A growing concern in the physician workforce over the last decade, burnout rears its ugly head again, this time peppered with a pandemic and racial and political tensions. In this medical education special issue, several authors have identified factors contributing to burnout, and those associated with wellbeing and, indeed, thriving while in training. Unfortunately, many of the actions we implemented as a result of the COVID-19 pandemic may have actually increased burnout and reduced wellbeing in our learners across the continuum of medical education. Recognizing these lessons now may help prevent the same mistakes and even serve to provide evidence-based alternate strategies to enhance wellbeing and mitigate burnout during our next medical crisis.

Introduction: Half of the U.S. population has chronic illness. Many disparities exist in health care for management of chronic disease among poorer individuals, including decreased access to healthy foods, homelessness, and difficulty navigating large hospital systems due to low health literacy. A survey of resident physicians found significant gaps in preparedness to provide cross-cultural care. Education is needed to promote consideration of patients' social and cultural barriers in managing disease and navigating the health care system. This module was created as an introduction to social determinants of health, and highlights disparities in access to healthy food, water, shelter, and medical care in a sample of the residents' own continuity clinic patient panel. Methods: We designed this experiential module to help internal medicine residents at an urban institution better understand how social constructs might hinder patient health. Activities were chosen by learners from a list of options, and carried out in small groups during a half day of protected time. We used reflective writing exercises to elicit resident thoughts about the module. Results: Thirty-nine second-year residents participated in the module. Following the course, 41% of residents submitted reflective statements about their experience. Reflective responses suggest an enhanced appreciation for social determinants of health, a sense of empowerment to advocate for better patient resources, and an appreciation for systems-level factors that play a role in social determinants of health. Discussion: Our results demonstrate that a short, experience-based module can impact resident attitudes about social determinants and improve advocacy around identifying community resources.

The coronavirus disease (COVID-19) pandemic in 2020 led to rapid collaboration between the undergraduate medical education (UME) and graduate medical education (GME) communities to support an all-virtual residency interviewing process. Although outcomes, such as new intern performance and satisfaction with virtual interviews, are not yet known, the medical education community must make decisions early in the process to allow students, internal medicine clerkships, and internal medicine residency programs to prepare for the 2021-2022 application season.