  The AAMC has put out a Policy document on student volunteerism and we are consistent with these guidelines which includes that  students may not participate in direct (F2F) patient care, and almost all opportunities will be indirect patient care.   At this time, academic credit is not available for volunteer programs, though this may become available sometime in the future.    To those of you who are already volunteering: You Have Done an Awesome Job!
     

T3’s:  Here’s the latest for your Class:

• Our number one priority is the safety and health of our students.
• Updates on Clerkships:
  • This includes clinical activities needed for Emergency Medicine, IDS Seminars, and AI’s.  
  • Neuro and Psych:   the onsite exam has been canceled and moved to a remote, on-line NBME  exam on Thursday, April 9th.  These clerkships, along with all others in the last Block of the donut will be graded P/F only.
  • Making up required clinical activities for all clerkships:  Our primary consideration is the safety of having students  and we are hoping you can participate in clinical activities by ???late May/June which is dependent on the status of the epidemic. We will also most likely be guided by national guidelines from the AAMC.
  • IDS: This is a great time to do your seminars.  Please sign up and complete any that you can during this period of time as you must have 5 for graduation.   One less thing to do next year.  
• Your 4th Year:  We are all anticipating that the normal expectations for ERAS, aways, etc., across the nation will be different but we have no information at this time as to how that will look.  Be prepared for significant changes to adjust for the disruption of medical education across the nation.
• Update from Financial Aid and Marissa:  Disbursements of aid for 3rd and 4th year students will still be the first week of July. She has reached out to Mike Goodman, the University Director of Financial Aid, to see if they are going to be adjusting any of the current cost of attendance’s to extend the timeframe. She will update you when she has more information.
• Volunteering:  
  • We are working with our hospital partners to develop a more comprehensive volunteer policy so that students can more easily find opportunities.  The AAMC has put out a Policy document on student volunteerism and we are consistent with these guidelines which includes that  students may not participate in direct (F2F) patient care, and almost all opportunities will be indirect patient care.   At this time, academic credit is not available for volunteer programs, though this may become available sometime in the future.    To those of you who are already volunteering: You Have Done an Awesome Job!
• MD/MPH students:  Dr. Krousel-Wood is aware of concerns regarding requirements for this group of students.  She is currently addressing the current T4 cohort to ensure everyone has what they need for graduation, then can begin to look towards what needs to be put in place for the current T3’s. For any specific questions, please contact her directly.

T4’s:  Congratulations on your Match results.  As usual, Tulane students will be spread across every corner of the country and representing us in outstanding programs everywhere.  Here’s the latest for your Class:

Our number one priority is the safety and health of our students.

• Class of 2020 students who still need graduation requirements:  This is our second p
  • This includes clinical activities needed for Emergency Medicine, IDS Seminars, and AI’s.  
  • Emergency Medicine:  Dr. Sorge, the clerkship director, is well aware of the need to have you complete your clinical requirements.  I spoke with him last night and he is going to ensure that all your didactic activities including your exam are completed over the next month, and he is already looking at templates to get all of you through the ED in a way that expedites but meets our graduation requirements.  Again, our primary consideration is the safety of having students and whether or not you can participate in clinical activities by ???late May/June which is dependent on the status of the epidemic. We will also most likely be guided by national guidelines from the AAMC.
  • IDS: If you still need seminars, please sign up and complete them now so you have completed 5.  
  • ACLS:  If you still need to complete ACLS, the didactic portion of the course can be done entirely on-line using Heartcode, with only the clinical exam necessary at the Sim Center when it opens.   If you still have this requirement to complete, please do the online work now.   We don’t know
  • We have a few students with great suggestions about their own unique individual circumstances who’ve emailed me.  Please continue to do so and I’ll let you know whether we can consider your suggestion or we can’t.    
• Quick update:  if you are currently on Neuro and Psych, the onsite exam has been canceled and moved to a remote, on-line NBME  exam on Thursday, April 9th.  These clerkships, along with all others in the last Block of the donut will be graded P/F only.
• Update from Financial Aid and Marissa:  Disbursements of aid for 3rd and 4th year students will still be the first week of July. She has reached out to Mike Goodman, the University Director of Financial Aid, to see if they are going to be adjusting any of the current cost of attendance’s to extend the timeframe. She will update you when she has more information.
• Volunteering:  
  • We are working with our hospital partners to develop a more comprehensive volunteer policy so that students can more easily find opportunities.  The AAMC has put out a Policy document on student volunteerism and we are consistent with these guidelines which includes that  students may not participate in direct (F2F) patient care, and almost all opportunities will be indirect patient care.   At this time, academic credit is not available for volunteer programs, though this may become available sometime in the future.    To those of you who are already volunteering: You Have Done an Awesome Job!
• Graduation:  There is no new information.  The decision regarding Graduation will be made by the President and his Cabinet (which includes Dean Hamm).
• Questions about MD/MPH:  Please contact Dr. Krousel-Wood.

