Evolving Otolaryngology Resident Roles and Concerns at the Peak of the US COVID‐19 Pandemic

Abstract

Background: The roles of US otolaryngology residents have changed in response to the coronavirus disease 2019 (COVID-19) pandemic. As the pandemic peaked in the United States, we characterized resident activities and concerns. Methods: A cross-sectional study of US otolaryngology residents between April 20, 2020 and May 2, 2020. Results: A total of 219 residents at 65/118 (55%) institutions responded. Thirty (14%) residents had been redeployed. Residents reported greatest concerns regarding education (P < .00001). Assuming adequate protective equipment, 55% desired active participation in high-risk procedures on COVID-19-positive patients. Redeployed residents had greater concern for burnout and reduced in-hospital well-being (P < .05). Resident satisfaction correlated with comfort communicating concerns to their department (odds ratio [OR] = 4.9, 95% confidence interval [CI] 1.4-17.3, P = .01) and inversely correlated with low perceived meaning in work (OR = 3.1, CI 1.1-9.1, P = .03). Conclusion: Otolaryngology resident concerns have evolved as the pandemic progressed. Residency programs should prioritize resident education, wellbeing in redeployed residents, and open communication as they transition toward recovery.

Burnout Assessment Among Surgeons and Surgical Trainees During the COVID-19 Pandemic: A Systematic Review

“…Among the 29 included studies conducted between April 2020 and December 2021, most were published in 2020 (n=16, 55.2%), 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 whereas the remaining papers (n=13, 44.8%) were published in 2021. 4 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 The majority of studies utilized cross-sectional, quantitative methods (n=27), 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 with only a small minority being qualitative (n=2). 4 , 34 The sample size varied widely across studies, ranging from 24 to 2,040 for quantitative studies and from 16 to 870 for qualitative studies.…”

“… 4 , 34 The sample size varied widely across studies, ranging from 24 to 2,040 for quantitative studies and from 16 to 870 for qualitative studies. Most of the studies were about the healthcare system in the United States (n=17), 19 , 21 , 22 , 26 , 27 , 28 , 29 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 42 , 43 while the remaining reports were from Singapore (n=3), 20 , 24 , 25 Egypt (n=2), 18 ,40 the United Kingdom (n=1),4 France (n=1), 44 Brazil (n=1), 24 Pakistan (n=1), 23 the Netherlands (n=1), 45 Romania (n=1) 31 and the Czech Republic (n=1). 41 Almost all studies included surgical trainees (residents, fellows) as part of the studied population (28 studies, 96.6%).…”

“…Rates of burnout measured using the investigator created assessment tools varied widely, ranging from 12.7% to 68.0%. 4 , 18 , 19 , 26 , 32 , 34 , 35 , 41 Chou et. al.…”

“… 19 , 20 , 27 , 29 , 30 , 34 , 37 , 39 , 40 Additionally, redeployment to COVID-19 wards, an increased workload and limited availability of personal protective equipment were cited by 4 studies each (13.8%). 18 , 22 , 25 , 26 , 29 , 30 , 34 , 41 , 42 , 45 These and other professional factors associated with higher burnout rates are noted in Table 3 . The qualitative themes highlighted by Abdelsattar et al and Al-Ghunaim et al echoed these results.…”

“…Eleven out of 29 (38.0%) articles mentioned a marked reduction in the elective and emergent operative cases. 4 , 18 , 19 , 20 , 23 , 26 , 29 , 32 , 34 , 39 , 45 The decrease in surgical case volume became a matter of great concern for the residents ( Figure 2 and Figure 3 ).19 While surgical personnel were redeployed (4 studies, 13.8%) 18 , 20 , 26 , 45 to other areas of COVID-19 care within the hospitals, hands-on experience (4 studies, 13.8%) 4 , 18 , 23 , 45 was also felt to be compromised. Furthermore, 3 out of 29 studies (10.3%) highlighted that the residents in their program were worried about not fulfilling the minimum requirements for Accreditation Council for Graduate Medical Education (ACGME) certification.…”