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Samar AhmedSamar Ahmed, M.Sc., M.D., J.M.H.P.E.
Director, ASU-MENA-FAIMER Regional Institute
FAIMER Institute 2011 Fellow
Director, Quality Assurance Unit
Ain Shams University Faculty of Medicine
Cairo, Egypt

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Dinesh BadyalDinesh Badyal, M.B.B.S., M.D., Dip. Clinical Research
Director, CMCL-FAIMER Regional Institute
CMCL-FAIMER Regional Institute 2007 Fellow
FAIMER Institute 2009 Fellow
Professor and Head
Department of Pharmacology
Christian Medical College
Ludhiana, India

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Ciraj Ali MohammedCiraj Ali Mohammed, M.Sc., Ph.D.
Director, MAHE-FAIMER International Institute for Leadership in Interprofessional Education
CMCL-FAIMER Regional Institute 2008 Fellow
FAIMER Institute 2010 Fellow
IFME 2013 Fellow
Professor of Microbiology and Deputy Director,
Manipal Centre for Professional and Personal Development
Manipal Academy of Higher Education
Manipal, India

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Sudha RamalingamSudha Ramalingam, M.D., P.G. Dip. (Bioethics)
Co-Director, PSG-FAIMER Regional Institute
PSG-FAIMER Regional Institute 2010 Fellow
Professor, Department of Community Medicine
Registrar Research
PSG Institute of Medical Sciences and Research
Coimbatore, India

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COVID-19: Reflections from the FAIMER Community

Fellows and faculty from the FAIMER Institute and Regional Institutes share their experiences during the global COVID-19 (Coronavirus) pandemic.

Syed Irfan Ali, M.B.B.S., M.D.Syed Irfan Ali, M.B.B.S., M.D.
MAHE-FAIMER Regional Institute 2019 Fellow
Associate Professor, Community Medicine
Great Eastern Medical School and Hospital (GEMS)
Srikakulam, India

The beginning of the year brings warmth and sunshine: We all make New Year resolutions and try to abide by them. Initial days of the year were indeed blissful, but the constant threat of the pandemic was lurking around subconsciously.

Scattered dark clouds which seem far away:
Acknowledgement of the threat and action against COVID started in the mid-week of April, when the government converted our institute into a 700-bedded district COVID hospital. New roles and responsibilities were entrusted upon us. Along came the realization that the “systems approach” we follow for delivering medical education is an open one. The change in environment forced us to change our usual approach of teaching-learning to an electronic platform. The new normal: virtual teaching and learning through online classes.
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The gale arrives and shatters normalcy:
No matter how well you prepare for a situation, things always escalate when faced with reality. We got our first COVID case in the mid-week of June and first COVID death a month later. They say familiarity is the best friend of efficiency, but isn't it keeping us packed warm and comfortable within a box? A box whose walls started collapsing on us, given the suddenness and unpredictability of COVID spread. Thinking out of the box was a necessity, but guidelines kept changing and all this added to the chaos. We felt like a horse running with blinkers, no matter how unknown the destination is!

The rain and the wind are here to stay:
By the last week of July, our district is reporting an average of 400 cases daily. Our own staff have started getting infected now, with most of them under home isolation. Our purpose keeps changing; maybe we are required to hold the fort till a vaccine shows up.

Seeking purpose in chaos:
Darkness is not an entity; it simply means absence of light. As Anne Frank said, “A single candle can defy or define darkness." We have a solemn duty to shine in this period of darkness. Doing our bit to define the new normal…
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Mitra AminiMitra Amini, M.D., M.P.H., M.S.
FAIMER Institute 2019 Fellow
Professor of Clinical Education Research Center
Shiraz University of Medical Sciences
Shiraz, Iran

There are many cases of COVID-19 infection and a high number of deaths all over the world. I am a Medical Doctor, and this affects me professionally. There are reported deaths among healthcare staff across the globe.

Medical schools’ missions have changed to e-learning courses. We are working hard to improve our lessons in an offline and online format. Our last-year medical students are working at hospitals. We are thinking of designing online teaching and learning opportunities for medical students in the clinical wards.
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I also tried to write some manuscripts about this pandemic. I sent a letter about the lessons learned during the COVID-19 pandemic to Medical Teacher journal, a Really Good Stuff about mentoring our students to medical education journals, and a rapid review of social isolation to the Iranian Journal of Medical Sciences. I am writing a review of all the different social aspects of this pandemic all over the world.

I am a professor and work at a medical school and also an outpatient clinic. My husband is an associate professor and an infectious disease specialist and visits COVID-19-infected patients in the hospital every day. My daughter is a medical student and works at a hospital. We treat all medical students like our children. We have tried to be the best role models as a dual-career academic medicine couple and a three-physician family in this hard situation. We decided to help our medical students, our people, and our community to overcome difficulties during the COVID-19 pandemic.
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Bhagyalakshmi Annappa, M.D.S., Ph.D.Bhagyalakshmi Annappa, M.D.S., Ph.D.
MAHE-FAIMER Regional Institute 2018 Fellow
Reader, Department of Orthodontics and Dentofacial Orthopaedics
JSS Dental College and Hospital
Mysuru, India

“Every problem comes with an equal and greater opportunity.” – Napoleon Hill

I was also equally upset and sad about the pandemic havoc created in our lives but as the above quote mentions, it did come with an equal and greater opportunity to me for updating and upgrading myself.

I am an orthodontist, researcher, and a teacher. Out of these three roles that I play, the teaching profession is what I personally enjoy more. Of course, nothing can replace a physical teacher but yes this was the time for online only mode. This online mode made me in fact connect more with my students with our teaching-learning programs on LMS as well as organizing cultural activities online. We did online role plays and videos for entertainment. This gave a feeling to my students that whether lockdown or no lockdown, their teachers and their campus are going to remain near and dear to them.
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Also, I got into several online faculty development programs (FDPs), webinars organized by FAIMER, and other higher education health universities. These FDPs have made me more empowered and honestly, I must reveal that had it not been for this lockdown I would probably never get an opportunity to get myself updated with new knowledge and skill. I feel richer than anyone today!

I prepared three scientific manuscripts out of which one is about COVID-19 in a pictorial mode for which I have received appreciation and recognition. The depiction in the picture (below) is what I really think is the impact of COVID-19.

Bhagyalakshmi Annappa Graphic
Click to open in a new window

So folks, let’s take this COVID-19/lockdown as a tool to empower ourselves and continue to shine brighter and brightest.
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Mohammad Waseem Faraz Ansari, M.B.B.S., M.D.Mohammad Waseem Faraz Ansari, M.B.B.S., M.D.
CMCL-FAIMER Regional Institute 2020 Fellow
Assistant Professor, Department of Community Medicine
ESIC Medical College Gulbarga
Gulbarga, India

The present COVID-19 situation has shaken the whole world and awakened it from an attitude and mindset of taking health, immunity, and more importantly life for granted. It was like any other epidemic at first, spreading like news and relaxing everyone with the thought of “Thank goodness it's not in our part of the world,” but then it turned into a pandemic and took everyone for a toll. It made us realize that all we prioritized were the materialistic things which would never be of worth to us in any aspect, and then we realized the importance of life, love, health, loved ones, togetherness, care, compassion, and gratitude for this wonderful life that has faded away and we missed it in our lives.
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The first COVID-19 death in India was in my city (Gulbarga). The district was on high alert and the administration took immediate and stringent steps to avoid further worsening of the situation. Our institute was designated as a COVID hospital of the district due to its magnanimous infrastructure and the responsibility of our department was to set up a Screening OPD for COVID-19 and establish a standard operating protocol for the hospital. From the office of the District Magistrate, I was made a member of the district taskforce for the COVID-19 prevention and control committee, the rapid response team for COVID, and the Expert Committee for training of essential services regarding COVID-19 in my district; as well as an Epidemiological Expert of the district branch of the Indian Medical Association COVID-19 expert group. I was also made a member of the District Surveillance Team for epidemiological investigation and linking, tracking the source of infection, interviewing positive cases, tracing the primary and secondary contacts, and preparing epidemiological reports to be submitted to the district and state taskforces. At my institution, I did my COVID ward duties and my Screening OPD duties as per the rostrum.