  ________________________________________________________________

March 24, 2020, 5:56 p.m.

Hi T2’s:  I hope you are all following guidelines that unfortunately keep us socially isolated, but keep us safe.   I wanted to give you the most recent updates so you know what we know and even know what we don’t know.  I’m working closely with an incredible group of dedicated faculty, staff, educators, and others to provide the best support, information, and educational experience.  I hope you appreciated Dr. LeDoux’s comments last night, we will continue to send daily Dean remarks.   Here’s the latest for your Class:

Dr. Krane

Step 1:  

• Dr. Gale Naquin our learning specialist has provided guidelines for all of you for Step 1 preparation.  This comes from her own expertise with input from her professional organization, the Medical Education Learning Specialists.  I think it will help re-assure and help you through this difficult period of time.
• Repeating:  Because clerkships will not start until July, if you lost your Step 1 date, you can now plan to reschedule in May or June.  It is expected that Prometric will increase the spots available.
• Repeating:  If for any reason you can’t take Step 1 before the clerkships, don’t worry.  You should still plan to start clerkships in July, but the policy will change to allow you to take Step 1 at a much later date.  No specifics yet.
• Additional Prep Materials:  Several of the national companies are making prep materials available free of charge.  We are registering for any of these materials we can and will let you know that we have confirmation they are available for our students.

Volunteering:  

• We are working with our hospital partners to develop a more comprehensive volunteer policy so that students can more easily find opportunities.  The AAMC has put out a Policy document on student volunteerism and we are consistent with these guidelines which includes that  students may not participate in direct (F2F) patient care, and almost all opportunities will be indirect patient care.  At this time, academic credit is not available for volunteer programs, though this may become available sometime in the future.  To those of you who are already volunteering: You Have Done an Awesome Job!

Clerkships:  Still planning for July, orientation the week of June 29.  This completely depends on what is happening at local, regional,and  national levels. I’m anticipating significant changes to all clerkships, building on what we have learning, and enhancing our educational programs.

  ________________________________________________________________

March 20, 2020 - 10:28 p.m.

T1’s:  The following decisions were made in the interest of all of you based on meetings with course directors and your student leadership.  We believe these changes will maintain the quality and integrity of your education while being in your best interest. Please to continue to follow all CDC guidelines and keep yourselves safe.  While this may be a tough period of time, the actions we take now will protect our safety and the safety of others.

Dr. Krane
 
Module Exam:

• You will be allowed to use one sheet of blank scratch paper. Normal labs will be provided.
• Ear buds are ok, headphones are not.
• There are a limited number of “loaner” computers.  If you need one, contact Dr. Rae ASAP (grae@tulane.edu).
• The make-up exam will be scheduled for Wednesday, March 25th.
• If you need to take any of the course exam(s) on Friday, you will be notified by the end of the day on Monday by that course director(s). Be certain to check your email.

All clinical duties including service-learning, preceptors, etc. are suspended and no credit can be given for clinical activities.  If you have specific questions about other FiM activities, please contact Dr. DeBord (jmcdona1@tulane.edu)

Information about the Inflammation Module will be sent out next week and will begin as scheduled on March 30th.

  ________________________________________________________________

March 20, 2020 - 10:05 p.m.

