This week, the American Association of Medical Colleges released guidelines for medical students who are volunteering in the wake of the Covid-19 pandemic. The association was careful to note that the guidelines did not take the place of any directives from an academic medical centre, but made special note that students should not be working in medical facilities at this time.

"Many of our students live in areas where restrictive local or state directives are in place," the guidance document stated. "Our medical students can best contribute to their local and state efforts by fully complying with these restrictive directives. This way, they are help flatten the curve by avoiding getting infected themselves and serving as role models and educators for their families, friends, and communities."

The guidelines also said that medical schools were working on ways to include students in "non-direct patient-contact activities," and that this should be the course of action unless there are unique needs.

"Our AAMC guidance continues to strongly support that unless there is a critical health care workforce need locally, medical students should not be involved in any direct patient care activities," the guidelines stated.

Harry Cheung, 25, is a second-year student at Yale School of Medicine. He is a clerkship student, which means he temporarily works on all of the major rotations, which are different specialities at a hospital or clinical setting. The school asked students to stop attending their clinical rotations for their safety and to preserve protective equipment, which is in limited supply. The students help in other ways.

"Some students in my class have been really proactive and awesome about organising ways for students to help out with tele-health," Mr Cheung said. "So, one thing we're doing is calling up patients since a lot of outpatient providers had to cancel their appointments because of the pandemic, and because it's unsafe for patients to come in."

Many medical students at Yale School of Medicine call patients, who have cancelled appointments, to ask if anything feels urgent, about prescription refills, or symptoms. Mr Cheung also said that some medical students, after 14 days of self-isolation, have offered to help in the food pantry and that some offered to provide childcare for healthcare workers with children who no longer have access to daycare. He is currently helping with research on cases in Connecticut, which is a study that is rapidly changing.

Robertha Barnes, 27, a first-year student a State University of New York Medical School, is aspiring to be an infectious disease doctor and is now taking her courses virtually because of the pandemic. She said she wishes she was qualified to help.

"My biggest regret during this time is that I am not qualified to help out yet," said Ms Barnes. "I still have to create a bubble around me to pass my exams because I won't be able to make the influence I want to in the future if I don't become a doctor."

The continued anxiety over exams, which are a large part of most medical school curricula, was expressed by another State University of New York Medical School student. Arnav Rana, 25, is an MD/PhD student in his second year. He said that at his school, second-year studies consist of studying for STEP 1, which is a licensing exam, from March until May. Students often work independently, but he said that he feels much more isolated because many of the school buildings closed, and everyone is physically distancing themselves from others.

"There's a feeling of uncertainty," Mr Rana said. "A lot of second-year students are finding it difficult to sit down and study for this test when they're not certain when they'll be taking it. You know, for example, Prometric is the company that administers the test, and they closed all their testing centres until April 15."

Mr Rana said many of the students he know are taking the test in early may but that people are wondering if the closure will continue in these ever-changing times. His PhD focus is in biochemistry, and he focuses on the heart and how mitochondria functions, but the state of the world has sparked some new possibilities.

"This virus is kind of making me wonder if my efforts would be better served in an infectious disease lab," said Mr Rana.

Mr Rana also said that physically distancing from others is also a service because it "flattens the curve," a term that refers to slowing the spread of the virus so that healthcare providers are not overwhelmed.

Sydney Russell Leed, 26, a third-year student at a school in upstate New York, said that medical students in her year are helping with a Covid-19 helpline. She said that most people working on the hotline are registered nurses, and she's worried that medical student volunteers will take shifts that could go to nurses who need to work remotely for income.

Ms Leed's clinical rotations have been replaced by interactive video learning. She said that she's a little disappointed that there will be no clinical surgery rotation because she's not going into a surgical speciality and won't have another opportunity to be in an operating room.

"But it's the ethical thing to do to stay out of the hospital," Ms Leed said.

Orly Naddell Farber, a student at Stanford University School of Medicine, wrote an opinion editorial for Stat News on March 14.

"There's no online substitute for learning direct patient care; sending students home would likely halt their education," said Ms Farber. "It could even delay graduating an entire class of new physicians, since students work on tight timelines to finish all the requirements necessary to become doctors."

Basia Giannakakos, 26, is a third-year student at State University of New York Medical School and said that many of her fellow students are eager to help. Some, she said, have expressed that they would love to work on the frontlines in roles different than a typical medical school curriculum, like as a nurse's assistant. However, she expressed that her fellow students also understand that, as medical students, they need supervision. In a health crisis, supervising could take up healthcare workers' attention, limiting capacity. Instead, the students are looking for other ways to help.

Ms Giannakakos said students in her year are helping with a blood drive and at a diabetes clinic, checking blood sugar levels, to help with other aspects of healthcare during the pandemic. Many students are also helping with State University of New York's Covid-19 hotline, set up on March 8, which helps field questions from patients who are worried about symptoms.

"We feel like we want to be useful, and we're almost there, but it's really just too early in our career to really be independent and be able to help independently," Ms Giannakakos. "So, this is like one of the best ways that we can help because at this point in our career we know how to talk to other people. We have learned a lot about that."

For now, students can't help in hospitals. Last Tuesday, the American Association of Medical Colleges released a directive on medical students' clinical participation.

"Starting immediately, the AAMC strongly supports our member medical schools in placing, at minimum, a two-week suspension on their medical students’ participation in any activities that involve patient contact," the directive stated.

The purpose for this, as outlined in the released statement, was to allow medical schools a two-week gap to develop programmes to educate their students to return to clinical rotations, a plan that may change as news of the pandemic progresses. The programmes would include information on Covid-19, and steps to ensure their own safety and the safety of their patients.

Another reason for the two-week suspension was to conserve personal protective equipment like N95 respirator masks, which the CDC recommends now only using when in direct contact with fluids from an infected patient. According to the New England Journal of Medicine, this means risking exposure if healthcare workers use other types of surgical masks that may not offer the same level of protection.

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Mr Cheung, the student at Yale Medical School, said that he feels that his school's administration is doing the best they can in terms of communication, especially in these challenging times.

"[The administration] understands that are kind of at a crossroads where we want to help out, but we don't really necessarily have the complete skill set or the ability to help in the ways we wish we could," said Mr Cheung. "I think they're pretty active about helping us stay engaged."