Unlike many who are spending much of their time with their families, it has been the other way around for me. I miss spending time with the family because of the professional responsibilities that are bestowed upon me, but I am happy that I am contributing a drop in the ocean of stalwarts working day in and day out to combat COVID-19. It was difficult at first to juggle between personal and professional commitments, but I have adapted to the “new normal,” as COVID-19 is here to stay and have blended the hectic into the routine. The stressful day with a thought of how to tackle the situation before having a peaceful sleep at night has given me immense strength and boosts an enthusiastic vibe within me to be the same COVID warrior the next day.
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Jarina BegumJarina Begum, M.B.B.S., M.D.
CMCL-FAIMER Regional Institute 2018 Fellow
Associate Professor, Department of Community Medicine
Great Eastern Medical School and Hospital
Srikakulam, India

Reflection: Phase 1
It’s all about survival of fittest,
revival of systems existed...
and adaptation at the earliest...
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Things may go wrong
Virus may get strong
But we learned the way beyond
So made true relation & worthy bond
Nothing is completely normal...
Nothing fitting to the rationale...
No one is in absolute health...
Seems like an undeniable truth...
If you will ask me about normality??
It’s like Einstein theory of relativity...
What exists in matter is time, space, and gravity...
We know it as our subconscious mind & subjectivity...
Yes, it is going to stay
There is no other way
Home is of course sweet home
But no other place to roam
Hours seems like ages
And the walls like cages
We all are scared to death
While doing the aftermath
It was just a small ripple indeed...
Brought the world into stampede...
Are we really expecting a miracle...?
When we realize no one is invincible...
Fear & crisis flaming everywhere,
We could do nothing but stare...
Don't want to look at the number...
Just be at home in deep slumber...
Hoping for the light to come through
Enduring all the pain and accrue
Going back to Stone Age like a caveman
But with laptops, mobiles, and virtual plan
Aspiring for a world with Naturalism
Evolution, adaptation, and Darwinism... (Submitted May 5, 2020)

Reflection: Phase 2
The world is now:
Struggling between optimism (All is well!!!)
and escaping the sarcasm (Am I going to die?)

We cannot live like this forever
Thinking someday it will be over
It's better for us, getting along with
After trying all tricks & every myth
Panicking around, crossing the lines
Trying all possible way for "The vaccine"
Perseverance is the way towards change
Keeping all our faith and hope to avenge
Resilience may break-up the glass
If you not let your fear to surpass
This is the time for transformation
with online classes and simulation
Liked the new teaching learning system ever so much
Yet, we all are missing the only thing 'The human touch'
We may leave behind great stories for our next generation
The creative minds of new world with technology & perfection
Get ready for innovation, rise for the machine revolution
To build another ark like "Noah" rescuing human population (Submitted August 31, 2020)
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Abebe BekeleAbebe Bekele, M.D., M.Med., Ph.D.
FAIMER Institute 2014 Fellow
Founding Dean and Deputy Vice Chancellor of Academic and Research Affairs
University of Global Health Equity
Kigali, Rwanda

“Some have described the COVID-19 crisis as a ‘great equalizer.’ After all, it has invaded the world’s richest economies, with the virus infecting some of their most prominent figures, from politicians like UK Prime Minister Boris Johnson to Hollywood royalty like Tom Hanks. But developing countries, especially the poor within them, remain far more vulnerable than their developed-country counterparts, not only to the pandemic’s health consequences, but also to insecurity—and instability—stemming from the response.
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So far, the most effective measures for limiting the spread of COVID-19 are travel restrictions, physical distancing rules, and full quarantine, where applicable. But rapid implementation is essential.

We have seen that in some African countries, such as Rwanda, where the government grounded all passenger flights for 30 days after confirming just 11 cases of the virus, and then placed the entire country on lockdown for 28 days. Neighboring Uganda soon followed suit, along with Nigeria, South Africa, and Ethiopia, among others.

But the responses elsewhere have been fragmented and weak. Given the scale of global interconnectedness, this should worry everyone.

Developed countries have stronger healthcare systems, but they are still deeply vulnerable: the United States recently reported more than 1,800 COVID-19-related fatalities in a single day. Imagine the effects of a similar outbreak in Africa. There are fewer than 500 ventilators in Nigeria, a country of 200 million people—roughly two-thirds the population of the United States, which has 172,000 ventilators. And as long as the virus is spreading in one country, every country is at risk of new waves of infections. But the danger extends beyond the virus itself. In many developing countries, the vast majority of workers depend on modest daily wages, and cannot work remotely. Social-distancing measures thus threaten their very survival. Only through strong leadership and informed decision-making can African governments protect these vulnerable groups.

Again, some countries are setting a positive example. Rwanda’s government has announced plans to deliver food to more than 20,000 vulnerable households in the capital, Kigali, and to provide essential services, such as water and electricity, for free. But, on the whole, social protections are nowhere near adequate to safeguard Africa’s poor during lockdowns.

For a continent whose recent history has included a lot of violent conflict, this is a recipe for disaster. Economic stress breeds frustration, especially with the authorities, heightening the risks of unrest, renewed civil wars, and military coups. As John Nkengasong, the director of the Africa Centres for Disease Control and Prevention, has warned, the pandemic could be a ‘national-security crisis first, an economic crisis second, and a health crisis third.’

The international community is not doing nearly enough to help African countries mitigate the COVID-19 threat. This is partly a matter of resource constraints: in a pandemic, funding from multilateral institutions like the International Monetary Fund, the World Health Organization, and the World Bank must be shared across many countries, and governments are focusing their resources on domestic needs.

So limited are public resources that many countries are now relying on philanthropic aid. For example, the Chinese billionaire Jack Ma donated 1.1 million testing kits, six million surgical masks, and 60,000 protective suits and face shields to Africa. (He also donated one million face masks and 500,000 test kits to the US—something that would have been unthinkable just a few months ago.) US corporations and billionaires have also made large donations.

But we cannot rely on the benevolence of philanthropists and corporations to win this battle. We need a unified global response—including coordination on measures like travel restrictions and quarantine rules—with effective leadership. And we need rich-country governments and multilateral organizations to increase support to low-income countries, without adding to their international debt.

Resources—from personal protective equipment to testing kits to ventilators—should be allocated according to need. At a time when WHO Director General Tedros Adhanom Ghebreyesus is warning of an ‘alarming acceleration’ of virus transmission in Africa, the continent’s need is clearly growing.

But containing COVID-19 is not enough. Countries must urgently strengthen their health systems, to protect against future outbreaks. This requires investments not only in equipment and infrastructure, but also in personnel, emphasizing medical professionals who are trained to think holistically. At the University of Global Health Equity in Rwanda, we teach our students from the outset to look beyond the immediate clinical reality to account for relevant social, economic, historic, and political factors.

