An innovative internship approach during COVID-19

A year ago, Jenae Vancura joined an elite group of college and high school students for a unique and innovative summer internship program at CHOC Children’s. The interns shadowed physicians, joined doctors on their rounds and attended meetings with a wide range of professionals in the medical field.

The days were long. The work was challenging.

And Jenae, a 21-year-old biology major from UC Santa Barbara, is back again this year, now serving as a lead intern for the Sharon Disney Lund Medical Intelligence and Innovation Institute  (MI3) summer internship program. She now helps guide a new group of students through the rigorous program.

“But this year is a little different,” Jenae says.

Now in its eighth year, the internship has been effectively reimagined as a virtual program, a pivot quickly executed at the onset of the global coronavirus pandemic.

virtual MI3 internship meeting
Jenae participates in a virtual meeting as part of the MI3 internship.

The COVID-19 crisis emerged just as CHOC leaders and physicians were gearing up for this year’s internship program. That meant that the 63 participating students would not be able to work directly with hospital staff or go on rounds to interact with patients as in years past.

Cancelling not an option

While many internship programs have been halted worldwide due to COVID-19, canceling the MI3 internship was simply not an option, organizers say. The experience was much too valuable and too many young had worked too hard to get this far.

“Many of our interns look to our program to affirm and motivate their decision to apply to medical school,” says Debra Beauregard, director of MI3. “Nearly all of the interns aspire to become physicians.”

So, with just weeks to go, the decision was made to recalibrate the program and put the whole curriculum online.

“The easy thing would have been to postpone or cancel,” says Dr. Anthony Chang, CHOC’s chief intelligence and innovation officer who launched the program eight years ago. “We wanted to give the students the same level of opportunity. To their credit, the team stepped up and made the internship rotation on par with previous years.”

Dr. Chang started the internship because he wanted to give young people an in-depth experience of the medical field.

“I felt like no one was really doing something like this,” he says. “The students were staying with one mentor doing one assignment. That sounds like a research assignment, not an internship. I wanted to give them access to something that gave them access to a hundred mentors.”

A rigorous pace remains

Even though the pandemic has restricted access to the hospital, it hasn’t slowed the  interns’ pace. Their work schedule starts early and, with a few breaks between, doesn’t end until the evening.

“We set up a lot of Zoom meetings,” Debra says. “Our interns have a full schedule. They participated in rounds and shadowed our physicians virtually. They were even able to remotely view multiple surgeries. This was a challenge, but everyone pulled together to provide what turned out to be a great summer program.”

a virtual session as part of the MI3 internship program
MI3 interns participate in a Zoom meeting as part of their virtual internship.

Dr. Chang says that while the interns are receiving the same level of instruction, what’s missing are some of the personal interactions that come with face-to-face contact.

“Not having one-on-one time in person and not having more intimate moments in small groups is difficult for us,” he says. “For instance, in past years they’ve had one-day retreats where they come to my house for breakfast and lunch. I wasn’t able to do that this year.”

But that doesn’t mean there isn’t room for a little fun.

“Our directors and lead interns made sure that all interns felt connected,” Debra says. “We included team-building exercises, interactive small group sessions, and even a virtual graduation ceremony. The leads even organized a virtual talent show and Zoomie Awards, in addition to a competitive team competition. Our leads have gone above and beyond to ensure that our interns had a meaningful and memorable experience.“

Dr. Sharief Taraman, internship co-director and pediatric neurologist at CHOC, has been part of the program almost since it started. He’s confident that this year’s group is better off than students anywhere else.

“They’re way ahead of their peers in terms of experience and what they can get out of the summer,” he says. “We have a lot of moving parts, so we had to pivot very quickly.”

And to ensure the interns get all the experience they can, they are being invited back next year when they are hopefully able to receive hands-on work.

“We have offered guaranteed spots for our interns next year, so they can have an in-person experience,” Debra says. “We are confident that most will be coming back.”

Student gratitude abounds

The interns themselves are grateful for the chance to continue their internships during these difficult times.

“When I thought it wouldn’t happen, I got very upset,” says 20-year-old Julia Keating from the Massachusetts College of Pharmacy and Health Sciences University. “It’s such a competitive internship.”