T3/4’s:  The following decisions were made in the interest of all of you based on meetings with course directors and your student leadership.  We believe these changes will maintain the quality and integrity of your education while being in your best interest. Please to continue to follow all CDC guidelines and keep yourselves safe.  While this may be a tough period of time, the actions we take now will protect our safety and the safety of others.

Dr. Krane

Important Clerkship Changes:

• Clerkships will not start until July.  This means that May and June, depending on when it’s safe for students to resume clinical work, will be used to make up clinical activities you have missed. Regardless of when you take your clerkship exams, your clerkship will not be complete until all your clinical activities including SP and Sim are completed.  
• Again: May/June is to make up clinical activities; 4th yrs will get priority.
• All Block 6 Clerkships will be graded P/F, but your transcripts will be amended to make it clear there were only two grade levels. Many other schools are doing the same so this will not be unusual.
• Exams for Block 6 for the 6 and 8 wk clerkships will be early on April 17.  Clerkship Directors will provide more information later, but plan your studying accordingly.
• A modified evaluation will be sent in the next 1-2 wks to get feedback on your current clerkships to help us make improvements.

Step exam delays:  All programs are aware of these delays and significant changes and flexibility slate anticipated for ERAS, residency applications and aways. These issues will be addressed at very high levels since everyone had the same issues.

IDS: They are a graduation requirement.  If you are a T4 and don’t have 5, do them now.  They are all on-line.  T3’s:  Now is a good time to do yours.

T4’s: T4’s with outstanding graduation requirements are a top priority.

AI’s that were suspended: if you completed all your required activities, you will be certified for full credit.  Clerkship Directors are reviewing each student now.  Emergency Med: I’m working with Dr. Sorge, the clerkship Director, and the plan is to do didactics now and have you return later for clinical work/shifts in the ED. As long as clinical operations are available for students, we’ll find a way to get these done in time for you to start your residency.

We are also looking at developing or having available new distance learning electives that could be available in May or June.

  __________________________________________________________________

March 20, 2020 - 9:21 p.m.

T2’s:  The following decisions were made in the interest of all of you based on meetings with course directors and your student leadership.  We believe these changes will maintain the quality and integrity of your education while being in your best interest. Please to continue to follow all CDC guidelines and keep yourselves safe.  While this may be a tough period of time, the actions we take now will protect our safety and the safety of others.

Dr. Krane

Clerkships:
Clerkships will not start until July. We anticipate that orientation will be the week of July 29 and clerkships will begin July 6, but this needs to be finalized. It is anticipated that 8 wk clerkships may reduce the number of weeks, while maintaining the same required clinical encounters, clinical activities, and didactics. How this is done is still to be determined but should make it easier when it comes to how your 4th yr will look.

Step 1:
Because clerkships will not start until July, if you lost your Step 1 date, you can now plan to reschedule in May or June.  Prometric is expected to increase spots. If for any reason you can’t take Step 1 before clerkships, don’t worry.  We will be changing our policy to ensure you have plenty of time to do so. I will provide specifics when available.

Besany contacted USMLE and found out they will send an email next week that eligibility will be extended to June.  Prometric will waive the rescheduling fee.

If you have not already done do, be sure you have completed your CBSSA, which is due now.

  __________________________________________________________________

March 19, 2020 - 6:03 p.m.

T1’s:  We had a meeting of the Course Directors and Drs. Gibson and Rae from the OME to construct your exam.  We are doing our best to also anticipate students who need to delay or have technical problems.  Please be sure to read and the following exam instructions provided by Dr. Rae. 

Your Phase 2 Course directors are also preparing for your three entirely remote, on-line modules that will complete the academic year, with no significant changes to the schedule anticipated. We are also working on finalizing the module dates for next fall’s semester.  This is a difficult time for all of us but we are all in this together and while we are addressing the current challenges we are also planning for the better times that will eventually come.

Take care, Stay safe
Dr. Krane

Date:  Your endo repro module exam is scheduled for Monday, March 23^rd

Time:  The time window you have to complete your exam is from 8:30AM till 4:30PM. The Endo Repro Module Exam will be given as four separate exams (Genetics, Biochemistry, Physiology, and Histology) rather than one, integrated exam. All of the exams are located in the Endo/Repro module in Canvas under the Assignments tab and then under Endo-Repro Module exams. Each is titled by the course name. You can take these exams in any order, but please be sure to complete all four of them prior to the 4:30 p.m. deadline.