The COVID-19 crisis has demonstrated how fast a new disease can envelop the world, causing widespread suffering and death. Rather than wait for the next outbreak to erupt, and then play catch-up again, all countries should be working to apply the lessons of this pandemic to bolster preparedness and prevention.

Although COVID-19 does not affect all equally, it does confirm the axiom that, in today’s interconnected world, global challenges require global solutions. The only way to build a safer post-COVID world is to ensure that Africa is not left behind.”

This piece originally appeared as an op-ed titled “Averting a COVID-19 Security Crisis in Africa,” published by the Project Syndicate on April 20, 2020.
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Saju Binu Cherian, M.Sc., Ph.D.Saju Binu Cherian, M.Sc., Ph.D.
MAHE-FAIMER Regional Institute 2018 Fellow
Associate Professor, Department of Anatomy
Apollo Medical College
Hyderabad, India

The COVID-19 pandemic hit the world and upturned every walk of life including medical education causing an unprecedented educational crisis. Medical students who longed for a holiday otherwise are now missing every nook and corner of medical college. They were forced to embrace technology and learn in the comfort of their homes.

As a medical teacher, my biggest challenge at the wake of COVID-19 was “Covido-pedago-phobia,” the fear to adapt quickly to online teaching from a face to face method of instruction. Webinars conducted by MEU India, Academy of Health Professions Educators (AHPE), and the FAIMER Institutes equipped me to face this challenge. It was indeed a new experience to combine synchronous and asynchronous modes of learning. I was very much excited to engage the learner online giving one assignment per week followed by my lecture.
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We started working through Google groups, designing concept maps using Cmap cloud tools. That was a joy to see the most innovative and creative means used by the student to design the concept map with the use of various connectors. The students were equally excited as they were awarded “Early Bird” and “Best Concept Map” certificates.

The thought of instilling leadership skills through collaborative learning came up as the next assignment as I thought teamwork and leadership skills was the need of the hour. The class of 100 was divided into groups of ten, each group with a specific subtopic and the students were asked to learn and present through collaborative learning.

Moving forward, as no signs of flattening the curve of the pandemic were shown, I decided to ignite their talent in medical humanities through “The Art of Story Telling.” The responses made me shed tears of joy as the student took the effort to immerse the reader connecting the events and merging with anatomical concepts garnished with terminology toppings which was rather a challenging job.

Using and playing with new online tools made both student and teacher interested in the subject and we moved to the fourth innovative method, to design Ishikawa/ fish bone diagrams to explain anatomical concepts, which was very well taken up by the students. I was taken aback to see the creativity and innovation in their presentations. These activities were strengthened by online live dissections which was another huge challenge during this epoch.

During this period of global catastrophe I learned students are treasures in clay pots and that teaching is about learning and yearning—learning to improve and yearning to excel only to unleash the potential!
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Sucheta DandekarSucheta Dandekar, M.Sc., Ph.D., M.H.P.E.
FAIMER Institute 2010 Fellow
Former Professor and Head, Department of Biochemistry
Seth G.S. Medical College and King Edward Memorial Hospital
Mumbai, India

I received the news of the FAIMER institute being postponed on March 4, 2020. My husband and I were to fly out of India on March 5, 2020 to come to the USA. We reached Miami and spent time there with our son's family, but by March 16 things were getting serious. Our return was scheduled for March 23. We had a Swiss Air ticket and the airlines cancelled all flights out of Zurich. Suddenly we were left without a way to return to India, as India decided to ban all International flights into India from March 23. Fortunately, our friend suggested that that we could fly to New York and take a direct 15-hour flight to Mumbai. We did that. We got back in the nick of time, on the last United Airlines flight out of New York. The flight was full of students returning home as most will have online classes.
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My husband and I arrived from the USA on March 21 at 8 pm at Terminal 2, Mumbai Airport. After a tiring journey, we were not sure what to expect. The international airport was a surprise of disciplined activity. It is so well managed by interns and community and medicine departments of the medical colleges. King Edward Memorial (KEM) Hospital interns and preventive and social medicine (PSM) department friends were on duty that day. As senior citizens, we were immediately taken for the quarantine stamp and explained that we would have to go for the tests. There was a choice between Seven Hills Hospital and some hotels on negotiated payment. We chose to remain in the Municipal Corporation of Greater Mumbai (MCGM) as I felt loyalty and knew I would be taken care of there. Our bags were disinfected on arrival at Seven Hills, along with the cab that we came in. We were given beds and clean bedsheets.

Interns, residents, nurses, and SMOs from all the medical colleges and peripheral hospitals were sent in rotation and were toiling round the clock. They worked tirelessly, answering every senior passenger’s queries patiently. What surprised me was that we were not only asked about our medications, but there was a facility to procure them for those who were running out of them. We were served breakfast, lunch, tea, and dinner. Water bottles, sanitizers, face masks, towels, toothbrushes, and toothpaste were provided for those who needed them; all made available for free. Community medicine, microbiology, medicine, nursing departments, and many others like housekeeping came to the rescue.

The Deans of the medical colleges ensured the smooth running of the system; kudos to them. All the departments of MCGM were so good to us, I cannot thank them enough. All services were free of charge. The security took care of the people, ensuring that they did not gather in herds and also looked after the belongings. Nowhere in the whole journey at Seven Hills Hospital were we ever referred to as patients. We were called passengers. That was a great morale booster indeed. Also, families were not separated and there were no male and female demarcations.

We were discharged on March 25 in the evening, after our throat swabs were negative. There is a lockdown in Mumbai but the MCGM sent us home in buses with emergency vehicle stamps on them. We were then placed in home quarantine until April 4.

The quarantine experience has taught me a lot. I met so many people from all walks of life and though we had social distancing, we talked to each other on phone. That was fun. We kept our spirits going. I wrote a post about my positive experience and the role played by our interns and residents and this has gone viral. The Commissioner's office contacted me and they have spread the blog to many groups. The newspapers also interviewed me and students’ parents have been calling me. Our students are helping in the quarantine places, taking blood pressure, counselling the inmates, and helping in the discharge process. My book in Biochemistry is coming up for the second edition so I am going to try and finish it. I am preparing for some workshops that are scheduled for later in the year. Telling myself that this too shall pass and we shall have a new beginning.
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Sanjoy DasSanjoy Das, M.D.
CMCL-FAIMER Regional Institute 2015 Fellow
Professor and Head, Department of Forensic Medicine & Toxicology
Himalayan Institute of Medical Sciences
Dehradun, India

With COVID-19 spreading its tentacles globally and the world going into a standstill all of a sudden, life became entirely different, difficult, and disrupted. As a Forensic Medicine expert and medical teacher, I thought that I shall have nothing to do and this worried me...until... one day I was chosen to work as the Nodal officer for COVID-19.
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This made me plunge into an entirely new dimension of reading all the guidelines issued by the government; planning isolation areas and facilities for COVID suspects; and charting out methods of triage, routes, testing, treatment, discharge of patients, and disposal of dead bodies. In addition to these, regular preparation of updates for reporting, public awareness mechanisms, and networking with various stakeholders including relatives and media have slowly become a part of my job description. Many a time I travelled back down the memory lane, reflecting on the communication and networking areas that I had so lovingly learned during my FAIMER Fellowship days.

