Medicine and surgery residents’ perspectives on the impact of COVID-19 on graduate medical education

Abstract

The COVID-19 crisis has had an unprecedented impact on resident education and well-being: social distancing guidelines have limited patient volumes and forced virtual learning, while personal protective equipment (PPE) shortages, school/daycare closures, and visa restrictions have served as additional stressors. Our study aimed to analyze the effects of COVID-19 crisisrelated stressors on residents' professional and personal lives. In April 2020, we administered a survey to residents at a large academic hospital system in order to assess the impact of the pandemic on residency training after >6 weeks of a modified schedule. The primary outcome was to determine which factors or resident characteristics were related to stress during the pandemic. Our secondary goals were to examine which resident characteristics were related to survey responses. Data were analyzed with regression analyses. Ninety-six of 205 residents completed the survey (47% response rate). For our primary outcome, anxiety about PPE (P < 0.001), female gender (P = 0.03), and the interaction between female gender and anxiety about PPE (P = 0.04) were significantly related to increased stress during the COVID-19 pandemic. Secondary analyses suggested that medicine residents were more comfortable than surgical residents using telemedicine (P > 0.001). Additionally, compared to juniors, seniors believed that the pandemic was more disruptive, modified schedules were effective, and virtual meetings were less effective while virtual lectures were more effective (all P ≤ 0.05) Furthermore, the pandemic experience has allowed seniors in particular to feel more confident to lead in future health crises (P ≤ 0.05). Medicine and surgery residency programs should be cognizant of and closely monitor the effects of COVID-19 crisis-related factors on residents' stress and anxiety levels. Transparent communication, telemedicine, online lectures/meetings, procedure simulations, advocacy groups, and wellness resources may help to mitigate some of the challenges posed by the pandemic.

Rebuilding Graduate Medical Education After a Crisis: Perspectives of Medical Residents in the United Arab Emirates

“…There is a large and growing literature documenting the challenges faced by training programs, including cancellation of elective procedures, loss of clinical and operative experience, increased tele-medicine with less hands on clinical care, redeployment to non-specialty services, and rapid and complete transition to virtual learning. [3][4][5] Moreover, trainees describe significant stress and anxiety related to the pandemic's effects on their personal and professional lives. 3,6 A study of medical and surgical residents in a large urban academic center in the United States showed that 50% of the respondents thought that the COVID-19 pandemic had affected their medical experience negatively, but that their experience could be compensated in the future.…”

“…[3][4][5] Moreover, trainees describe significant stress and anxiety related to the pandemic's effects on their personal and professional lives. 3,6 A study of medical and surgical residents in a large urban academic center in the United States showed that 50% of the respondents thought that the COVID-19 pandemic had affected their medical experience negatively, but that their experience could be compensated in the future. 3 Academic medical centers have a responsibility to provide care to large surges of COVID-19 patients, whilst mitigating disruptions to education and ensuring resident safety and wellbeing.…”

“…9 To date, however, there is limited literature on the effectiveness of these interventions, and resident reactions to these contingency plans remains largely unknown. 3 As internal medicine residents serving on the frontlines of a COVID-19 designated government hospital in the United Arab Emirates, we also faced significant challenges and uncertainties during the pandemic. We have worked extra shifts and extended hours and provided care under highly stressful conditions for many months.…”

“Am I audible? Are my slides visible?” – Do we need to flatten the webinar curve?

“…This may be explained by an increased need for educational guidance and accountability, which are best delivered through the nuances of in-person interaction. [ 4 ] On the contrary, senior residents found online meetings less effective than junior residents, which may again be explained by the more personal nature of in-person communication. [ 5 ] In a survey of ophthalmologists, 86% were not satisfied with e-Learning as the sole method for undergraduate teaching.…”

Untitled

“…9 Similar to other events of the 20th century, the pandemic has disrupted medical education on a major scale. 10 The pandemic has had an adverse effect on GME at various levels ranging from: cancellation of elective procedures and educational activities, increased clinical burden or taking care of patients beyond their specialty, shifting from in-person to online didactics, cancellation of skills training, inability to meet stipulated educational requirements, changing to virtual interviews and newer training in personal protective equipment (PPE). The pandemic has also had a major impact on well-being of the house officers due to various reasons ranging from: sense of uncertainty, fear of contracting COVID-19, capacity issues with testing for COVID-19, unprecedented clinical volume of work, disruption of normal work patterns, lack of peer interactions and delay or unavailability of counseling services.…”