June 2020

By Jennifer Lyons, MBBS 2021

Strict lockdowns, unreliable WiFi and Medical School exams. How are students coping?

The lockdown in Cyprus began on 19 March. For many international students at the University of Nicosia, this followed a mad dash to pack up dorm rooms and catch the last flight home. Others, who chose to stay behind, said goodbye to their friends and settled into a seemingly interminable isolation. Three months of online lectures have passed and, for many, exams are either over or nearly so. How has the 2019-2020 school year come to a close for these future doctors? I spoke to six students about their experiences during lockdown.

Saying Goodbye

“Early days were really sad when everyone left.”

Daniel Couchenour is an MBBS rising P year. He certainly wasn’t expecting to cut his time in Cyprus short and rush to catch one of the last flights out before the lockdown. “A lot of the stuff I just left behind,” he says about hurriedly packing up the last two years of his life and trying to find a loving home for his microwave at extremely short notice. The mass exodus of students left no time for goodbyes for many students like Daniel who is set to start his P year rotation in Chicago this month.

Rites of passage, like the White Coat and Graduation ceremonies, were cancelled/postponed and the well-earned celebrations for many students who would go their separate ways after exams didn’t happen, as students hurriedly ended rental contracts and hoped the evolving situation with flights and quarantines would allow them to make it home before everything shut down entirely. Aline Mosconi, a rising 4th year MD student, commented that “early days were really sad when everyone left.”

Studying at Home

“I used to work the night shift, so I treated it like that.”

One downside of heading home for the lockdown was that students not only suffered jet lag, but also had to keep very unusual hours to stay on schedule with their online classes. Harik Patel is a rising T year in the MBBS programme and found that his twice-weekly PBL was now from 2am to 5 am. “I used to work the night shift, so I treated it like that,” Harik described how his days would revolve around his PBL schedule. He says he would stay up on Thursday night until PBL was over so that he could get back to a normal sleeping pattern over the weekend.

Over the years, students have developed study habits to stay healthy and motivated. With the restrictions put in place by the lockdowns, these have been upended. Daniel shared advice he was given in his undergraduate studies that you shouldn’t study where you sleep. With the Medical School, UNIC libraries and coffeeshops closed, home is the only place left where you can study. Students who are parents themselves have additional distractions, needing to balance their own education with the care and teaching of their children, let alone find a few minutes of peace to revise for exams.

A common experience, waiting for an online lesson to start.

Still having some fun, when Harik’s video wasn’t working, friends in his PBL created this image for him to use during report back.

 “The online stuff, you don’t get that interaction, so you’re not forced to pay attention.”

“The online stuff, you don’t get that interaction, so you’re not forced to pay attention,” James Hebbard a rising 3rd year MD student explained. There is a big difference between being there in person and logging in for lectures. Many students expressed similar sentiments, although some, like Agni Tsangarides a rising 5th year in the MD programme, believe that it gives students more flexibility in organising their day. “It will be interesting to see whether COVID results in more lectures being offered online,” Agni stated. I imagine, lecturers would have an easier time attending scheduled presentations without needing to leave their practice. As the Medical School starts back up in the fall, we will see if the difficulties that were encountered in the rush to provide online content in the spring have been worked out.

Taking Exams

“I honestly think I had more anxiety about the possibility of the internet going wrong than I had about the actual exam.”

Lockdown means we are all at the mercy of our WiFi, and interruptions can have dire consequences when they happen in the middle of an exam or during a presentation. Every student that I spoke to expressed anxiety over connectivity issues. Carmella Beastall, an MBBS rising P year confessed, “I honestly think I had more anxiety about the possibility of the internet going wrong than I had about the actual exam.” Agni noticed that there have been more issues with connectivity than in the past and assumed it was due to greater demand. The format of exams was also affected by the method of delivery. For MD students, multiple- choice questions were out and students found themselves writing long papers in short-answer format. Creating a space with no distractions was another hurdle for many.

Since students went home, preparations needed to be made to ensure we could hog the WiFi during exam time. While most families have been understanding, it’s another story when the disruptions come from outside the home. UNIC students might recognise the sound of the local vegetable vendor driving his truck down neighbourhood streets, loudly proclaiming his offerings over a bullhorn. It certainly adds to test anxiety when he makes his appearance in the middle of a timed exam. Students had to become creative, thinking through possible distractions and doing their best to head them off, by speaking to neighbours who’ve just purchased a reciprocating saw or making appeals to potential doorbell ringers.

Puppies and Kittens

“Like every other person during lockdown, we got a dog.”

