Image by Luis Melendez via unsplash.com

In 2020 the pandemic brought education to a screeching halt, while at the same time throwing health care into the forefront. Central Valley health care career educators couldn’t let Covid-19 stop training in the face of another crisis — a shortage of health care professionals.

As schools from pre-k to universities were sent online, those educating future health care professionals suddenly had to move hands-on clinical cycles into far lower risk settings. They also had to move theory classes online, often fighting student’s access levels to technology and the internet.

Fresno City College had to move its hands-on learning to simulation rooms with medical mannequins in their health science building and turned theory classes online when the state of California claimed a state of emergency in March 2020, said Pat Vogel, interim director of nursing.

“When we were displaced from the hospitals there was so much uncertainty about when we’d return, when it would be safe for students and instructors, and what the availability of clinical placement would be,” Vogel said. “We planned different scenarios of how it would work out.”

Vogel said they were able to decrease the number of clinical hours needed to graduate and graduated just over three hundred students between May 2020 and May 2021.

Some of the nursing classes were allowed to operate on campus because they were classified as first responders, but Vogel said students struggled to be isolated from their learning cohorts and some students had to work in the parking lot of the college to get access to wifi.

The California Health Science University, which was founded in Clovis in 2012 and has a pharmacy and osteopathic medicine program, was still ramping up capacity when the pandemic struck, said Dr. John Graneto, dean of the College of Osteopathic medicine.

That allowed students training to be doctors to more easily socially distance within the facility when they returned part-time on campus, Graneto said. They also weren’t pulled out of clinical rotations because they don’t have any students in that stage of a medical degree yet.

Graneto said, though, the curriculum was changed in some ways so their medical students could still participate in fighting the pandemic.

“All the students who are applying for a health care career want to participate in the solution to the problem, and they all are eager to help,” Graneto said. “Typically learning how to do an injection to give a vaccine is something students don’t learn until their second year of medical school. We offered the opportunity to accelerate that into the first year so they could participate and almost all students wanted to do that.”

At Fresno City College’s nursing program, students were also able to participate in vaccination clinics on campus. Vogel said as nursing students watched the demands on nurses during the pandemic, they got to see both the real world strains of the career and the selfcare needed to maintain stamina and rigor in the position.

At the same time the Central Valley is facing a worsening shortage of both physicians and registered nurses. According to the University of California San Francisco, while most of California is seeing some declines, the San Joaquin Valley could see a shortage of more than 4,000 primary care physicians and between 6,000 and 10,000 registered nurses in 2030.

Graneto said CHSU was started because without a university offering a full four-year medical degree, individuals interested in becoming a doctor often leave the area for school and do residencies elsewhere, making it unlikely they will return to the Valley to practice.

In the Valley the number of doctors retiring is outpacing the number starting a career, and a few key factors are driving that. Where a medical student is from, where they attend medical school and where they do their residency are the biggest factors in where they end up practicing medicine, Graneto said.

“If you combine two of those factors, the chance of those doctors staying in the Valley really goes up tremendously,” Graneto said. “The benefit of that, of course, is to train more doctors and retain them here so the brain drain doesn’t occur, where smart people leave for opportunities in the Bay Area of Southern California.”

Along with training more doctors in the area, Graneto said, for the health care system in the Valley to work, the same needs to be done for other medical professionals like nurses, pharmacists and psychiatrists, among others.

Coming out of the pandemic, Vogel said Fresno City College has developed an online theory curriculum that works for students and may stick around, which could be a great benefit to student parents. The pandemic also prompted the school to modernize their simulation labs.

The American Medical Association predicts there will be a number of ongoing changes to medical training curriculums. Among them, they predict schools will provide more education on public health, re-evaluate graduation requirements, change inequitable residency practices and be more prepared to continually adapt curriculums to current issues in the field.

After a global pandemic which has eased in the U.S. and other wealthy countries, but is still raging in less developed countries like India, Graneto said he also predicts health care career education will include more focus on being prepared for similar diseases and their impact on not just a local area, but the world at large.

“I think there will be somewhat more attention paid to the global health care or the world,” Graneto said. “It’s okay if the U.S. is isolationist and we all get vaccinated, but the reality is if people are still dying in India today, that’s going to affect air travel and commerce, and the global health concerns of the global economy.”