Teaching-learning has always been in my mind, and one day, I dawned upon creating a different type of multiple choice questions (MCQs) for my students; especially when classroom teaching and assessment has come to a grinding halt. I started creating graphic MCQs using Adobe Photoshop with stems conjured to induce high order thinking. This made me realize that Forensic Medicine & Toxicology has an unfathomable bounty of resources for such creativity. To date I have designed about 500 such MCQs. I am waiting to administer these to the medical students and build a question bank of graphic MCQs after assessing their difficulty indices.

As a nature photographer, I have discovered that there are more birds and small animals in my backyard than I had ever imagined. I am planning to prepare the second edition of my book on wildlife, titled The Jungle Call. I have adapted myself to the theme of staying safe, helping COVID containment, and creating... even some new recipes in the kitchen.
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Ben Halili, M.A., Ph.D.Ben Halili, M.A., Ph.D.
FAIMER Institute 2014 Fellow
Head, Instructional Materials Development Office
Zamboanga State College of Marine Sciences and Technology
Zamboanga City, Philippines

We are beginning a nationwide quarantine. By midnight, nobody is allowed to go out. When rebels attacked our city in 2013, the same measures were practiced but more stringent. At least then, we knew the enemy and it was contained through dragnets and bullets, but the current pestilence is invisible and might have already invaded us.

Mariya  JiandaniMariya Jiandani, M.Sc.
GSMC-FAIMER Regional Institute 2014 Fellow
Associate Professor
Seth G.S. Medical College
Mumbai, India

A tiny microscopic thing shook the whole world with its might. A blow out of the blue to say, “Whoever you may be, fear me.” An unexpected turn of events when students went on preparatory leave, not knowing that they would not return to give exams in the normal way. Faced with new challenges, coping with mandatory assignments to save the academic year, and waiting for guidelines to conduct exams tested resilience in all alike. Meeting ends of new course amidst the ongoing old course brought in many uncertainties. Conduct of clinical exams left us pondering to scenarios we never imagined would arise. Travel with fear of the unknown, eyeing every individual as a suspect COVID-19, and putting the best foot forward to protect oneself and family became the new norm.
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COVID taught innovative ways of teaching-learning and recording attendance and a switch to both online teaching and assessment to be used as an asset in future. It taught us to deal with connectivity issues and find simple solutions. It also brought out the importance of face to face interactions, the acknowledgement of expressions, the healing clinical touch, and an automated mode of flexibility in teaching. COVID gave a number of moments to reflect on life and the pace at which we lived.
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Roopashree Mallya, M.Sc.
Roopashree Mallya, M.Sc.
MAHE-FAIMER Regional Institute 2017 Fellow
Tutor, Department of Physiology
Kasturba Medical College, Mangalore
Manipal Academy of Higher Education
Manipal, India

The COVID-19 pandemic forced us to become online educators overnight. Rapidly transitioning from conventional learning to online education compelled us to review each known advantage and disadvantage of online learning very closely and clearly. We started asking several questions related to resources, training and effort required for this change. For many of us this meant coming out of our “comfort zone” to engage to our learners. This was followed by a series of online training sessions, reading and reviewing articles on online learning, and attending countless webinars.
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Sometimes it felt like webinar was the new pandemic. We then started to explore the applications needed for learning and attempted to embrace technology through the Microsoft Teams application. We started online classes for theory, small group learning, problem based learning, clinical examinations, and early clinical exposure sessions. We brainstormed about online learning and assessment with our peers, any chance we got.

Though it felt impossible in the beginning, we are not only surviving online learning but thriving. Every day we overcome our fears linked to change, isolation, and technology. Numerous hours of faculty training helped us to not only master the apps and tools but also to maximize learning by use of interactive polls, quizzes, and games to keep the sessions interactive and the learners interested. We understood that teachers can learn from their students too, especially when it comes to technology. We also gratefully recognized the power of the moral support extended by our colleagues and institution.

Roopashree Mallya graphic
Click to enlarge
We transitioned from traditional teaching to emergency online education, and we are now moving towards providing enriching online experience. We will be reflecting on our knowledge, practices, attitudes, and behavior towards online learning and advance in the direction of innovation in planning, implementation, assessment, and evaluation of online strategies to manage and maximize learning. I am pleased to share this graphic (at right) on the online education cycle, illustrating the flow of events to achieve an enriching online learning experience.
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Imran Pasha Mohammed, M.D.S.Imran Pasha Mohammed, M.D.S.
MAHE-FAIMER Regional Institute 2019 Fellow
Yenepoya Dental College
Mangaluru, India

With COVID-19 spreading its tentacles globally and the world going into a standstill all of a sudden, life became entirely different, difficult, and disrupted. As a Forensic Medicine expert and medical teacher, I thought that I shall have nothing to do and this worried me...until... one day I was chosen to work as the Nodal officer for COVID-19.
Read More »

The various activities undertaken by FAIMER and its collaborative efforts helped me plan a better project and change it to an online program; hopefully it will bear the fruits in days to come. The ASU-MENA-MAHE-FAIMER lecture series was excellent and helped in understanding and making the online education more interactive. Also, the AHPE Lecture Series that was organized made me more confident in delivering online content and also making the online programs for my project. It also has given time to organize, stop, think, and prioritize your work and family life. In the end, the COVID scenario has brought families together and has made technology the necessary tool for education.
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Tanushree Mondal, M.D.Tanushree Mondal, M.D.
CMCL-FAIMER Regional Institute 2019 Fellow
Assistant Director of Medical Education
Government of West Bengal
Associate Professor, Department of Community Medicine
Calcutta Medical College
Kolkata, India

To introduce myself, I am Dr. Tanushree Mondal, Associate Professor and Assistant Director of Medical Education to the Government of West Bengal, India. I serve two roles, academic as well as administrative. The land of Kolkata from where I hail from is the City of Joy, and it has given birth to noble laureate over the years. The medical institution where I teach holds a huge significance as it was the first ever medical teaching institution established in the whole of Asia, and its first Principal was M.J. Bramley.
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With a regular intake of 250 MBBS students every year and around 330 faculties in all the departments, the college faced a big challenge this time when it came to face the Coronavirus pandemic. The classes in the big auditoriums were replaced by online classes and it became the norm of the pandemic. Like the Coronavirus in the news, and the sanitizers, hand washing, use of masks, social isolation trends, online classes became the routine practice in the New Normal Period. This was both asynchronous as well as synchronous in nature.

The asynchronous mode of teaching-learning included posting of the teaching-learning materials in the Google classrooms. Also, the YouTube classes were conducted where MCQs were discussed by me and the students answered in the chat box that was aired live on the internet. At the same time, feedback was given by the students at the end of the lecture class in YouTube.

Moreover, poll questions were posted on Telegram Group so that they can participate and practice those which come very commonly during the exams. Furthermore, there were synchronous modes of exchange of information to the students including Zoom face to face conversations and discussions, Google Meet, Cisco WebEx, Skype, etc. For assessments, Google Quiz and Hot Potato were applied.

