Resident Wellness During the COVID-19 Pandemic: A Nationwide Survey of Orthopaedic Residents

Abstract

Introduction: The COVID-19 pandemic has influenced the resident workforce to a particularly powerful and unexpected extent. Given the drastic changes to resident roles, expectations, and responsibilities, many valuable lessons regarding resident concerns and wellness can be garnered from this unique experience. Methods: A voluntary survey was sent to 179 Accreditation Council for Graduate Medical Education-accredited orthopaedic surgery residency program directors to distribute to their residents. Questions focused on issues that may have occurred, program's responses, and expectations of programs during the pandemic. Results: In total, 507 residents completed the survey, and 10% reported being deployed to do nonorthopaedic-related care, with junior classes being more likely to receive this assignment (P < 0.001). The greatest concern for respondents was the possibility of getting family members sick (mean = 3.89, on scale of 1-5), followed by personally contracting the illness (mean = 3.38). Discussion: The COVID-19 pandemic has resulted in numerous changes and novel sources of adversity for the orthopaedic surgery resident. Contrary to popular opinion, most residents are comfortable with the proposition of providing nonorthopaedic care. The possibility of bringing a pathogen to the home environment and infecting family members seems to be an overarching concern, and efforts to ensure resident and family safety are key.

Clinical Rotation Handbook Promotes Orthopaedic Resident Wellness: A Quality Improvement Study

“…The recent pandemic has imposed additional stress on trainees, falling disproportionally on the shoulders of junior orthopaedic residents, some of whom were temporarily reassigned to provide direct care of patients with COVID-19. 8 In this high-stress environment, program directors and faculty members, who themselves were subject to the negative effects of chronic stress, 3,7,9 must be cognizant of their obligation to train residents not only to be competent clinicians and surgeons, but also to maintain a healthy work-life balance.…”

Promoting Wellness in Orthopaedic Surgery Residency

“…In addition, only 41.6% of residents reported nonacademic events held to maintain interaction during the pandemic, whereas 64.2% endorsed weekly communication with their program directors. 14…”

“…In addition, only 41.6% of residents reported nonacademic events held to maintain interaction during the pandemic, whereas 64.2% endorsed weekly communication with their program directors. 14 Although the harmful effects of the COVID-19 pandemic have been felt throughout all aspects of healthcare and all medical professionals, innovations and adjustments in residency practices because of the COVID-19 pandemic do offer a silver lining regarding wellness. The widespread adoption of online video format for meetings offers the opportunity for easier access to resident lead happy hours, visits with mental health professionals, check-ins with program directors and faculty mentors, and the ability to network with attendings at other programs.…”

“…38 Despite the reports of exceedingly high costs attributable to physician burnout in the United States, with estimates between $2.6 and $6.3 billion dollars annually, hospital-sponsored residency events were put on hold as ventilators, PPE, and screening tests became the focus of institutional resources. 39 Nolte et al 14 demonstrated the increased emotional burden faced by residents because of the COVID-19 pandemic, with 44.5% of residents reporting that time away from coresidents had a negative effect on overall resident cohesiveness, with junior residents more likely to experience a lack of program cohesion. As junior residents have been shown previously to be at a higher risk of burnout at baseline, this becomes a worrying predicament.…”

“…Furthermore, the impact of the COVID-19 pandemic on resident wellness has been profound and further emphasized the need to address mental health and well-being from early training to practice as an attending. 14 In this article, we highlight successful initiatives that have been undertaken by other orthopaedic surgery programs, programs in other medical specialties, and professions outside of medicine and offer suggestions that can hopefully act as first steps in improving resident wellness around the country (Table 1). By increasing the awareness of different resident wellness initiatives, programs can develop their own approaches that will allow their learners to develop the skill sets to succeed in residency and have a foundation to approach stressors in practice, ultimately diminishing the likelihood of burnout and depression.…”