Training to be a doctor during a pandemic 

When My-Linh Nguyen cocooned herself in her apartment in Spokane, Washington, to study for the first stage of her medical licensing exam, her life seemed on track.

Scholarship - My-Linh

It was early January 2020, and she had just completed her second year at the UW School of Medicine. Her brand-new white coat — a gift from the school’s alumni association to mark the transition from classroom-based learning to clinical training — hung in her closet. She expected to don that coat for her very first clinical rotation in family medicine, once she passed her exam.

But then the virus that causes COVID-19 roared across the globe. Nguyen emerged from the isolation of her studies to find the world and her plans drastically altered: All licensing exam testing centers were closed. Her test date was postponed — and would be multiple times. Her clinical rotation was cancelled. Her white coat would remain in her closet.

“It seemed like the world had fallen apart,” says Nguyen. “I was supposed to be taking my first steps into the hospital, figuring out what it actually means to be a physician.”

Those first steps would be put on hold, and life for Nguyen would change in unanticipated ways, yet one thing that never wavered was her passion for providing care to anyone who needs it.

Nguyen’s journey toward a career in medicine began amid the wail of ambulance sirens and the sight of scrub-clad personnel dashing to and from work. The daughter of Vietnamese refugees, Nguyen came of age in the shadow of Harborview Medical Center, a seven-minute walk from the Central District neighborhood in Seattle that she calls home.

“It was really nice growing up in an immigrant community, because everyone watched out for each other,” says Nguyen.

She and her friends walked to school each morning. Families bought in bulk from the grocery store and shared food. Neighbors swapped recipes and exchanged home remedies for ailments big and small. The center of community life was the Catholic church, where people gathered for worship, celebrations and fellowship.

It was also a place where access to healthcare was fraught with challenges — a lesson Nguyen learned at the age of seven, when she would help her mother transport the older women in their community to and from their medical appointments. While her mother parked the car, Nguyen would escort these neighborhood grandmothers, most of whom did not speak or understand English, down unfamiliar, labyrinthine hospital hallways. Her mother, who often needed a translator herself, would attempt to facilitate communication between the women and their healthcare providers.

“Looking back, it gave me perspective on how difficult it can be to navigate the healthcare system — particularly when you don’t speak English — and why people often turned to home remedies first instead of seeking medical care for problems,” says Nguyen.

A few years later, when Nguyen was in fifth grade, her mother lost her job and her healthcare coverage due to illness, a hardship that kept Nguyen from playing sports and participating in other school activities that required a physical.

But this experience also served as an inspiration; it was one of many that opened her eyes to the inherent disparities in the U.S. healthcare system and propelled her into the field of medicine.

“My mother instilled in me this value for community. I want to be able to care for people regardless of where they are in life, how much they make or who they are,” says Nguyen.

The UW School of Medicine’s WWAMI program was an ideal choice for Nguyen, who envisioned learning and training within the Pacific Northwest, where she plans to one day practice medicine. The aim of the five-state medical education program is to train students from the region — Washington, Wyoming, Alaska, Montana and Idaho — for the region.

However, Nguyen’s excitement about starting medical school was tempered by financial concerns. Her mother was in shock at the amount of debt Nguyen would incur by the time she graduated.

“It was more money than my mother would probably make in her lifetime, so she asked me if I could decline my acceptance and do something else,” says Nguyen.

Fortunately, Nguyen didn’t have to change her career plans; she was the recipient of the John and Florence Cooper Endowed Scholarship in Medicine. “Having a scholarship brings a sense of relief, because that’s a chunk of money less that I have to pay back,” says Nguyen. “My future is more my own.”

Nguyen chose to embark upon that future east of the Cascade Mountains, in Spokane, Washington, a place whose family-like, community-oriented atmosphere reminded Nguyen of home. Thanks to a partnership between the UW School of Medicine and Gonzaga University, Nguyen spent the first 18 months of her medical education on the Gonzaga campus.

“Spokane is a really great place to go to school,” says Nguyen. “The faculty here put a lot of emphasis on supporting each other, rather than competing with each other. This is how medicine should work.”

