**Abstract**

The beginning of the year 2020 marked the biggest pandemic of the twenty-first century. COVID-19 not only jeopardized the global health care system but also lead to unprecedented effects on every aspect of life. The tragedy evoked by the virus, resulted in disruption of face-to-face learning across the globe. The aftermath of this pandemic on medical education will be enormous and long-lasting. Therefore, it is of utmost importance to identify the challenges and threats facing medical education, both at undergraduate and postgraduate level. Comparative analysis of the innovative models adapted globally in post-COVID era will help countries learn from success stories. Amidst the uncertainty posed by the pandemic, there is a special prospect for medical education. Medical educationist and health policy makers may convert this crisis into opportunity through innovative strategies maximizing the outcome of e-learning. This is the time to relook medical curricula, redesign assessment, focus on standardization of e-learning and upgrade faculty development programs to produce doctors equipped and prepared to serve in the new era.

**Keywords:** COVID-19, medical education, virtual learning, E-learning, training during COVID, undergraduate, postgraduate

### **1. Introduction**

The beginning of the year 2020 marked the biggest pandemic of twenty-first century. COVID-19 not only jeopardized the global health care system but also lead to unprecedented effects on every aspect of human life. The tragedy evoked by the virus, resulted in disruption of the face-to-face learning across the globe. Amidst the uncertainty, fear and crisis situation faced by the world the whole learning cycle came to a halt, till the stakeholders proposed innovative strategies of online learning in medical education. Though blended learning was in vogue in pre COVID times, but the sole dependence on online learning in the "New normal" phase has raised questions. Clinical and soft skills teaching is widely accepted to be best taught through physical interaction with patients. Even for undergraduate pre-clinical years, teaching of basic sciences requires performing procedures and demonstration in the skill laboratory, which was also disrupted due to social restriction.

This chapter gives an in-depth understanding of the impact of the COVID-19 pandemic on transforming medical education and the challenges faced by medical education, both at undergraduate and postgraduate level. It also elaborates how

countries all over the world embraced this challenge, recognized the opportunities and responded to the crisis by ongoing waves and variants of COVID-19. Amidst the uncertainty posed by the pandemic there is still hope. The tremendous opportunity of innovative advancement in technology along with sensible decisions to adopt learning, need to be aligned to survive in the "new normal" world.

## **2. The knee-jerk response to pandemic**

The COVID-19 pandemic that has affected almost 221,134,742 people around the world and has claimed 4,574,089 lives, evoked huge fear and uncertainty among people all over the world [1].

The novelty of the situation, uncertainty and limited research on the clinical course of the virus forced policy makers to rush towards difficult decisions. This led to stopping or slowing down academic and nonacademic activities until the world started adopting the best evidence-based recommendations to deal with the catastrophe.

#### **2.1 A hiatus in medical education**

Soon after official declaration of pandemic by World health organization (WHO), almost 182 countries in the world closed their educational institutions in response to the regulatory bodies' decision on social distancing and lockdown [2, 3]**.** Medical schools and universities faced dual challenges; first to respond to the clinical and administrative demands, in order to prevent the health care system from collapsing; second was to maintain an effective educational system in order to produce doctors with strong foundation of patient care. In March 2020, the Association of American Medical Colleges (AAMC), released their guidelines for immediate disruption of all clinical rotations till they get further enlightment and preparedness to handle the situation [4]. Italy has faced the worst situation of COVID-19, with almost 4,574,787 cases reported till September 2021 [5]. At the onset of pandemic, their government responded by immediate suspension of all in-campus learning at medical schools [6]. The example of US, UK, Italy and China was followed by developing countries. Though the numbers of cases affected by the virus were comparatively lower in these countries; however, considering the dreadful situation of the developed world, the underprivileged nations were not ready to risk testing their health care system. In India, Pakistan and Bangladesh, all face-to-face educational activities and clinical rotations were suspended after implementation of a nationwide lockdown [7]. The rationale behind these decisions was to conserve the resources including personal protective equipment for front line workers; minimize exposure of health care professionals, protect well-being of students and their families and prevent the already fragile health care system from further declining.

#### **2.2 Fast tracking medical graduates into health care system**

Uncertainty lead to halting of the education system in early 2020, hence there was an urgent need to develop an alternative system to enhance capacity. With a case fatality rate of 12.6% and total reported fatalities of 17, 600, Italian government responded in the most urgent manner by taking tough decisions regarding Medical education [8]. The 'Cura Italia' decree passed on 17th March 2020, revolutionized the rules of Italian Medical board examination [8]. According to this decree almost 10,000 medical graduates were given license to practice without taking post

#### *Unveiling the Uncertainty-Revolutionizing Medical Education in COVID-19 Era DOI: http://dx.doi.org/10.5772/intechopen.103918*

graduate examination at the end of their practical training. In other words, this change lead to graduates joining the health care system almost nine months earlier than they would otherwise have done in the pre-COVID era. A 10.3% increase in hospital doctors, was anticipated through its implementation to provide services and support departments or intensive care units (ICUs) dedicated to COVID-19 Care [8]. Exemption from medical licensing exam puts an additional bar on the system to evaluate their medical practices, the impact of which is yet to be seen in the coming years.

This practice of introducing young medical graduates in clinical practice, was followed by other countries including US, Ireland and UK, where health care system needed a boost [9].
