Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey

• Type of Material: Article
• Authors: Frederique St-Pierre, Northwestern University; Romela Petrosyan, Harvard University; Arjun Gupta, The Mount Sinai Hospital; Stephen Hughes, Naval Medical Center San Diego; John Trickett, Mayo Clinic, Phoenix; Susan Read, American College of Physicians; Vanessa Elizabeth Van Doren, Emory University; Andrew Zeveney, American College of Physicians; Christiana Shoushtari, Oak Street Health
• Language: English
• Date: 2023-11-22
• Publisher: BMC
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1186/s12913-023-10237-9
• Title of Journal or Parent Work: BMC Health Services Research
• Volume: 23
• Start Page: 1285
• Grant/Funding Information: UCLA National Clinician Scholars Program; American College of Physicians.
• Keywords: Training; Internal medicine; COVID-19; Pandemic; Resident; Fellow
• Research Categories: Health Sciences, Education

Abstract

Background Internal medicine (IM) residency is a notoriously challenging time generally characterized by long work hours and adjustment to new roles and responsibilities. The COVID-19 pandemic has led to multiple emergent adjustments in training schedules to accommodate increasing needs in patient care. The physician training period, in itself, has been consistently shown to be associated with vulnerability with respect to mental well-being. The impact of the COVID-19 pandemic on the experience of IM trainees is not well established. Objective Characterize the impact of the COVID-19 pandemic on trainee clinical education, finances, and well-being. Methods We developed a survey composed of 25 multiple choice questions, 6 of which had an optional short-answer component. The survey was distributed by the American College of Physicians (ACP) to 23,289 IM residents and subspecialty fellows. We received 1,128 complete surveys and an additional 269 partially completed surveys. Results The majority of respondents reported a disruption in their clinical schedule (76%) and a decrease in both didactic conferences (71%) and protected time for education (56%). A majority of respondents (81%) reported an impact on their well-being with an increase in their level of burnout and 41% of respondents reported a decrease in level of direct supervision. Despite these changes, the majority of trainee respondents (78%) felt well prepared for clinical practice after graduation. Conclusions These results outline the vulnerable position of internal medicine physicians in training. Preserving educational experiences, adequate supervision, and humane work hours are essential in protecting trainees from mental illness and burnout during global emergencies.