Exam taking process:  You will be taking the exams through Canvas using the Respondus lockdown browser plus the respondus monitoring feature.  You may have never used the respondus monitoring feature before, therefore, we would like you to try it by taking a mock exam before 6:00 a.m. on Friday, March 20th.  The mock exam is located in the Endo/Repro module under assignments and is titled ‘Test Respondus with monitoring’. If you experience technical issues while going through the pre-exam steps, you can communicate directly with Respondus by clicking ‘it’s not working’.  If the issue can’t be resolved using their help prompts, you can click ‘need more help’ to access the Respondus live chat feature. If there are still technical issues or your computer doesn’t meet minimum requirements, please contact OME directly @ ome@tulane.edu.

Timing:  You will have 90 seconds per question on each course exam plus five minutes added for additional start-up time.  Each exam has its own time limit according to the number of questions on each exam.

• If you experience technical issues during the exam on Monday, interact with Respondus using their help feature and live chat.
• If you have non-technical issues taking this exam and need to postpone or schedule a makeup:  please contact Elma LeDoux ASAP to discuss your situation @ eledoux@tulane.edu

 

Guenevere Rae, M.S., Ph.D. (grae@tulane.edu)
Associate Professor
Assistant Director of Medical Education
Office of Medical Education
Cell (386) 216-9643

  __________________________________________________________________

March 18, 2020 - 4:51 p.m.

T3’s and T4’s:  Your Clerkship Directors, with input from students, educational faculty and staff, are working to maintain the quality of your education while ensuring your safety, meet accreditation standards, prepare you for the residency preparation process, and ensure you graduate on time.  We are all communicating with national organizations like AAMC and LCME, as well as Clerkship directors around the country. We are trying to do our best for you under very difficult circumstances for all of us and for the nation.  At this time, given many uncertainties, this is what is planned:

1. T4’s who were on electives and had them suspended but had finished all other requirements will be certified for graduation without finishing their elective.They do not need any additional electives.
2. Students who only completed 2 weeks of their Acting Internship MAY receive full credit if they completed all required clinical encounters AND have this reviewed by the respective Clerkship Director.
3. Students who cannot finish their required clinical encounters at this time must still complete them to graduate-accreditation rule.  Therefore, it may be necessary for those 4th yr students who can’t do EM now will have to come back in ? May/June.  While I know this not a appealing option, it may be the only one and we will figure it out.
4. Spring Break:  We’ve made no changes but it is still possible we may need to use some of that time for exams. Too soon to know.
5. Didactic activities in all clerkships will continue via on-line remote including interactive sessions.  Our goal is to have you complete the didactic work, including exams on the current schedule if at all possible.  You will then have to come back at a later date (TBD) to complete  your required clinical encounters, and SP and Sim work to complete your clerkship.  
6. We are going to try and give the neuro and psych Clerkship exams as scheduled, and those directors will reach out and work with their students.
7. We are going to be proactive and anticipate that Clerkships for the new T3’s may not start until July.  By doing so, we could potentially “make-up” any missed clinical activities in May/June depending on the status of the pandemic. T4’s who need activities for graduation would have priority.
8. Travel: this is an individual decision and we have  no specific guidelines since everyone’s circumstances are different.  Just be safe.
9. For safety reasons, the physical library space is closed; at this time Murphy and Hutchinson remain open.
10. Concerns about Step2CS, away rotations, residency process, etc.:  there are no answers because everything everywhere is suspended. How these are resolved will likely occur at a national level to accommodate the challenges required to solve them.  

Again, we are in uncharted territory, but our top priority is your health and safety and education, and we are all trying to do what is in your best interests.  I will provide information as it becomes known. Your Clerkship Directors are very much on top of things. While Match will be different, it’s no less of an accomplishment so enjoy the moment!

Be safe, be smart,
Dr. Krane

   __________________________________________________________________

March 18, 2020 - 11:47 p.m.

