This study aims to assess the symptoms of burnout, depression, and anxiety in Brazilian medical residents during the COVID-19 pandemic and to compare residents' beliefs and clinical practices related to COVID-19 patients among all six years of medical residency training in Brazil. METHODS: A quantitative study was conducted in April 2020 with a convenience sample of medical resident volunteers from an anonymous online survey. This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, the Patient Health Questionnaire (PHQ-9) to measure depression, and the General Anxiety Disorders (GAD-7) to measure generalized anxiety disorder. This study also developed a COVID-19 Impact Questionnaire (CIQ-19) to assess the residents' beliefs and clinical practices related to COVID-19 patients. RESULTS: Our sample comprised 3071 respondents. Depressive symptoms were the most common among second-year residents (70.5%), followed by anxiety symptoms (56.0%) and burnout (55.2%) among fourth-year residents. We also observed burnout symptoms (55.1%) among second-year residents. CONCLUSION: The COVID-19 pandemic increased the risk of mental illnesses in some years of residency. Our study could not conclude the reasons why the incidence varies among levels of physician training. Final year medical residents have avoided seeing COVID-19 patients.

In December 2019, a new disease caused by the virus SARS-CoV-2, popularly called coronavirus disease 2019 (COVID-19), was identified in Wuhan, China. This disease has high infectivity and transmissibility rates, with a reproductive number greater than one. 1 Since then, as stated by the World Health Organization (WHO),

Purpose Medical residents’ mental health is currently an issue of concern for medical educators worldwide. The COVID-19 pandemic has raised the greatest concerns given the psychological effects of this scenario on medical residents on the frontlines of the pandemic. To assess the psychological impact of the COVID-19 pandemic on physicians in residency training, the collective symptoms of burnout, depression and anxiety are used to identify the residents’ beliefs and clinical practices related to COVID-19 patients and their behaviors concerning disease prevention. Method This observational study involved 3071 medical residents from all regions of Brazil. An online questionnaire assessed the presence of burnout using the Oldenburg Burnout Inventory, depressive symptoms using the Patient Health Questionaire-9, anxiety symptoms using the Generalized Anxiety Disorder-7, and COVID-19 Impact Questions to assess the residents’ beliefs and clinical practices related to COVID-19 patients. Exploratory analyses, logistic regression and multinomial regression analysis were performed in this investigation. Results Moderate and severe depressive symptoms were the most common (67.7%) followed by anxiety symptoms (52.8%) and burnout (48.6%). The difference between residents with or without contact with COVID-19 patients was significant increased when analyzing different aspects of clinical practice, behavior, substance use and mental health. Conclusions These results suggest an increase in depression and anxiety symptoms among medical residents dealing with COVID-19, upstaging previous concerns about medical residents’ mental health. The prevalence of burnout is similar to that of a nonpandemic scenario. Considering the severity of the pandemic scenario and the overburden of healthcare services, medical residents’ mental health deserves special care.

Introduction: Emergency medicine is a relatively new medical specialty in Brazil, approved just in 2016. Residency training programs have been implemented ever since. The emergency environment is known to represent a death-and-life tension on the professional team, culminating with high rates of mental illness in this population. The Covid-19 pandemic seems to be affecting these rates of depression, anxiety, and burnout in health professionals. Objective: To assess the symptoms of burnout, depression, and anxiety in Brazilian medical residents of Emergency Medicine during the Covid-19 pandemic and compare the residents’ beliefs regarding clinical practice related to Covid-19 patients. Methods: A quantitative study was conducted with a convenience sample of volunteer medical residents from an anonymous online survey, available during April 2020. This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout; the Patient Health Questionnaire (PHQ-9) to measure depression; and the General Anxiety Disorders (GAD-7) to measure generalized anxiety disorder. This study also developed a Covid-19 Impact Questionnaire (CIQ-19) to assess the residents’ beliefs and clinical practices related to Covid-19 patients. Results: The survey consisted of 63 respondents, about 26,35% of emergency medicine residents in Brazil. Only 39.6% residents felt safe while working with Covid-19 patients. Mild depressive symptoms were found in 68.2% of the residents, followed by anxiety symptoms in 50.7% and burnout in 54.0% overall. About 12% of the residents do nothing about their mental health status, while some prefer to talk with family or friends (36.1%) and discuss with their team support (24.3%) when they need mental health care. Conclusion: Emergency medicine residents have high rates of mental illness and it could get worse when submitted to stressful and unknown situations, such as the Covid-19 pandemic. Initiatives should be made to improve these physicians’ mental health status. It is proposed that health institutions pay medical supervisors a closer and more unique look at physicians in training. A mentoring program proposal is an opportunity to reflect on technical and personal improvements for medical residents.

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Introdução: De acordo com a Resolução nº 3, de 2014, que institui as Diretrizes Curriculares Nacionais (DCN) do Curso de Graduação em Medicina, o(a) graduando(a) em Medicina deve ter formação geral, humanista, crítica, reflexiva e ética, com capacidade para atuar nos diferentes níveis de atenção à saúde, dentre estes, a prevenção. A investigação diagnóstica deve ser realizada com base nas melhores evidências científicas e conforme as necessidades da pessoa. Nesse sentido, a prevenção quaternária e seus princípios têm relação com os objetivos da DCN. Objetivos: Realizar a intersecção a partir de periódicos científicos brasileiros entre a prevenção quaternária e o ensino médico após a implantação da DCN de 2014. Métodos: Revisão integrativa dos artigos disponíveis nas plataformas da CAPES, Scielo, PubMed e Google Acadêmico, a partir do ano de 2014 até outubro de 2017, por meio das palavras chave “prevenção quaternária” e “educação”. Critérios de exclusão: artigos patrocinados por indústrias farmacêuticas, indisponíveis na íntegra, sem resumo e estrangeiros. Resultados: Foram encontrados 33 documentos e 9 artigos selecionados para análise, voltados principalmente para a prática da prevenção quaternária. Apenas 3 estudos fazem alusão à educação médica. Conclusão: A prevenção quaternária é um tema de grande relevância na prática médica, entretanto, ainda é deficiente na graduação, baseado nas restritas produções disponíveis. Apesar da nova DCN do curso de medicina, o ensino médico no cenário atual é predominantemente voltado para especialidades, dificultando a atuação integral e centrada na pessoa.