The COVID-19 pandemic highlighted the importance of hospital intensive care units, commonly known as ICUs, along with increased demand for critical care resources like ventilators and highly trained ICU physicians.
Dr. Jarone Lee, medical director of the Blake 12 ICU at Massachusetts General Hospital, teaches premed students, medical students, residents and fellows. He says the ICU is a unique and valuable experience for premed students in multiple ways.
Reasons ICU Experiences Are Important to Premed Students
The ICU is one of a few places in a hospital where premed students can learn about critically ill patients.
“Patients in the ICU require some form of life support, in which patients cannot maintain their own health without medications and technology that must be precisely prescribed” and adjusted, Lee says.
Premeds can learn about managing ventilator settings when a patient needs help breathing, or treating patients who are experiencing kidney failure.
In the ICU, premed students also can get to know patients over a period of time, as these patients are often hospitalized for days or weeks. ICU physicians often provide longitudinal care and take care of the “sickest and most complex patients in the hospital,” Lee notes.
By following ICU patients throughout their hospital stays, premed students can see how health improves or deteriorates for patients over time. They can also learn how one body organ can affect others.
Because of the complexity of each patient, the ICU consists of an interdisciplinary medical team, typically including a doctor, bedside nurse, respiratory therapist, pharmacist and nursing assistants. Additionally, medical teams often work with other specialist physicians, nutritionists, physical therapists, occupational therapists, speech therapists and social workers.
The ICU is also a good place for premeds to learn about medical ethics and end-of-life decisions. Because patients in the ICU can require life support, there are regular discussions about end-of-life care. Premed students can observe how physicians communicate with families about this sensitive topic and other medical decisions.
“There are extensive conversations about medical procedures like CPR and how to balance aggressive medical treatment with quality of life,” Lee explains.
Given the incredible learning opportunities in ICUs, premed students can get involved through shadowing and observing a clinical team, clinical volunteering, clinical research and projects related to hospital administration and technology.
Learning About Neurology in the ICU
Interest in neurology led Nikita Bastin to volunteer at the Penn Presbyterian Medical Center ICU in Philadelphia for the past two years. Prior to the pandemic, she shadowed doctors and nurses and read to patients.
In the ICU, doctors taught her how to differentiate between different types of strokes. She observed how doctors read vital signs, adjusted medications and conducted physical exams to reassess a patient’s progress throughout the hospital stay,
“Because ICU patients are in critical condition, they have lengthy medical histories and medical problems,” she says. “I learned so much about how their medical histories affected and informed their current state.”
Bastin, who graduated from the University of Pennsylvania, recalls an incident in which she was talking with a patient after the patient’s brain surgery. The patient indicated that she felt as if she might faint, and Bastin summoned medical staff. As a result of the episode, she learned about the complications a patient can face after a neurosurgical operation.
Getting Experience in a Pediatric ICU
Sreevidya Kurra, a graduate of the University of California–Davis, volunteered in the pediatric ICU at UC Davis Medical Center, where as a child life intern she helped ensure that children in the ICU were happy and engaged.
Each week, she received a unit census and attended rounds with the medical team to design a plan on how to engage each child based on his or her unique illness. Activities included reading, talking and playing games.
Kurra says her ICU experience differed from her other clinical experiences “in that we were treating severe cases in a high-stress environment, since a patient’s health could change very quickly.”
One patient Kurra took care of for weeks was a 10-month-old baby who was hospitalized after being abused by his mother. He had a severe head injury and difficulty breathing, so he needed a tracheostomy tube.
“Although the baby would be fussy at first, over time he warmed up to me as I would rock him,” she recalls. “It was a memorable experience because I got to see his recovery until he was finally discharged from the hospital with his adoptive parents.”
Throughout her ICU experiences, Kurra — who is now a student at Western Michigan University‘s medical school — learned from the nurses and doctors who took care of patients who had a variety of illnesses and needed close monitoring.
Medical experts say the ICU is a great place for premed students to gain exposure to a wide breadth and depth of patient care. Lee encourages premeds to think beyond the scope of hospital walls.
“The pandemic highlighted the need for critical care experts in public health emergencies and in the creation of public policies,” he says. “As the ICU is a deeply interdisciplinary field of medicine, I encourage all aspiring physicians to bring their passions and expertise in technology, public health, policy and research to improve our care for the sickest patients.”
More from U.S. News