Pediatric Training Crisis of Emergency Medicine Residency during the COVID-19 Pandemic

Abstract

Coronavirus disease 2019 (COVID-19) is an emerging viral disease that has caused a global pandemic. Among emergency department (ED) patients, pediatric patient volume mostly and continuously decreased during the pandemic period. Decreased pediatric patient volume in a prolonged period could results in inadequate pediatric training of Emergency Medicine (EM) residents. We collected data regarding pediatric patients who were first seen by EM resident physicians between 1 February 2019, and 31 January 2021, which was divided into pre-epidemic and epidemic periods by 1 February 2020. A significant reduction in pediatric patients per hour (PPH) of EM residents was noted in the epidemic period (from 1.55 to 0.81, p < 0.001). The average patient number was reduced significantly in the classification of infection (from 9.50 to 4.00, p < 0.001), respiratory system (from 84.00 to 22.00, p < 0.001), gastrointestinal system (from 52.00 to 34.00, p = 0.007), otolaryngology (from 4.00 to 2.00, p = 0.022). Among the diagnoses of infectious disease, the most obvious drop was noted in the diagnosis of influenza and enterovirus infection. Reduced pediatric patient volume affected clinical exposure to pediatric EM training of EM residency. Changes in the proportion of pediatric diseases presented in the ED may induce inadequate experience with common and specific pediatric diseases.

Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France

“… 8 , 9 , 10 Various studies have reported a marked increase in the incidence of different diseases in 2021, supporting the relevance of the concept of immunity debt for RSV and enterovirus. 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 …”

Changing patterns of infectious diseases in children during the COVID-19 pandemic

“…A report from Taiwan suggested an approximately 50% reduction in pediatric patient volume per hour at the emergency department between February 2020 and January 2021 compared with the pre-COVID-19 period (February 2019 to January 2020). The most obvious drop was noted for infectious diseases, especially influenza and enterovirus infections ( Huang et al., 2022 ). The general population of Taiwan is approximately 23 million.…”

Impact of the COVID-19 Pandemic on Pediatric Emergency Medicine: A Systematic Review

“…With the progression of the pandemic, the patient volume of the emergency department (ED) has continuously decreased, especially regarding the number of pediatric patients, in many countries [3][4][5][6][7][8][9]. Moreover, this situation was noted in some countries with a low severity of the pandemic [10]. This decrease may be partly attributable to Medicina 2022, 58, 1112 2 of 11 parents' fear of being infected or anti-epidemic policies, including wearing a mask, social distancing, and school closure, which have reduced the spread of diseases that typically infect children [9,11,12].…”