A common theme in conversation with students, is the effect this interminable time spent in our homes has had on our pets. Co-dependent cats and dogs have been loving the extra time with their owners. Carmella’s dog came “trotting in and stared” at her during her exam; she says it was hard to take questions seriously under his inquisitive gaze. Other pets have proved to be good study buddies. Aline’s kitty spends most of her days trying her best to lounge on her laptop and notes. One surprising effect of the lockdown has been the addition of new furry family members. Daniel says that, “like every other person during lockdown, we got a dog. This is the one time where you’re always going to be home, so you can spend all your time with the dog.”

Staying Connected

A violinist walks down the road, entertaining the neighbourhood.

“I know it’s a horrible thing [the virus], but it’s brought a lot of people together that wouldn’t normally be together.’’

I was in a shop today, and a lady was telling another customer that she’s never spoken to her neighbours before, but now they’ve got a WhatsApp group going and they’re all friends and they swap vegetables, and I just think that’s very nice.”

Despite the stress of exams and a pandemic, Carmella is using this opportunity to invest in relationships with her family, friends, and community. She has signed up for an NHS app which connects volunteers with lonely and socially isolated people in the community to chat on the phone.

Her neighbourhood is really committed to maintaining a sense of community with local musicians playing in their front gardens, or whilst walking down the road after their weekly five-minute clap for the NHS.

Taking Care

“I try and exercise every day if I can.”

As the lockdown in most countries has inconsistently begun to lift and governments are recommending social distancing, many have started to adjust to this new life that revolves even more around screens. Online yoga classes are being offered by UNIC.

Flexibility and creativity are essential in finding ways to take care of ourselves in spite of the restrictions. James has continued to train for rugby, “I try and exercise everyday if I can,” he says, to avoid injuries when he returns to playing.

Following the News

Of course, COVID has the world’s attention, but medical students are uniquely interested in this top news story. While some feel the need to avoid the news cycle and the constant updates, others have become obsessive news junkies. Still others are taking this opportunity to study the impact COVID-19 has had on the lives of other students and the general public by participating in studies and surveys. What can we learn from this outbreak? How can we be better prepared in the future when the next outbreak happens? What are the non-disease related consequences of the lockdown? Aline is participating in one such study of reactions to the pandemic. “The aim of this study is to find patterns in how people cope, and we want to make the data useful to governments to make guidelines and create social programs for the future” using a lengthy questionnaire to gauge pre- and post- COVID-19 health behaviours. She hopes that this study can be used to inform policy decisions when the next disease hits, to help Cypriots weather the storm more constructively and emerge healthier.

“We want to make the data useful to governments to make guidelines and create social programmes.”

Coming Back

UNIC has assured students that the Fall semester will begin on schedule.  ‘’Courses will be delivered in-person and /or online based on public health recommendations which relate to the current pandemic’’, the School’s announcement says on its website.

Even as the world is starting to relax lockdown orders and restrictions, social distancing is not going to go away. In April, researchers at Oxford suggested that intermittent social distancing may continue to be necessary through 2022. Medical schools around the world are grappling with how to proceed in this new normal. How will instruction be delivered in the Fall and how will placements commence? Will patients be comfortable having extra and unnecessary observers sitting in on their consultations?

Carmella observed, “We don’t know how temporary this is. You offer your hand as a sign of respect, but now it’s a sign of respect not to shake someone’s hand.”

Travel is still an incredibly difficult prospect for many, with airports remaining closed and opening at varying times around the world.

James is trying to plan out the logistics for when he returns to Cyprus as he helps in organizing the freshers’ orientation week and has to be sure that he won’t be under quarantine during that time.

“Just because the lockdown is over, doesn’t mean that the danger isn’t there.”

As the lockdown in Cyprus has lifted, locals have flocked to the open porches of coffeehouses. Aline summed up the response to the reopening in ominous tones, “now that lockdown has finished, people are acting like COVID never happened. Just because the lockdown is over, doesn’t mean that the danger isn’t there.”

The pandemic is nowhere near over yet and this is a unique time for medical students to see the importance of public health playing out on the world scale. We must have respect for the healthcare systems that we plan to join and learn from this experience so that we can improve those systems to better cope with the next pandemic. Despite lots of conjecture, we don’t know what the new normal will be, will there be a vaccine, how long do antibodies confer immunity, will people go back to business as usual in the next year or adjust their entire lives to practise distancing in social bubbles? There is still so much that is unknown about the coming year for medical students around the world. The students of UNIC have shown resilience and good humour despite these challenging times and will make up the ranks of great doctors in the years to come.