So, I tried my hands-on Jigsaw T-L mode in an online mode, using Zoom breakout rooms. This can also be used in case of other software that provided the opportunity of breakout rooms like the BigBlueButton. I felt that there was lack of interest among students to attend conventional asynchronous online lecture classes of Community Medicine and herein Jigsaw seemed to be a promising interactive learning method which has a student-friendly approach. This was all the more pertinent due to the COVID emergency as an online platform was the only refuge to teaching-learning. So my objectives were:
  1. To assess the perception of the MBBS students towards the Online Jigsaw learning method.
  2. To assess the perception of faculties towards the Online Jigsaw learning method.
  3. To find out the effectiveness of the Online Jigsaw learning method in terms of attendance, participation, and performance of the students.
It was a cross -sectional study with purposive sampling. Faculties were sensitized by me online on Zoom meetings. Around 110 students were enrolled for the study, out of which three did not participate and seven were lost to follow up. With a total of 100 students, random allocation of these students was done into two groups of 50 each (see graphic below). IEC was taken, validated tools were administered, consent was asked through Google forms, and pre- and post-interventional tests were taken. These students were put to asynchronous online teaching method (Google classrooms as well as YouTube classes) on one hand, and the other group was exposed to the Online Jigsaw T-L method using breakout rooms. All the norms were followed in planning of the Jigsaw classes and to complete the whole process it took two hours. The Zoom subscription was already a paid version by the Medical Teaching Institution, so it could be delivered easily. Again the groups were crossed-over in the next week with different topics for discussion.

Tanushree Mondal study graphic

There were highly significant changes noted in the Online Jigsaw classes. Students felt that Online Jigsaw helped in understanding the topics better. Faculties felt Jigsaw created interest and evoked participation among the students, and the activity improved the group dynamics and reduced absenteeism. There was enhanced knowledge and satisfaction of the students as was reflected from their assessment scores. So the COVID-19 era which showed an emergency period paved the way for innovation. As the proverb goes, “Necessity is the mother of innovation.”
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Mergan Naidoo
Mergan Naidoo, M.B.Ch.B., M.Med., M.Sc., Ph.D.
FAIMER Institute 2019 Fellow
Family Physician
Associate Professor and Academic Leader, Teaching and Learning
School of Nursing and Public Health
University of Kwazulu-Natal/Wentworth Hospital
Durban, South Africa

I am a now a full-time clinician at a local hospital. We have run out of personal protective equipment (PPE) and we have no N95 masks in the hospital. We are currently all using surgical masks which may prove to be a major problem as we still see many patients with tuberculosis (TB) on a daily basis. I examined three patients with suspected TB during my ward round yesterday. The 24-hour hotline is overwhelmed and nobody answers it anymore. Yesterday, a sister hospital had a very ill patient with suspected pneumonia though to be due to COVID-19.
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They intubated the patient in the Emergency Department of a district hospital and then could not get the patient accepted at any intensive care unit (ICU) because the COVID-19 ICU needed the patient to be confirmed as a case and the non-COVID-19 ICU did not want to risk infecting others. It is an absolute ridiculous state because the emergency physicians are not equipped to manage such patients for a prolonged period of time and this is also not good for other health care workers (HCWs) and patients using the facility. Test results take 24-48 hours. There is a lot of panic, even among HCWs. A patient of mine was refused an emergency CT scan of the brain on Friday as the radiologist wanted me to exclude COVID-19 despite the patient not satisfying the case definition for a person under investigation. (Written March 23, 2020)

I am now the chair of the COVID-19 task team (TT) at my hospital, and we are slowly implementing measures to deal with the anticipated surge that we are expecting in the coming weeks. We still have minimal PPE at the hospital, and we have started using private sponsors who have been great in supporting HCWs at the institution. The Gift of the Givers, a South African based humanitarian organization heard of our plight and assisted with PPE. As a TT we meet daily and tweak what we are doing. Patients with suspicious symptoms are triaged out of the queue before they enter the facility, given a mask, and moved to a special area in the hospital, where they are assisted. We are advocating for universal cloth masks for the public and a group of women sewed approximately 600 masks which we distributed to all staff and encouraged them to wear in public areas. Our lockdown has been extended to five weeks and one is only allowed to go out to get groceries or medical assistance. The outpouring of assistance from private individuals has been phenomenal with various companies helping with food, PPE, and even ventilators. Our infections are predicated to peak in July/August 2020, so we are still very early into our epidemic. The lockdown has allowed us to prepare our facility for the coming uncertain days ahead. (Update provided April 17, 2020)
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Rano Mal Piryani, M.B.B.S., M.C.P.S., D.T.C.D., M.D.
Rano Mal Piryani, M.B.B.S., M.C.P.S., D.T.C.D., M.D.
PSG-FAIMER Regional Institute 2011 Fellow
Consultant, Internal and Pulmonary Medicine & Medical Education
Professor and Head, Department of Internal Medicine
School of Nursing and Public Health
Universal College of Medical Sciences
Bhairahawa, Nepal

I travelled along with my family on February 6, 2020 from Karachi, Pakistan for Kathmandu, Nepal, the country where I have been working since April 11, 2003. I didn’t see and perceive any of the signs or evidence of arrangement by authorities in both countries, any health desk at both airports, awareness of people, or fear and anxiety among concerned people about the SARSCoV-2 virus outbreak; but colleagues working in the healthcare sector showed some apprehension once the World Health Organization (WHO) declared it a “public health emergency of international concern” on January 30, 2020. Authorities and public in both countries gradually awakened and became serious and thoughtful after WHO declared COVID-19 a global pandemic on March 11, 2020. I perceived the situation to be a pandemic in the first week of March and mentioned this in a poem I wrote on March 8. Everyone knows how this pandemic has affected the lives of all us from various perspectives. My institution nominated me as a coordinator of a COVID-19 task committee in the second week of March. It was a challenge and stress because of the rapidly unfolding situation of COVID-19 and the update of instructions flowing from the government on a day to day basis, but as a team we managed to get the situation under control and continue to do so.
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There is a dilemma as to when the pandemic would end. According to historians, pandemics predictably have two types of endings: the medical, which occurs when the incidence and death rates significantly fall; and the social, when the epidemic of fear about the disease fades. The fear factor has already started fading.

I attended the four-day comprehensive online “COVID-19 Training of Trainers” jointly organized by Project Hope International, Center for Human Rights and Humanitarian Studies, Watson Institute for International and Public Affairs at Brown University, Nepal Study Center, The University of Mexico, Government of Nepal Province 5, and Pratiman-Neema Memorial Foundation Nepal held May 11-14, 2020; at a time when the USA was the epicenter of COVID-19 and U.S. healthcare professionals faced a critical situation, responded, learned, and got experience. It was scholastic learning with emotions. I have planned to train around 200 nursing staff in the next four weeks on “The COVID-19 Preparedness & Response Training Program,” “Strengthening Health Workforce Preparedness and Response to COVID-19.” I believe that nursing staff are the first and foremost among the first line healthcare professionals to take care of COVID-19 suspects and patients.

In the last week of June, I took seven credit hour sessions on assessment in face to face faculty development training at the Nepalese Army Institute of Health Sciences Kathmandu for 12 participants following physical distancing, infection prevention and control measures, and wearing masks. This is what I call a professional commitment and emotional attachment with profession.

