Ali Jandal was the student speaker for the medical school graduation at UW-Madison.(Photo: Courtesy of Ali Jandal)

As he approached graduation and a move to the University of Vermont for the start of his career in medicine, Ali Jandal acknowledged that he was afraid.

"How I feel about it changesday by day," said Jandal, who is from La Crosse."I think I've always been a little scared, because viruses are easy to spread and it's really hard to keep yourself safe from them."

In their final weeks of medical school at the University of Wisconsin-Madison, Jandal and his peers had seen the world turned upside down.

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"I want to argue that the end of our medical school careers is poetic," Jandal said in an addressduring the school's virtual graduation. "And if any class was made for this challenge, it was us."

They were the first to navigate the medical program's new curriculum. They spent the last weeks of school at home, as thedoctors they knewfoughtCOVID-19 on the front lines. They celebrated Match Day the day they learn where they'll work their residencies and graduation from behind computer screens.

Now, they'll put their training to use.Working ininternal medicine, Jandalexpectsto see COVID-19 patients who aren't sick enough to be in an intensive care unit boththose who are getting better and those who mayget worse.

He'll be joined by the Class of 2020's newly-minted nurses, public health professionals and other health care workers as he wadesinto largelyuncharted territory. He knows that work comes with risk.

"I think the scariest part is I haven't actually worked with these people in the hospital yet. I haven't seen the people around me get sick," he said."To go from being a citizen, civilian, to being a front line workeris going to be dramatic and scary."

University of Wisconsin School of Medicine and Public Health Dean Robert Golden participates in the school's first virtual graduation ceremony held during the COVID-19 pandemic.(Photo: Todd Brown, Courtesy of UWMadison)

Wisconsin graduates of medicine, nursing and public healthsaid they're ready to get to work. They've been reading up on everything they can about an unpredictable disease.

The Class of 2020s educational experience has been capped by a global public health and medical crisis unlike any other we have experienced in the past 100 years," Robert Golden, dean of UW-Madison's school of medicine and public health, told medical school graduates.

Brianna Stankey, a senior nursing student at Alverno College, has yet to graduate, butshe's already hard at work.

When her school moved online and her clinical at Froedtert Hospital was canceled, Stankey, 22, started working full time in her training programas a certified nursing assistantat a local hospital, working primarily with cancer patients.

She plans to stay on as a nurse after graduation. Stankey, ofTrempealeau, has applied to work as a "grad nurse," working ona temporary permit that would allow her to work before she passes herlicensing exam. She'll stay in the same cancer unit.

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"I'm excited. I feel like there is no better time for me to get into this profession and to be working with these people," Stankey said. "It's hard being a new nurse because I don't know everything ... but it's exciting in the sense that I'm able to jump in and I'm able to help now."

It's also a bit scary, she said, and her life has changed significantly.Instead of kissing her boyfriendas she walks through the door, she runs straight tothe shower.

Work has changed, too. A mask hides the smiles she once loved to share withher patients and co-workers. Her patients arrive for treatments alone. She tries to take more time to sit with them and talk, knowing there's more to nursing than caring for people's physical needs.

"I can't imagine being a patient right now, and being at the hospital alone," she said.

There is an understandable fear in coming to the hospital during a pandemic,John Kopriva, a UW-Madison medical school graduate, said. Hospitals will need to work to reassure patients that they can seek treatment safely.

John Kopriva, center in cap and gown, is graduating from UW-Madisons medical school as an MD. At home with his family in Wauwatosa, they will be watching the graduation speeches on a laptop on the kitchen island while having brunch and celebrating the event. From left to right are his girlfriend Hailey Rowen, mother Angela, graduate John, father John, brother Joe, sister Katherine and brother David.(Photo: Michael Sears / Milwaukee Journal Sentinel)

This is true for the patients Kopriva anticipates seeing in orthopedic surgery at Emory University in Atlanta this summer. He expects he'll be busy with the backlog of elective surgeries postponed early in the outbreak. He knows there's a chance he'll run into COVID-19 as well, especially if there's a localsurge in cases.

"I think it's something that's going to define the time that I graduated," Kopriva said. "Hopefully when I'm an older attendingand looking back and giving advice to a younger medical student, I can tell them that 'Hey, that was the time when COVID was a problem. Look at all we've done since.' "

For recent graduateswho hope to find work in other areas less touched bythe pandemic response, the search is proving to be tough.

Kelly Hackett, ofWaukesha, graduated from UW-Madison with her master's degree in public health. But she's still struggling to find work formonths amid hiring freezes.

"I keep saying it's like I'm in a fragmented reality where everything around me all the news, social media, friends, family people are constantly talking about public health, whether or not they realize they're talking about public health," said Hackett.

"And yet, I'm looking at not having a job at the end of this, at a time when public health is critical."

Kelly Hackett and her family celebrate her graduation from UW-Madison.(Photo: Courtesy of Kelly Hackett)

She's still applying to jobs and interviewingwithin her expertise, which includes researchingsocial causes of health disparities factors that experts say have allowed the pandemic to affect some communities worse than others.

Ajay Sethi, an associate professor of population health sciences, said he's seen his students adapt and answer the call to help however they can.

"There is this national call to address this pandemic and public health departments everywhere are thinking of how to scale up contact tracing," Sethi said."And our students, even if they have otherinterests, many of them are eager to do that, just to answer that call."

Hackett acknowledgescontact tracing is not off the table.

"If contact tracing is what's needed and it's what is available, at least it's work and it's a way that Ican contribute," she said.

Geoffrey Watters, 50, earned his doctorate in nursing practice from UW-Madison this spring. He's feeling confident about job prospects, but others in his specialty ofpsychiatric nursingare struggling, especially in outpatient care. One of his classmates got a job, only to lose it when her employerfolded.

"There's a lot of uncertainty," Watters, of Milwaukee,said."It seems counter-intuitive that health care workers would be losing their jobs in the middle of a pandemic, but it's happening."

It shows how medical careextends beyondemergency rooms and ICUs, even in a pandemic.Mental health care remainsimportant for patients and health care providers alike, Watters said.

"Everyone is under a lot of stress and especially people who work in health care," he said.

Like so many members of the Class of 2020, there is a disappointment that comes with missing major milestones in theirfinal semesters. As is true forso many, the pandemic has exacted a personal toll.

For Stankey, missing out on the chance to celebrate the end of her senior year wasparticularly painful. Her undergraduate career was not without struggle: She spent most of it working two to three jobs to pay for school. She lost loved ones, including herfather. But she also made lifelong friends, who she's now separated from.

"As things were getting canceled, I was just whiting them out in my planner, like this is just so sad," she said. "I'm not getting that closure, of being done with school."

Jandal's wedding plans were canceled.He and his fiancee, also a new physician, will now marry in a small ceremony before they move to Vermont to start their residencies.

Hackett's father-in-lawdied the day before her graduation. He tested negative forCOVID-19. But thepandemic meant they had been unable to visit in recent weeks.

Still, each acknowledged the need for everyone to do their part to protect thosemost vulnerable to the virus.

"As talented and as smart and as many resources as you have, in a public health emergency, if you still have people who aren't convinced and won't be a part of the effort, the entire effort could fall apart," Jandal said.

Contact Devi Shastri at 414-224-2193 or DAShastri@jrn.com. Follow her on Twitter at @DeviShastri.

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