T2’s:  The following are the latest updates.  Changes to the exam administration were made to provide some flexibility and support for you, while maintaining the quality of your education during very difficult times.   We are working as a team with student leadership, course directors, and educational support faculty and staff and will be meeting on an on-going basis to adjust to the very fluid situation that currently exists, but we are here for you.

Stay safe,
Dr. Krane

• We know that you all have been studying hard during a very distracting time, focused on Step 1, therefore your final exam will ONLY be given to a small number of students and they will be notified individually, we anticipate by the end of the day.
• For these few students,the exam will be administered on Thursday, March 26, at 8:30 AM as a 3-hr remote, on-line exam that you should be taking from “home”.  Students who need accommodations will have the appropriate time for their specific exams.  Exams will be administered via Canvas (NOT Examsoft), using Canvas’s on-line proctoring software.  Additional instructions will be provided for the testing procedure as the exam gets closer.   Students who need to delay this exam should contact Dr. LeDoux directly (eledoux@tulane.edu). We anticipate scheduling a makeup exam soon, but that date has not yet been finalized.
  • Be sure that you have access to a computer that meets the school requirements:  http://tmedweb.tulane.edu/clubs/orientation/information/new-computer-re…; This includes a video camera.
  • We are trying to see if/how we can provide loaners.
• We know that Prometric closing down their test centers for USMLE Step 1 until at least April 16 is a major issue and it is impacting students around the country.  Because this just occurred, we have not yet developed a specific plan; however, I can promise you whatever we do will accommodate this delay, be done with student input, and take into account your clerkship activities. This issue is under discussion and I will provide information as soon as there something definitive.
• I was asked about an email sent by the University Dean of Students:  The message appears aimed at undergrads, but regardless, everyone needs to decide what is best for their own circumstances.  If you  think it’s best to go back home for the rest of the year, that’s no problem, but there may be students who have reasons to stay here. We are anticipating that the curriculum will be delivered entirely on-line for the rest of the academic year.
• Will clerkships start on time?  Probably not (personal opinion) and we are going to begin contingency planning now.  Regardless, there is plenty of time to do everything including future electives, aways, and everything else. The healthcare system and medical education, like the rest of the nation, is being tremendously stressed, but we are resilient and innovative and we will land on our collective feet - not unlike what happened to the School following Hurricane Katrina.
• Many of you have asked about these above scheduling issues.  We don’t have specifics YET but we are actively working on solutions, and planning for delays in terms of when students can take a Step 1 and start clerkships.
• There are many unknowns during this period of time and we will do our best to answer those questions, but we don’t know when clinical work can safely resume or when Prometrics can open. We appreciate your patience during this period of uncertainty but we are connected to national organizations and will provide information as it becomes available.
• I encourage you to send questions to your class leaders with whom we will be having regular meetings.

   __________________________________________________________________

March 18, 2020 - 6:23 a.m.

T1’s:  The following are the latest updates.  Changes to the exam administration were made to provide some flexibility and support for you, while maintaining the quality of your education during very difficult times.   We are working as a team with student leadership, course directors, and educational support faculty and staff, and will be meeting on an on-going basis to adjust to the very fluid situation that currently exists, but we are here for you.
Dr. Krane