Rano Mal Piryani COVID-19 Poem
Click to enlarge
I have written 13 articles related to COVID-19 during last four months. This is what I feel is my duty and service. Seven articles have been published, on the subjects of COVID-19 testing, lockdown, social distancing, hospital policies, use of masks, efforts in Nepal to contain COVID-19, and deaths due to COVID-19 in affected countries. Another six articles are in the process of publication, on topics including the care of non-COVID patients during the COVID-19 pandemic, herd immunity, transmission dynamics, the impact of COVID-19 on medical education in South Asia, and the idea that recovery will likely soon be the rule and death will be exception. Lastly, I mention that I have written more than 50 poems on COVID-19; that is my true reflection. The first of these poems is included here (at right). I have compiled the poems into a PDF that I would be pleased to share with anyone who is interested.
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Shalinee Rao, M.B.B.S., M.D.
Shalinee Rao, M.B.B.S., M.D.
GSMC-FAIMER Regional Institute 2019 Fellow
Professor of Pathology
Head of Advanced Center of Continuous Professional Development
All India Institute of Medical Sciences
Rishikesh, India

It has been a unique and a lifetime experience working during this unprecedented situation created by the COVID-19 pandemic. Our institute was designated as a COVID hospital and hence lot of preparation in terms of logistics had to be made by administration with support of faculty and staff. As the Head of the Advanced Center of Continuous Professional Development (CPD), I was given the responsibility of providing preparedness training to combat COVID-19 to all health care workers (HCWs) and non-medical staff working at my institute, All India Institute of Medical Sciences, Rishikesh, during the nationwide lockdown. The main aim was to strengthen and build the capacity of the workforce to face this situation as rapidly and successfully as possible. In March 2020 there was a general fear in everyone’s mind due to the situation prevailing in the United States, Italy, and other European countries at that time and also because of the fact that not much was known about the disease biology at that time.
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Under the guidance of our Director, Dean of Academics, and Dean of Hospital Affairs, my team and I from CPD quickly responded to the situation by identifying areas that required training. Coordinators for each training program were identified and in-depth discussion carried out on learning objectives in reference to target participants and preparation of training and assessment modules based on the needs and responsibilities of health care workers. Every cadre of health worker be it medical, paramedical, nursing staff, technicians, sanitation workers, social workers, medical record clerks, mortuary attendants, and hospital kitchen staff, hospital security staff, and non-medical staff was taught about all protective measures irrespective of their level of education and occupation to safeguard their health, which was a challenging task. Training included general instructions, personal protective equipment (PPE) donning and doffing, hand hygiene, and cleaning and disinfection Do’s and Don’ts. Focused training [was held on topics] such as sample collection, contact tracing, airway management, video-laryngoscopy, ECG changes and management, mechanical ventilation and basic critical care skill and adjuncts, cardiopulmonary resuscitation (CPR) recommendations as per the American Heart Association (AHA) for COVID-19, quarantine team workflow, ambulance disinfection, and handling dead bodies of COVID-19 cases. I was overwhelmed by the support received from my clinical colleagues, the Nursing College Dean, faculty, and tutors to deliver time based rapid training. The training instructors and non-medical staff of CPD worked persistently and patiently to support and run parallel sessions simultaneously in the Institute everyday onsite with social distancing and offsite through videoconferencing platforms. For successful completion of each session proper planning and implementation was required before the session such as ensuring availability of resources manpower (instructors), consumables, equipment for running the training, sending communications to participants, arranging audio-video, preparing attendance sheets, evaluating assessments, identifying participants who needed remedial action, and many more. I realized that at such situations the most important thing one needs to do is to program one’s own mind and at the same time have a meticulous plan in hand which works very well to reduce work stress. The working hours were much longer than usual working days but fatigue was not perceived due to the constant encouragement given by my Director, Dean of Academics, and Dean of Hospital Affairs.

I could see seriousness in every participant and uncertainty in their eyes when they came to attend the training sessions. I can see the change in their attitude now because despite a rise in case inflow to the hospital, I notice that they appear to be more confident and positive. It was indeed a herculean task to train every individual in the Institute as per their job profile within a limited time and this was only possible due to interprofessional team effort and commitment of each health care worker and staff working in the Institute. We do learn new things while we work and it was a learning experience for me too because I had to do a lot of homework before scheduling a new training program. It has been a satisfying experience for me and it has given me a sense of accomplishment to contribute my little bit as a health care professional.

I have also noticed a favorable change in my colleagues and myself, in that we have adapted and accepted to the new normal in life created by the COVID pandemic. Every piece of good news is being shared and cherished much more than in non-COVID times. I am eagerly looking forward to success in vaccine trial to successfully combat this disease.
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Shivani Rao, M.B.B.S., M.D.
Shivani Rao, M.B.B.S., M.D.
MAHE-FAIMER Regional Institute 2019 Fellow
Assistant Professor, Department of Community Medicine
Maulana Azad Medical College and Associated Hospitals
New Delhi, India

The emergence of this disease novel Coronavirus has changed everyone’s life holistically. I am working as Assistant Professor in the Department of Community Medicine in a medical college and hospital in Delhi. It’s not a hidden fact about the scenario of cases and deaths in Delhi. Corona has changed everyone’s life, be it family life, social life, or professional life.

Our medical college and hospital became a designated COVID hospital of Delhi when the pandemic started in our country. Initially our department started off being posted only in screening OPD for fever cases but as symptomatic cases were on the ascending trend, admissions in ward increased. Due to a shortage of doctors in the hospital along with clinical branch, pre- and paraclinical doctors also got posted in the COVID ward. All of us got trained for donning/doffing of PPE and taking samples like oropharyngeal and nasopharyngeal samples before ward posting.
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On the first day of my posting in the Corona ward, I started off with two patients and slowly cases started increasing every day; by the end of two weeks the ward was full with 71 patients. This disease was not like any other disease. There was a lot of panic in everyone’s life including doctors. A lot of adjustments had to be made in personal life to balance professional life. It came to my mind to resign but then I felt at this stage that, being a doctor, it’s unethical to take a step like this when it’s time to serve humanity.

The first thing I did was to shift my seven-year-old daughter to my parents’ house just before my ward posting as I didn’t want to take any chance of getting her infected. Days used to be very gloomy if any patient died or if any patient was shifted to ICU, but there was indeed a smile when patients recovered and got discharged.

Our department being a part of public health is playing a key role in this pandemic. Doctors from the department are posted in state and district rapid response teams. We are helping in formulating guidelines regarding containment, decontainment, reporting mechanisms, data quality, and hand holding with districts for implementation of the guidelines and also in contact tracing. We have been involved in developing modules for health workers and all sections of people in the community. Teams from the department are also deployed in surveillance activities. In addition to this, primary care is provided through three urban and one rural center under the department of community medicine. In our health centers we are conducting routine OPD services, antenatal care, and immunization. Activities like training and sensitization regarding COVID-19 are being undertaken for frontline health workers viz. accredited social health activist and Anganwadi workers in batches, who are the grass root level health care workers from the community in India. Information Education Communication (IEC) programs are being regularly conducted at all its health centers regarding prevention of COVID-19 for the community. We have been involved in various research activities focusing on chemoprophylaxis, sero-surveillance, vaccine, etc.

Amidst this pandemic we are still continuing our online classes for all undergraduate students since April 2020. We are conducting postgraduate presentations and discussions through online platforms.

Professional life has changed drastically; it has shifted from a realistic world to a virtual world altogether. The magic of face to face meetings and conversations is missing as safety of self and others have become a priority now. Presently each of us is worn out as there are no vacations, no leave granted to us. We have been working relentlessly since the time of lockdown and we are still working every day, risking our lives entering the hospital campus, not knowing whom we are coming in contact with, or if he or she is a carrier. To add to my pain suddenly I developed carpal tunnel syndrome affecting my right wrist, which is my dormant hand, but with all of the physical and mental stress in life I had to learn to cope up, keep going, and fulfill all my responsibilities.

Each day life teaches a new lesson in this COVID situation. There were times when I was depressed or felt low and within minutes of leaving a message in the FAIMER group, FAIMER faculty and Fellows immediately responded and they have always been motivating me and encouraging me each day.