Following in her mother’s footsteps, Nguyen became active in her Spokane community. She served as an officer for Underrepresented in Medicine, a student-run group that helps students facing barriers to higher education — such as first-generation students or those from rural areas — reach their goal of attending medical school. She also cared for patients at a clinic for people experiencing chronic homelessness. On weekends, Nguyen frequently traveled back to Seattle, where she volunteered with the Vietnamese Eucharistic Youth Movement.

“Volunteering energizes me. It’s what I look forward to in my day. I come home and feel like I’ve made a difference,” says Nguyen.

And so her full life of studying, attending classes and serving her community in Spokane and Seattle continued to flourish. By January 2020, the first 18 months of medical school were in Nguyen’s rearview. White coat in hand, she was poised to take the leap from classroom to clinic — until her path took an unexpected turn.

When the virus that causes COVID-19 sparked a global pandemic, Nguyen’s life — and the lives of many medical students across the country — was thrown into uncharted territory. Medical schools had to quickly adapt curriculums and schedules to quell the spread of the virus and protect students, faculty, staff and patients.

At the UW School of Medicine, coursework for all students shifted to a virtual format. Clinical rotations for third- and fourth-year students were suspended, and the students’ work in clinical settings was paused, due to serious concerns about the availability of personal protective equipment (PPE) for clinical staff and in an effort to slow the spread of the disease. While all students would still gain hands-on exposure to the six major specialties — family medicine, internal medicine, OB-GYN, pediatrics, psychiatry and surgery — the number of clinical hours required for graduation was reduced.

“In addition to keeping everyone safe and ensuring our patients are able to get the care they need, one of our guiding principles has been to keep students on a trajectory to graduate on time,” says Suzanne Allen, MD, MPH, vice dean for academic, rural and regional affairs at the UW School of Medicine.

One of the ways the School is keeping students on track is offering online electives for credit in lieu of clinical rotations for the spring 2020 quarter. The electives span a variety of topics, from how health systems respond to pandemics to the intersection between medicine, poetry and grief. “One of the positives of this whole experience has been the opportunity to take classes on subjects that wouldn’t have been offered otherwise,” says Nguyen.

When clinical rotations resumed in June 2020, they looked a little different. For many physicians — including Allen, who sees patients at a family medicine practice in Boise, Idaho — virtual office visits have become a routine part of her workflow.

“Students will be able to learn and utilize telehealth, which is good for patients, particularly those who lack transportation or have mobility issues,” says Allen. “One of the things the pandemic has shown us is that there are lots of opportunities to continue improving the way we provide care.”

Some students like Nguyen, on the cusp of their third year, have had to contend with more than the adjustment to virtual classes and the postponement of clinical training.

Prometric, the company that administers the first stage of the medical licensing exam Nguyen was set to take in March 2020, closed all their North American testing centers in response to COVID-19. Typically, students are required to pass this exam before beginning their clinical rotations. The UW School of Medicine has relaxed this rule, allowing students to begin their clerkships without it.

For Nguyen, the exam has fulfilled dual roles, prompting stress and providing a sense of purpose.

“I feel like I’m stuck in limbo, constantly preparing for an exam that I don’t know when I’ll ever be able to take,” says Nguyen. “Yet having to study has kept me grounded. It’s given me a schedule and something to work toward.”

Since the pandemic erupted, Nguyen’s life has changed in other ways, too. She has moved back to Seattle with her mother, to the Central District community where she grew up. Meetings held via Zoom have become a daily part of life, serving as the vital link to friends and to medical school. Her volunteer endeavors, which fuel her passion for the field of medicine, have come to a halt.

While the UW School of Medicine has sponsored a variety of COVID-19-related service learning projects for students — from holding drives for personal protective equipment to providing patient hotline support — Nguyen hasn’t been able to participate. Taking online electives and studying for her licensing exam has left time for little else. While it’s been hard to sit on the sidelines, she finds that it is shaping her perspective on health care in powerful ways.

“Before all this began, I was interested in going into emergency medicine, and that hasn’t changed,” says Nguyen. “But what I’m seeing now — how much of a role a person’s social situation plays in their ability to maintain their health — will only make me a better physician in the future.”

By Meredith Bailey
Photography: Kollin O’Dannel and Doug Plummer


If you’d like to help students like My-Linh fulfill their dream of an outstanding medical education, make a gift to the WWAMI Spokane Scholarship Fund.