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On the Job Training: Coming of Age in Healthcare During the COVID-19 Crisis

Inside an already thinly stretched, healthcare labor force, current health professions students are coming of age in the 21st century during a public health crisis. Time magazine reported, “at least 13 U.S. medical schools have allowed students to graduate early and join the COVID-19 response.” [1] Indeed, fourth-year medical students replaced their graduation robes for white coats to serve in emergency rooms and ICUs - alongside current providers who are overworking to save lives.

It is no secret that America has a growing health care provider predicament. Studies indicate, “the heath care workforce is already older than most -” [2] with many general practitioners nearing retirement. And, there are inadequate replacements of graduating medical students – especially those interested to serve in rural and underserved counties or content to practice in primary care.

Decades ago, Area Health Education Centers or AHECs were funded by Congress - along with other federal agencies: the National Health Service Corps, Nurse Corps, and the Health Resources Services Administration (HRSA) - to address the workforce “health crisis in the 1950s and 1960s.” [3] These agencies implemented a three-prong approach to recruit, train, and retain a struggling health care pipeline: “physicians, nurses, dentists, therapists, and others who deliver health services to individuals in physicians’ offices, health centers, clinics, and other community-based health care settings “ (Reyes-Akinbileje, 2013). [4] In 2020, the effort continues in almost all 50 states - across the nation – but vacancies for unfilled provider spots continue.

However, focused on the goal, AHECs across the nation continue to forge alliances with like-minded community partners and academic institutions to fulfill the mission: to create greater access to quality health care. It is an intentional effort to improve the supply and distribution of providers across the service areas by working with students at several levels.

Locally, the Southeast AL AHEC staff recruits high-school students from 62 public high schools in 15 counties to identify young men and women who may have an interest to consider health care careers. This effort is welcomed in rural and underserved counties whose leaders are eager to promote a local health care environment by raising their own providers – often with incentives - in hopes those educated will return and serve where they were reared.

Additionally, health professions students from 8 colleges and regional universities in the SEAAHEC service area can participate in AHEC Scholars, one of the newest programs introduced and mandated by HRSA in 2017 to better prepare health care graduates to enter the workforce. Scholars acquire a total of 160 hours: 40 clinical hours and 40 classroom hours, annually, within the extra-curricular, two-year program.

The timely opportunity provided by the COVID-19 pandemic allows Scholars the opportunity to gain frontline experience by donating blood, working at food pantries, and providing support to current clinical providers throughout the region.

Scholars from all five Alabama Centers participated in “a bio-terrorism case [study] that focused on medical ethics - ” a real- time research effort to examine similar issues providers may experience during “the COVID-19 pandemic,” according to Executive Director Paula Cheatwood. She explained that the group consisted of 40 Scholars, from across the state, who participated in a Zoom call to discuss the case study as a group.

Additionally, program specific curriculum reinforces the classroom training in required topics: Cultural Competency, Social Determinants of Health, and Emerging Health Issues. Scholars are rewarded with front line, on-the-job training and prepared to enter the workforce as skilled professionals. It is a win-for-all: a positive and unseemly by-product of a crisis.


Photo 1: Courtesy of the Center for Disease Control; Photo 2: SEAAHEC AHEC Scholars

[1] Abrams, A. and Ducharme, J. (2019). Meet the Medical Students Becoming Doctors in the Middle of a Pandemic. Time. Retrieved: 19/

[2] Lyman, Stephen W. (2013). The Aging Workforce in Healthcare: Challenges Ahead. THR Insights for Healthcare.

[3] National Health Service Corps. (2020). HRSA Health Workforce. Retrieved: scholarships/nhsc

[4] Reyes-Akinbileje, B. (2013). Health Workforce Programs in Title VII of the Public Health Service Act. Retrieved: file:///C:/Users/vigne/Downloads/744097%20(2).pdf

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