I believe every cloud has a silver lining. So I hope this pandemic will also end one day and all our lives will get back to normal. It’s almost four months now and I am still waiting for this crisis to end so that I can meet my parents and daughter.
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Jyotsna Rimal, B.D.S., M.D.S.
Jyotsna Rimal, B.D.S., M.D.S.
CMCL-FAIMER Regional Institute 2013 Fellow
Professor and Head, Department of Oral Medicine and Radiology
Coordinator, Health Professions Education Core Group
Department of Health Professions Education
BP Koirala Institute of Health Sciences
Dharan, Nepal

By specialization, I am an Oral Physician and Maxillofacial Radiologist. After lockdown, the university management decided to halt the outpatient service until further notice. BP Koirala Institute of Health Sciences being one of the Level 3 hospitals in the country, the logistic, infrastructure, and hospital consumable needs were reprioritized. In spite of having plenty of Personal Protective Equipment (PPE) provided by the government and donations received from organizations, the rapid response team (RRT) was not utilizing them.

Though not active in the hospital services, I was vigilantly observing the gap. I did not have a frontline role; however, my human side did not allow me to just stay at home idly. The concern of health care professionals, especially allied health workers, was bothering me. The RRT was working hard like Trojans but there seemed to be a chaos. After a conversation with RRT team members, it was realized that the PPE kits were incomplete. N95 masks, protective eyewear, and face shields were not included in the kits.
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My department team agreed to help out on this. We approached the Rotary club who arranged N95 masks and protective eyewear. Face shields were not available in the market, hence our team decided to make face shields in the department. Other dental departments also extended their support. So far, we have supplied 350 face shields and are continuously making more. RRTs were also overburdened in providing hands-on training of donning and doffing procedures for PPE. To extend support, our team got trained by the RRT and provided training to a total of 75 allied health workers in small groups.

It is a difficult time for all. Altruistic behavior is what is needed at this point of time. FAIMER association has been an integral part in inculcating team building and community of practice in me. I am happy that my team has been able to hone altruism in this crisis situation.
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R. Shyamala, M.D.
R. Shyamala, M.D.
MAHE-FAIMER Regional Institute 2019 Fellow
Professor of Microbiology
Malla Reddy Medical College for Women
Hyderabad, India

To introduce myself, I am Dr. R. Shyamala, a MAHE-FAIMER 2019 Fellow working as a Professor in the Microbiology Department of Malla Reddy Medical College for Women, Hyderabad, Telangana State, India. On January 30, 2020, India reported its first case of novel Coronavirus (COVID-19) in Kerala, which increased to three cases by February 3; all were students returning from Wuhan, China. The first confirmed case of COVID-19 in Telangana was reported from Hyderabad on March 2, where a man who had recently returned from Dubai tested positive for the virus.
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I had to conduct my FAIMER project workshop in the third week of March. I got my Institutional Ethical Clearance. Everything was ready and then we got a circular of closing the college due to the COVID-19 pandemic (no gatherings, no conferences, no workshops allowed).

Day by day cases were increasing in our city, Hyderabad. One day I got a call that I was given the role of Incharge of the RT-PCR lab and I had to oblige. From scratch, I was responsible for the place for the RT-PCR lab, the number of rooms, equipment required, number of technicians, and their training. I took it in my stride and started by sending a few technicians for training in a molecular lab in Hyderabad and getting permission for the equipment for the RT-PCR lab.

Meanwhile one day I spoke with Dr. Ciraj Sir, my project guide, regarding the workshop for my FAIMER project (I was worried as lockdown was not ending). It was under the esteemed guidance of Dr. Ciraj that I decided to do a Zoom workshop for my FAIMER project, “An Interprofessional Approach towards Antimicrobial Stewardship.” I made all of the arrangements and finally conducted the workshop for second-year MBBS students, BDS students, nursing students, and interns on June 5, 2020. The workshop was successful, with 80 students participating in it.

After the workshop I was relieved that my project was done. Meanwhile, at the RT-PCR lab we were working for accreditation by the National Accreditation Board for Testing and Calibration Laboratories (NABL). Cases were increasing and I was busy with getting things done for the assessment by the NABL.

There is actually no time to think, daily going to lab, working again the next day. No break or holiday. I wished for the first time in my life that I had 30 or 40 hours in a day. The days are flying; from June we have come to August. I am hoping for the vaccine to come soon to India and everybody to be successfully vaccinated.
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Laxmi Subedi, B.Sc., M.P.H.
Laxmi Subedi, B.Sc., M.P.H.
FAIMER Institute 2019 Fellow
Assistant Professor, School of Public Health and Community Medicine
BP Koirala Institute of Health Sciences
Dharan, Nepal

I am a public health expert working as an Assistant Professor in the School of Public Health and Community Medicine at BP Koirala Institute of Health Sciences in the Eastern Region of Nepal.

COVID-19 has affected low resourced countries including Nepal. The cases are on raise and the country has already faced more than three months of lockdown. This has crippled the healthcare system. Drawing a line between asymptomatic COVID cases and non-COVID cases is difficult.
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Though the morbidity and mortality related to COVID has been relatively low, the collateral damage has been extensive. The educational system has gone into total change. Medical education has been transformed into online teaching and an online assessment system. The economy has been badly affected.

I am a public health expert, so my role has been very vital in this pandemic. We are mainly focused in advocacy and contact tracing. We have formed a team of medical students who focus on community education. We also have formed a team of specialist medical doctors and public health experts for effective tracing of COVID-suspected people. With this role, the progress of work has been good. I have been able to perform the task assigned for me. The work has been applauded by colleagues and management. I have also designed and conducted research focusing on online learning assessment during the COVID-19 pandemic. With this I hope to contribute more to science, public health awareness, and medical education during this pandemic.

The pandemic of COVID-19 has refrained people from gathering to some extent but still there is a large portion of people who still are gathering for religious and recreational activities in the context of our country. The government has made different strategies to alert people to stay safe. We are hoping everything will be good soon.
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Narasimman Swaminathan, M.P.Th.
Narasimman Swaminathan, M.P.Th.
PSG-FAIMER Regional Institute 2010 Fellow
Professor of Physiotherapy
Vice Principal
Sri Ramachandra Institute of Higher Education and Research
Chennai, India

The current situation created a radical change in higher education across the globe. Providing continuous learning opportunities to the students enrolled in the health professional education programs is a great challenge during this pandemic. At Sri Ramachandra, we realized this as an opportunity to strengthen our e-learning. When the lockdown was announced, at initial stage we did not realize the impact of the pandemic on teaching/learning. After a couple weeks, we brainstormed as a team on how to engage student learning. At our institute we offer various health sciences programs including allied and health sciences, dental, medical, nursing, pharmacy, and public health. Catering to the learning needs of the diverse health sciences students online is a great challenge.
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We identified the online teaching tools to provide synchronous and asynchronous learning. We also strengthened our learning management system. The next challenge was to train our faculty members in using these tools while adhering to the principles of learning. We trained our faculty members in identified methodologies like Moodle, Google Meet, and Big Blue Button. We also introduced online tools like Kahoot and GoSoapBox to our faculty members. We created step by step video tutorials for the benefit our faculty members.

