Background The rapid spread of COVID‐19 has placed tremendous strain on the American healthcare system. Few prior studies have evaluated the well‐being of or changes to training for American resident physicians during the COVID‐19 pandemic. We aim to study predictors of trainee well‐being and changes to clinical practice using an anonymous survey of American urology residents. Methods An anonymous, voluntary, 47‐question survey was sent to all ACGME‐accredited urology programmes in the United States. We executed a cross‐sectional analysis evaluating risk factors of perception of anxiety and depression both at work and home and educational outcomes. Multiple linear regressions models were used to estimate beta coefficients and 95% confidence intervals. Results Among ~1800 urology residents in the USA, 356 (20%) responded. Among these respondents, 24 had missing data leaving a sample size of 332. Important risk factors of mental health outcomes included perception of access to PPE, local COVID‐19 severity and perception of susceptible household members. Risk factors for declination of redeployment included current redeployment, having children and concerns regarding ability to reach case minimums. Risk factors for concern of achieving operative autonomy included cancellation of elective cases and higher level of training. Conclusions Several potential actions, which could be taken by urology residency programme directors and hospital administration, may optimise urology resident well‐being, morale, and education. These include advocating for adequate access to PPE, providing support at both the residency programme and institutional levels, instituting telehealth education programmes, and fostering a sense of shared responsibility of COVID‐19 patients.

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Purpose of Review The COVID-19 pandemic brought unprecedented challenges for urology resident education. In this review, we discuss the pandemic’s impact on urology trainees and their education. Recent Findings Urology trainees were often redeployed to frontline services in unfamiliar clinical settings. Residents often experienced increased levels of stress, anxiety, and depression. Many programs instituted virtual “check-ins” and formed liaisons with mental health services to foster cohesiveness. Urology trainees experienced the integration of telehealth into the clinical realm. Virtual surgery lectures and simulations were utilized to augment surgical education. Academic governing bodies upheld resident protections and provided dynamic guidance for training requirement throughout the pandemic. Medical students were unable to participate in traditional in-person away rotations and interviews, complicating the residency application process. Summary The COVID-19 pandemic shook the healthcare system and ushered in seismic changes for urology trainees worldwide. Though the longstanding effects of the pandemic remain to be seen, urology residents have demonstrated tremendous resilience and bravery throughout this challenging period, and those qualities will undeniably withstand the test of time.

Older buildings in the United States often contain lead paint, and their demolition poses the risk of community lead exposure. We investigated associations between demolitions and elevated blood lead levels (EBLLs) among Detroit children aged <6 years, 2014–2018, and evaluated yearly variation given health and safety controls implemented during this time. Case-control analysis included incident EBLL cases (≥5 µg/dL) and non-EBLL controls from test results reported to the Michigan Department of Health and Human Services. Exposure was defined as the number of demolitions (0, 1, 2+) within 400 feet of the child’s residence 45 days before the blood test. We used logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs), and test effect modification by year. Associations between demolition and EBLL differed yearly (p = 0.07): 2+ demolitions were associated with increased odds of EBLLs in 2014 (OR: 1.75; 95% CI: (1.17, 2.55), 2016 (2.36; 1.53, 3.55) and 2017 (2.16; 1.24, 3.60), but not in 2018 (0.94; 0.41, 1.86). This pattern remained consistent in sensitivity analyses. The null association in 2018 may be related to increased health and safety controls. Maintenance of controls and monitoring are essential, along with other interventions to minimize lead exposure, especially for susceptible populations.

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