摘要：
Background: The Covid-19 pandemic has created significant challenges for medical student education. Many if not most medical schools have placed significant limitations on direct patient contact by medical students which may persist indefinitely. Novel approaches are required to provide students with clinical experience. In response to this need, a case-based fourth year medical student (M4) elective was developed. Description of elective: In the first five offerings of the elective, two to nine M4 students enrolled. M4 electives are scheduled to begin on Mondays. On the first Monday morning, following a brief orientation, a lecture on aspects of the physical examination relevant to Hematology (such as physical findings of anemia, polycythemia, thrombocytopenia, lymph node examination, and spleen palpation) was presented using the Zoom application. Otherwise, the structure of Monday-Thursday sessions were identical. Each morning by 730 AM, students received an email containing a brief PowerPoint representing the information that was known to the Hematology attending at the time of initial clinic or inpatient referral. All identifiers were removed from the PowerPoint. All cases represented patients actually followed by the elective's faculty member (RTM). Students were expected to research the case and be prepared with additional history questions and additional laboratory tests. For tests requested, students were expected to have a plan for follow-up testing based on the different possible results. Students were also expected to have a differential diagnosis and, where appropriate, a proposal about whether treatment was indicated. At 1PM each day, students and the faculty member assembled on Zoom. After class discussion of the patient's presentation, diagnostic evaluation, and differential diagnosis. Images of blood and bone marrow were provide when appropriate. This segued into a discussion of the natural history, pathophysiology, and treatment of the patient's cli
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