In two months, we could engage our learners seamlessly through online and started receiving positive feedback from our learners of various health sciences programs. We are also exploring the possibilities of conducting formative assessment (cognitive domain) online and hope to succeed in this initiative. I also shared the methods of online teaching with other institutes to webinars and online workshops. I conducted three online workshops for the teachers of other institutes and shared the practices. The COVID -19 pandemic has provided an opportunity explore online teaching. FAIMER provided a platform to collaborate and achieve a common goal. Our Health Professional Education team has eight FAIMER Fellows including our Vice Chancellor and Associate Dean of Education. The situation has created opportunities to overcome the challenges in implementing online education. In the future, depending on the success of these online initiatives, we see an opportunity to explore blended learning in Health Professional Education.
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Padmini Venkataramani, D.C.H., M.D.
Padmini Venkataramani, D.C.H., M.D., PG.Dip.Med.Ed.
CMCL-FAIMER Regional Institute 2017 Fellow
Professor, Pediatrics & Medical Education
Universiti Kuala Lumpur Royal College of Medicine
Perak, Malaysia

“Set thy heart upon thy work, but never on its reward.”
“Perform all work carefully, guided by compassion.” – Ved Vyasa, The Bhagavad Gita

I was on the way to India on January 24, 2020, when Malaysia reported the first person infected with COVID-19. In India, I spent the first week in Shimla and the second week at the CMCL-FAIMER Regional Institute as an honorary faculty for the contact session. By then, India also had reported the first person infected with COVID-19. However, there was not much alarm in general and I returned to Malaysia without any incident.
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Gradually, as the numbers increased, on March 18, a movement control order was imposed in Malaysia and on March 19, WHO had declared COVID-19 a pandemic!

Our university handled the emergency very well. All the faculty and support staff had rigorous training in Microsoft Teams for the first few weeks; I was the team leader for practicing the same in pediatrics. This was followed by orientation of students and we soon started online sessions of our seminars, lectures, and integrated learning activities. Our university had implemented blended learning of at least 30% by all faculty during the past few years. This facilitated smooth transition from face-to-face to online teaching.

Clinical sessions and assessment for the clinical years were deferred, while the preclinical students had all of their summative assessments online. The theory sessions for the clinical students were completed on online platforms during the work-from-home phase.

Clinical sessions for the fifth-year students were started on July 6 and for the third-year students on August 24, with precautions of face mask, hand hygiene, and physical distancing. The “observed long case” examinations have been completed successfully. The final professional examinations are scheduled to start this week, observing similar precautions.

I think it was a wise move to defer clinical placements until the movement control order (MCO) was lifted and students had access to the green zones of the hospital. During the initial phase of the MCO, students who were stranded in Ipoh were identified and food was delivered to them until the MCO was lifted. All the faculty and staff had a mobile attendance check-in which also kept track of our health status, during the work-from-home phase. The weekly CMEs were continued on online platforms.

On a personal front, during the MCO, it was good to hear the songs and tweets of birds regularly in the mornings, as the noise from automobiles had decreased suddenly! I attended a lot of webinars on a regular basis, started myself on a regular, strenuous exercise regime, continued on my healthy diet as usual, and even managed to lose some weight! My immediate concern is about my family and friends in India. I hope that this pandemic will pass and restore health to the millions who are afflicted.

I have managed to review more manuscripts than usual, send a manuscript to a journal, and I am currently working on another. I participated in the faculty development initiative of CMCL-FAIMER and have been invited to give a talk as one of the panelists by Global Health Academy. I am also participating in a competition on educational innovations, organized by UNITEN, Malaysia.

I have renewed hopes that health professions education, predominantly through online education as outlined in one of the papers I had published in the pre-COVID-19 era, is no longer a dream, but has an opportunity to become a reality in the post-COVID era, with the lessons learned during the COVID-19 era!
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Z. Zayapragassarazan
Z. Zayapragassarazan, M.Sc., M.Ed., PhD.
PSG-FAIMER Regional Institute 2015 Fellow
Convener, MCI Regional Centre
Advanced Trauma Life Support (ATLS®) Educator
Additional Professor and Head, Department of Medical Education
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)
Puducherry, India

The COVID-19 pandemic has offered me new experiences that can be reflected upon to gain further insights on how educational systems are undergoing transformation at various degrees and how these transformations would redefine medical education and health profession education in the near future.
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The lockdown which has been imposed to strictly implement social distancing to combat COVID-19 has threatened the right to education of students all over the world. This has forced educational institutions to shut down until further orders and have suddenly shifted to online teaching and assessment of their students. Institutions and individuals once skeptical towards online have resorted to online tools as an alternative to classroom teaching. This situation has forced all teachers and learners including the technologically challenged ones to start using different technological tools for their teaching and learning activities. Institutions have started exploring alternate ways for engaging their remote learners to keep them productive during the lockdown period. Teachers have actively started looking for alternate methods for assessing their students using valid and trustworthy tools. Teachers and educational administrators have started thinking about technological tools that can complement or substitute classroom teaching. Institutions have started conducting webinars to train their faculty in using digital tools. Implementation of online teaching has transformed the way students use their mobile phones and laptops and have suddenly become aware of educational apps and have started devoting dedicated screen time for their learning tasks.

Our institute (JIPMER) was successful in engaging our teachers and students to use Zoom, Canvas, and Google Classroom for online teaching and assessment activities. This lockdown has provided a doorstep opportunity for teachers to explore and experiment with various technologies for teaching, learning, and assessment purposes. Just three weeks before the lockdown we from the Department of Medical Education in JIPMER organized an in-house workshop on “Information and Communication Technologies (ICT) in Medical Education” providing hands-on experience on selected tools for online education. These encouraged our faculty to employ the technological tools comfortably and were able to cope up with this unprecedented educational crisis due to COVID-19.

The Department of Medical Education coordinated with the Dean (Academic) for successful implementation of online teaching, learning, and assessment activities. I utilized this opportunity to compile different strategies for engaging remote learners in the wake of COVID-19 and published a strategy document titled "COVID-19: Strategies for Engaging Remote Learners in Medical Education" in the F1000Research which can be accessed from

Though I am extremely happy to witness the role of technology in medical education in the current scenario of educational crisis, at the same time, I am also excited to know to what extent the educational responses by medical institutions to this COVID-19 has yielded the desired outcomes. It has increased my interest in knowing the effectiveness of these technological tools employed for teaching, learning, and assessing students in a professional course like MBBS, which is typically conducted as a formal face-to-face educational and training program all over the world.

It has invariably been a heated discussion in many of the faculty development programs about how difficult it is to change a system. In the present climate, I have understood systems ordinarily require a crisis to transform, i.e., necessity is the mother of invention. This has forced educators like me to think of newer perspectives in training the teachers of health profession education.

The education policy makers once apprehensive about allowing cell phones inside college campuses have now started feeling the presence of classrooms inside the cell phones. The lockdown is an opportunity to educational researchers to test how effective it would be if health profession courses are offered as distance education programs. Since most teachers and students have suddenly embraced this type of education, this gives us an opportunity to study the success factors behind remote learning. The apprehension regarding the validity and trustworthiness of unsupervised online tests has motivated me to prepare guidelines for unsupervised online tests. This COVID-19 pandemic has minimized the digital divide among teachers and students and a new beginning has started in the health profession education. Students and teachers have learned to use their mobile gadgets and computers purposefully for their teaching-learning activities. The current lockdown is only for physical spaces and physical contact and not for our minds. The techno pedagogical practices that emerge in response to COVID-19 may be investigated to identify the best educational practices. These best practices may then be recommended for implementation in medical and health profession education which, I believe, could transform the way we educate our future doctors and other health professionals.
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[last update: October 8, 2020]