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China formally established a system of national standardized medical residency training in 2014, which affects the health of its 1.4 billion people. Accompanying this system were new guidelines and standards for internal medicine residency training. However, the majority of the standards focused on process measurements, such as minimum case requirements of diseases and procedural skills, rather than describing broader physician competencies in the domains of professionalism, patient care, communication, teamwork, quality improvement, and scholarship. While China has taken a large step forward with standardization of certain aspects of internal medicine residency training, the next step should focus on outcome measures and creating a system that is competency-based.

A medical school in China engaged in reform in 2009 by adapting the medical curriculum of the University of Chicago, USA. Freshmen volunteered for the reform and 50 were randomly selected while the rest remained in the traditional curriculum. In 2014 a study was conducted to determine whether the views of traditional and reform curriculum students on their respective educational experience differed and to identify reform areas that needed improvement. A survey was administered to graduating students to gauge their views on basic science and clinical science education, clerkships, general medical education, and readiness for residency training. Frequency distributions, Mann-Whitney U tests, and Chi-squared tests were used for analysis. Reform curriculum students were more positive about their basic science and clinical science instruction. Clerkships were only somewhat satisfactory to students in both curricula. Reform curriculum students were more likely than those following the traditional curriculum to consider instruction in clinical decision-making and patient care as ‘adequate’. Instruction in population health was considered inadequate by the majority of students. Reform curriculum students were more confident about their preparedness for residency. The traditional curriculum was in need of reform. Reform has been effectively implemented and has increased student confidence and satisfaction with their education although there is room for improvement.

During the early months of the COVID-19 pandemic, when health systems were overwhelmed with surging hospitalizations and a novel virus, many ambulatory patients diagnosed with COVID-19 lacked guidance and support as they convalesced at home. This case report offers insight into the implementation of a telehealth service utilizing third- and fourth-year medical students to provide follow-up to ambulatory patients diagnosed with COVID-19. The service was evaluated using medical student surveys and retrospective chart review to assess the clinical and social needs of patients during the spring of 2020. Students assessed symptoms for 416 patients with COVID-19 from April 8 to May 20 and provided clinical information and resources. Eighteen percent of these patients sought higher levels of medical care, in part from student referrals. Three key implementation lessons from this experience that may be relevant for others include: 1) Vulnerable patient populations face unique stressors exacerbated by the pandemic and may benefit from intensive follow-up after COVID-19 diagnosis to address both medical and social needs; 2) Medical students can play value-added roles in providing patient education to prevent the spread of COVID-19, assisting patients with escalating care or resource connection, and providing emotional support to those who have lost loved ones; 3) Continuous re-assessment of the intervention was important to address evolving patient needs during the COVID-19 outbreak. Future work should focus on identifying high-risk patient populations and tailoring follow-up interventions to meet the unique needs of these patient populations.