Christopher Johnson picked his path mid-way through high school. The 26-year-old from Dothan had always been a smart kid and decided to put that to use helping patients after he shadowed a couple doctors in town.

After finishing the pre-med curriculum at Auburn University, he applied to the University of Alabama at Birmingham School of Medicine. He marched through the milestones: the white coat ceremony that marks the beginning of medical school, the classes and exams.

Johnson picked a specialty, family medicine, that would allow him to concentrate on treating athletes. Like a lot of medical students, he kept an eye on the coronavirus as it swept across the globe earlier this year. But it didn’t hit home until mid-March, when UAB cancelled its March 20 Match Day ceremony – the NFL draft of med school, when young doctors learn which medical system picked them for specialty training.

“Our match week has historically been filled with a lot of fun activities that we all do together, followed by a big ceremony,” Johnson said. “But we didn’t have any of it.”

The disappointment of missing the ceremony quickly gave way to the gravity of the situation.

“At that point, I had the chance to reflect and think, this is why we got into this field,” Johnson said. “I thought, ‘This is about to be us. We are about to be on the front lines of this.’”

As patients with COVID-19 flood hospitals around the world, doctors and other medical workers find themselves in mortal peril. Exposed over and over to the dangerous virus, many have fallen ill and some have died.

And almost no one spends as much time at hospitals as medical residents, doctors-in-training who work notoriously long shifts. It’s not unusual for doctors-in-training to work 24 hours straight, up to 80 hours a week, caring for patients.

Emergency licensing

Some of Johnson’s classmates are headed to places already gutted by coronavirus. Ricky Seeber, 25, matched to a hospital in Massachusetts, which has about 6,000 confirmed cases of coronavirus. Hundreds of hospital workers there have contracted the illness. Medical centers have struggled with staffing as the tide of patients continues to rise.

Seeber unexpectedly received an application for an emergency Massachusetts medical license late last week.

“It was a two-page form that will give me expedited licensing,” Seeber said.

Ricky Seeber is heading to a residency in Massachusetts, where hospitals have been hit hard by coronavirus

In Massachusetts, New York and California, officials have rolled out programs that would allow graduating medical students to start work early at hard-hit hospitals. Italy did the same thing in mid-March, moving students into the workforce months earlier than originally planned. Alabama officials have not announced any plans to follow suit.

So far, his residency program has not announced any changes in the start date. Seeber plans to move to Massachusetts in June and start his residency later that month, unless he hears otherwise.

Seeber said he understands the risks but isn’t afraid. He finished his clinical education in February and has been watching from the sidelines as doctors care for critically ill patients.

“There is a part of me that is excited to be joining the fight,” he said.

“Anybody who’s been paying attention is scared"

Felicia Hataway will stay in Birmingham for her residency. She had another career before medical school as a laboratory scientist and was still on clinical rotations in March when medical school officials decided to pull students out of hospitals and clinics.

Hataway has a husband and kids at home. She worries about them and about her own health. She suffers from asthma and worried about her exposure as the virus spread across the United States. In Alabama, UAB Hospital has absorbed the brunt of the impact, with dozens of patients with either presumed or confirmed cases.

Felicia Hataway is graduating medical school in 2020, right into a pandemic

“Anybody who’s been paying attention is scared and should be scared,” Hataway said. “My first year is internal medicine and I will be in the clinic working with patients. I think it is extremely possible that when I start, I could get sick.”

For Wilson Ricketts, the virus has put up practical barriers too. His move to Southern California for a residency at UCLA has been complicated by a statewide shelter-in-place order that makes it difficult to find a place to live.

His father has also threatened not to allow his mother to help him move. Los Angeles County had almost 2,500 coronavirus cases Tuesday with 44 deaths.

Wilson Ricketts is graduating from medical school this year

Ricketts said his feeling about the crisis are complicated. He’s scared, but also eager to help where it’s needed most.

“It feels very grave and sobering to be starting your training during a pandemic," said Ricketts, "but it also sort of underscores the immense privilege of being a physician.”

Class of 2020

Residencies don’t typically begin until late June, but Dr. Craig Hoesley, UAB’s senior associate dean for medical education, said students have already gotten involved where they can. Dozens have volunteered to man the phone lines that screen patients for coronavirus testing.

The group donated money raised for canceled Match Week activities to a fund supporting Christ Health Center in Woodlawn, which is offering a clinic dedicated to COVID-19 patients.

So far, Hoesley said he has not heard from any students saying they are rethinking a career in medicine.

“If anything, I think it’s kind of reinforced their desire to become physicians,” Hoesley said.

The class of 2020 found quieter ways to celebrate the end of medical school. For Hataway, it was a video chat with an old friend and a weekend away with her husband – the last for a very long time. Ricketts celebrated over steak with his family. Seeber gathered with some friends, and one of them put the results of each match in an envelope so they could open it, similar to a traditional Match Day ceremony. Johnson and his wife had breakfast out in the front lawn with other medical students as they shared their results with each other.

Seeber said the thing he missed most was celebrating his classmates’ accomplishments – the biggest achievement most have earned in almost a decade of schooling.

“But ultimately, that’s not what we go to medical school for,” Seeber said. “That’s not what it’s about.”

Hoesley said he anticipates this crisis will forever shape the paths of medical students studying in the time of coronavirus.

“I’m an infectious disease doctor myself,” Hoesley said. “I don’t know how you can live through this time and not develop an interest in infectious disease and epidemiology. It’s fascinating what is happening, just watching this invisible pathogen and the reign of terror it can have not just on people but also on communities.”