• All classes are now on Zoom videoconferencing until further notice and we anticipate that will be the case through the end of the academic year.
• The Endo/Repro Module Exam will be administered on Monday, March 23, at 8:30 AM as a 2 ½ hour remote, on-line exam that you should be taking from “home”.  Students who need accommodations will have the appropriate time for their specific exams.  Exams will be administered via Canvas (NOT Examsoft), using Canvas’s on-line proctoring software.  Additional instructions will be provided for the testing procedure as the exam gets closer.   Students who need to delay this exam should contact Dr. LeDoux (eledoux@tulane.edu) directly. We anticipate scheduling a makeup exam soon, but that date has not yet been finalized.
  • Be sure that you have access to a computer that meets the school requirements:  http://tmedweb.tulane.edu/clubs/orientation/information/new-computer-re…; This includes a video camera.
  • We are trying to see if/how we can provide loaners
• There will be ONE cumulative, end of Phase 1 exam to be administered on Friday, March 27 at 8:30 AM as a 3 hour remote on-line exam that you can take “at home”.  
  • This exam will NOT be an NBME exam but instead will be a Tulane written, cumulative final.
  • There will be 125 questions provided by the course directors, encompassing content from the past integrated modules (including the Endo-Repro module).
  • This exam will also be administered via Canvas (NOT Examsoft), using their on-line proctoring software. Again, you must have a computer that meets school requirements.
  •  It is highly suggested that you take the exam to gauge your understanding of the phase 1 material; however, students may opt out of the exam if circumstances require.  This exam will provide feedback on your knowledge base of the Phase 1 courses, and if you do take the exam, it will be graded in a way that it can ONLY IMPROVE your final course grades.  The course directors are currently working on systems for how your grades will be calculated.
  • There are a small number of students for whom this exam will be mandatory; they will be notified individually.
• Prometric is closing down their test centers for USMLE Step 1 until at least April 16.  While this is a significant concern for T2’s, this should NOT be of any concern for T1’s.  
• I was asked about an email sent by the University Dean of Students:  The message appears aimed at undergrads, but regardless, everyone needs to decide what is best for their own circumstances.  If you think it’s best to go back home for the rest of the year, that’s no problem, but there may be students who have reasons to stay here. We are anticipating that the curriculum will be delivered entirely on-line for the rest of the academic year.
• There are many unknowns during this period of time and we will do our best to answer those questions we can and tell you when we don’t know.  I encourage you to send questions to your class leaders with whom we will be having regular meetings.
• The three spring modules will proceed as planned.  We are working closely with the Phase 2 course directors to make the necessary adjustments for an entirely remote, but on-line curriculum, including interactive activities.

__________________________________________________________________

March 16, 2020 - 8:53 p.m.

To All T3’s and T4’s:  Since the earlier announcement regarding the temporary suspension of clinical activities, I’ve worked with your student leadership, clerkship directors, and others to address many of the questions this has generated.

• Each clerkship has both didactic and clinical activities that MUST be completed to satisfy both institutional and accreditation standards.   At the present time the clerkship directors are going to maintain their current didactic activities, via distant learning, so you should be prepared to take your clerkship examination on the currently scheduled dates which will satisfy the didactic requirements.  If the NBME does not change its current policies regarding administration of the shelf examination, we are considering using end of clerkship self-assessment examinations which would be taken distance on-line under the School’s honor code.  This would ensure that students could advance through clerkships having completed their written exams and remain on the “Donut”.
• For required clinical encounters, simulation activities or standardized patient assessments that have not and cannot be completed at this time, students would receive an “incomplete” and given opportunities during their fourth year to complete these residual clerkship elements.  Details of this have not yet been decided.
• All simulation center activities and standardized patient activities are suspended until further notice.
• All clerkship directors will continue to deliver educational content through both synchronous and asynchronous remote, on-line methods, primarily Zoom.  
• Multiple alternatives are being considered by each clerkship director to supplement your education.  These include high-fidelity on-line simulations, Aquafer cases, or other on-line resources
• Whether any change to Spring Break will occur has not been decided.
• At this time there is not a recommendation for students to return to their family homes but particularly if you have unique reasons to do so, I’d urge you to contact Dr. LeDoux eledoux@tulane.edu.  Students who are in locations away from New Orleans may want to consider remaining at these sites for safety reasons.

Issues regarding specific requirements:

• Emergency Medicine:  Dr. Sorge is exploring how to deliver EM as an on-line educational experience, especially for 4th year students who need this requirement for graduation
• Outpatient Surgery:  The Curriculum Committee has suspended this requirement for T4’s, however some students may need to replace this with another course to meet their graduation requirements.  If this is problematic, we need to address this on an individual basis
• Radiology:  This course will move to an entirely on-line course.  Details to follow.
• Interdisciplinary Seminars (IDS):  You must still complete 5 IDS for graduation and this requirement is NOT being waived.  However we are going to try and increase the number of seminars available and because they will all be on-line, can move to unlimited enrollment.  We will be in the process of promoting these so students who need to complete these seminars will have no trouble doing so.