For Jessica Octavio, a 20-year old San Diego State student majoring in microbiology, going online was positive experience.

‘’We’re lucky,” she says. “They’ve been more than flexible. The biggest thing was learning this online interface, but as far as programming goes, it’s almost advantageous for us.”

While working on site would have been ideal, Luke Arnold says he appreciates all the work the health system staff have put into making this year’s program a success.

“It’s not ideal and obviously we’d like to have this in person,” says the 21-year-old biology major from Chapman University. “But being in quarantine has given us opportunities to work in group settings. We’re all in this together.”

For intern Nicole Fraga, working from home has had some surprising benefits.

“It can be a very rigorous process,” says the 22-year-old recent graduate from Brown University. “But ironically, I think they’re getting closer to the interns online because we are meeting in small groups. We are able to communicate on Slack and share memes. We have a smaller community.”

Dr. Chang calls the internship a “circular experience.” The health system staff, he says, learn as much from the students as the students do from the physicians.

“We’re grateful that the interns are even more inspired to go into medicine despite the pandemic,” he says. “It’s very heartwarming to hear. The future of medicine is in good hands. I see the interns push back against the temptation to give up. They have the idealism and no fear of failure.”

Learn more about CHOC's MI3 internship

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  • CHOC Patient Inspired to Become CHOC Doc
    At 6 years old, Vanessa Avina was more interested in viewing the monitor for her echocardiography (heart ultrasound) than watching a cartoon during her doctor’s visits. Her CHOC pediatric cardiologist ...

CHOC Patient Inspired to Become CHOC Doc

Vanessa Avina, with her father and Dr. Chang.
Vanessa Avina, center, with her father and Dr. Chang.

At 6 years old, Vanessa Avina was more interested in viewing the monitor for her echocardiography (heart ultrasound) than watching a cartoon during her doctor’s visits. Her CHOC pediatric cardiologist Dr. Anthony Chang recognized her curiosity and through the years nurtured her interest in the field of medicine. When Vanessa was 17, Dr. Chang encouraged her to participate in the hospital’s Sharon Disney Lund Medical Intelligence and Innovations Institute’s (MI3) internship program. Vanessa jumped at the chance and is now—two years later—majoring in pre-med biology at California State University, San Bernardino.

The MI3 internship program is designed to offer the brightest high school and college students in Southern California with meaningful experiences in medicine. Interns have the opportunity to shadow CHOC physicians as they conduct rounds in the hospital and see patients in the clinics. They research and present exciting topics related to the future of pediatric medicine, and attend special field trips, including this year meeting Dr. Eric Topol. A practicing cardiologist, professor of genomics and director of the Scripps Translational Science Institute in La Jolla, Dr. Topol is one of the top 10 most-cited researchers in medicine. His special interest is digital innovative technologies designed to reshape the future of medicine.

Vanessa particularly enjoyed meeting Dr. Topol and learning how he focuses on the most important development in health care today – putting the patients at the center of everything clinicians do. She’s quick to point out that her mentor, Dr. Chang, and the other CHOC physicians she has met share that viewpoint.

“It’s clear that CHOC physicians put patients and families first, and partner with them to advance treatment and care.   I experienced that as a patient and I have witnessed that time and again throughout my internship,” said Vanessa.

While Vanessa isn’t quite sure what field of medicine she wants to pursue, her experience with CHOC has solidified her interest in pediatrics. “I’ve learned so much from so many CHOC subspecialists.  They’ve truly sparked my interest in so many different specialties, from infectious diseases to oncology. They’ve especially inspired me to continue to realize my dream of practicing pediatric medicine, bringing hope to children and their families,” explained Vanessa.

A college sophomore, Vanessa knows she has a long road ahead of her, including medical school, residency and fellowship. But the 19-year-old, who will be the first in her family to graduate from college, is determined to become the kind of physician her mentor, Dr. Chang, would want her to be.

“Dr. Chang is an incredible doctor. He’s so smart and innovative. He also has an amazing bedside manner. He has been such an inspiration to me, motivating me to continue on with my dream of working at CHOC,” said Vanessa.

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