COVID-19 Pandemic and Medical Education in a Developing Country

In March 2020, the World Health Organization considered coronavirus disease-2019 (COVID-19) as a worldwide pandemic [1]. This leads to serious effects on medical education in medical schools. Medical students are potentially susceptible to COVID-19 owing to their contact with in-patients during the clinical teaching classes and their common rotation between the hospital depart ments [2]. Closure of medical schools and continuing the educational process from home for both staff and students became urgent to ensure social distancing. Ahmed M Abbas1,2*, Islam Hussein Hassan2,3, Reem Sayad2,3, Mark Mohsen Kamel2,4, Fatma A Omar2,4, Lobna Ahmed2,4, Amera S Salem2,3, Shimaa H Elsamman2,4, Alshaima Refai2,4, Andro T Fawzy2,3, Mario S Shawky2,4, Ahmed Saeed Mostafa2,4, Ebrahim A Yousof2,4, Shimaa Salah Ali2,4, Asmaa AbouBakr2,4, Nermeen Bahaa2,3, Sherry Michael2,4, Marco Ghobrial5, Mai E AbuElmagd2,4, Mostafa H Abdelsalam2,4, Alaa A Abdelmonsef2,6, Ghada R Fathalla2,6, Walaa R Fathalla2,4, Islam M Ebrahim2,3, Abdelrahman G Ramadan2,3, Alaa Rashad Ali2,4, Menna Allah Nashaat2,4, Heba Allah Nashaat2,4, Marina Farah Fawzy2,4, Shimaa Selim2,4, Safaa Ahmed2,4, Yasmin Ismail2,4, Yasser M Abd Elaal2,4, Hanan F Fouly2,4, Naglaa Mohamed2,4, Randa Wanees Ahmed2,4, Sara Magdy2,4, Amera Imam2,4, Nourhan Mahmoud2,4, Zeinab Y Zaki2,4, Salma A Samy2,4, Shrouk Gad2,4, Aya Shaban2,4, Mohamed Ashraf Salah2,4, Mohamed M Abdelkarem2,4, Areej A Khamees2,3, Aya Abdelnasser2,4, Samar Mamdouh Mostafa2,4, Alaa Bazeed Dardeer2,4, Ahmed S Sedik2,4, Hossam Aldein Samir2,4, Mahmoud M Saad2,4, Zakria Y Elessemy2,4, Karim O Sleem2,4, Mohammed H Abdelhafez2,4, Eshak N Youssef2,4, Zeinab M Bakr2,4, Micheal Mohab Nady2,7, Mohamed Salah Abdo2,3, Mohamed O Omar2,3, Mahmoud Kamel2,4, Hajer Y Moustafa2,3, Hala Hashem2,3, Hagar A Elotifiy2,3, Areej A Abdelaziz2,3, Tarek M Essa2,3, Fatma A El-Saaid Monib2,3, Nehal Gamal Omar2,3, Moaiad Eldin A Mohamed2,3, Andrew Nasseh Hafeez2,3, Esraa Atif Hassan2,4, Ahlam O Ali2,4, AlBatool M AlMahdy2,4, Alya O Mohamed2,4, Shorouk M Adel2,4, Sarah Khaled Fahmi2,3, Abeer Abdel-Fattah2,4, Mariam Salah Moris2,8 and Safaa K Fathy2,4

As the COVID-19 problem evolved in Egypt, education in the whole universities was suspended for several weeks. The classes for all six years of the undergraduate medical teaching were stopped.
This had a detrimental effect on medical students due to less exposure for clinical teaching classes and patient examination. Clinical teaching and exams using live patients are a crucial part of a medical student's education. Integration of information technology into the teaching and problem-based learning (PBL) methodologies at our medical schools was the solution. Moreover, all medical conferences and presentations carried out by the students were canceled.
This affected student' skills and experiences as these methods are used to build up medical student curriculum vitae.
The following alternative modalities for classical teaching were advocated to keep the students on track with the medical curriculum. Streamed online lectures and prepared online modules were used for delivery of the theoretical lectures [3]. PowerPoint presentations with the lecturer's voice were recorded and made available on each faculty website. This was an excellent substitute for collection of large group of students in a lecture hall with high possibility of viral transmission. Besides that, it avoids the rush of the students at 8:00 am to attend the lectures.
In the past decade, many academic institutions worldwide undertook curricular reforms to promote flipped classrooms and active learning that facilitated a transition of preclinical learning to an entirely online exercise.3 Previous study showed a prior evidence that these active techniques are preferred by trainees and can help develop a valuable learning skills in undergraduate medical students [4]. Many faculties use customizable cloud-based learning management platforms such as "Moodle" to make the online lectures more accessible and organized [5].
Additionally, PBL tutorials and small group sessions have been replaced with interactive Webinars through web conferencing platforms with the medical staff. Our medical school staff used "Zoom" to be a real interaction between them and their students and by this way they can provide information better. This site has already proven to be effective in attracting large number of medical students [6]. One of the most effective ways which use web conferencing is the flipped classroom, in which there is providing learning recourses like videos, voices, articles, pictures, online books and YouTube links before the class then the class will be only for the discussion [5]. The main advantage of these learning resources is the easy access from smart phones while staying safe at home.
High-fidelity simulation models were used for recording videos to facilitate student learning and training on the clinical skills [7].
This offers the opportunity for demonstration of essential procedural clinical skills and training in interpersonal communication. Social media can provide an easily accessible and interesting method for medical education specially Twitter that play an important role in many clinicians' continued education, and online journal clubs or "tweetorials" can enable residents and medical students to interact with world leaders in their areas of interest [8]. Telehealth has become an important factor to develop health care during COVID-19 pandemic so engagement of medical students in this method will be very beneficial for them. Through telehealth, medical students can to be simplified and consistent with testing necessary learning objectives. Patients will not be allowed to be part of clinical exams and substitution with virtual models will be the best way for testing the clinical and procedural skills.

Declaration of Interest
The authors state that there are no conflicts of interest.