We are doing our best to ensure your safety and maintain the quality and integrity of your education.  T3’s should anticipate that there will be changes to your 4th year schedule, however we will try and maintain your electives.  At the present time, almost every school has put “away” rotations on hold and therefore national organizations will be re-evaluating how this affects the entire residency process and we’ll have to wait to see how this plays out.  Dr. LeDoux and I remain in close contact with the student leadership, and we are monitoring activities at both the local and national levels.   I encourage you to submit concerns and questions to your student leaders who will ensure that we can provide updates for all students.

Please stay safe,
Dr. Krane

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March 16, 2020 - Noon 

To All Students:

In the best interests of all our students, the health care institutions, and the community, a decision has been made by the School Leadership to suspend all clinical activities for two weeks, effective immediately.  Further communications will specify when activities will definitely resume.  We ask that you discontinue your clinical activities, regardless of your clinical site at this time.
 
We are in the process of discussing and reviewing other activities to supplement your activities that do not involve direct patient care to supplement your education, and will be addressing how to create future opportunities to make up for clinical requirements that may not have been completed.  Equally as important, we would expect all our students to serve as healthcare role models through social distancing and avoidance of group gatherings while modeling the guidelines recommended by the CDC during this pandemic, which has worsened exponentially in the greater New Orleans area in just the past week. We have not made any decisions regarding the administration of Shelf Exams at this time and are waiting for guidance from the NBME.  However, we encourage students to continue their study activities outside the clinical setting for all clerkships.
 
This is a very fluid situation and may seem overwhelming, but be reassured that we are working directly with your student leadership, clerkship directors, and national educational organizations to meet your educational objectives while keeping students and the community safe and we will get through this together. I will continue to send updates as specific plans become available.
 
Please stay safe,
Dr. Krane

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March 13, 2020 - 3:56 p.m.

T3’s and T4’s:   I am working directly with your class leadership, Dr. LeDoux, and the clerkship directors and other educational leaders to ensure your health and safety and the integrity of your educational activities.  Here is the latest update to ensure you have accurate and timely information.

• Clinical Activities in all Clerkships:  Clinical activities are on-going in all clerkships.  The key policy changes are that students are not to provide care to a suspected or confirmed case of COVID-19 and all patients must undergo primary screening before students can participate in their care.  If these policies are not being followed at ANY site (inpatient or outpatient) please email me directly.   Activities should also be re-structured to minimize use of PPE’s.  We are working with everyone to be sure all attendings and residents are aware of this policy.
• IDS (Interdisciplinary Seminars):  At the present time, we have not canceled our policy that you must complete 5 seminars for graduation.  However, we are working to increase the number of seminars and their enrollment and move them all to distance, on-line so they can be easily completed. The Curriculum Committee is continuously reviewing this issue.
• Shelf Exams:  We are reviewing multiple options so that we can administer your shelf exams as scheduled. At the present time, the NBME still requires on-site administration and we are waiting to see if changes are made.  For now, plan on taking your shelf exam as currently scheduled.
• All didactics in all clerkships are going distance, on-line as of Monday, March 16.  Activities such as Grand Rounds will be determined on a departmental basis.
• Any student with underlying medical problems or having concerns about seeing either Standardized Patients or other patients should speak directly with your Clerkship Director.
• At this time, all medical center facilities are maintaining their current hours of operation.

Dr. Krane

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March 13, 2020 - 3:44 p.m.

T2s:

• ALL exams will be given through distance on-line software, using on-line proctoring.   At the present time, the exams provided by the NBME cannot be administered in this manner; therefore, all exams will be developed by your course directors. If/when the NBME develops a different solution, we will resume the use of their exams, but you will receive advance notice if this occurs.
• You should have received an email earlier today with instructions on how to download your voucher for the Comprehensive Basic Science Self-Assessment (CBSSA). When asked to choose a form, please note that you can choose any form available in the list.
• If you had already purchased all of the CBSSA vouchers using your own funds but have not yet redeemed them, the NBME will work with you to issue a refund for one voucher that you purchased. You can either call +1-215-495-6000 or email nbmewebtest@nbme.org.

Dr. Krane