COVID-19 and the Impact on Doctor Wellbeing and Training

Abstract

Introduction - There is limited literature on how the COVID-19 pandemic has affected the wellbeing and training of junior doctors. The restructuring of rotas, redeployment of specialties and daily risk of COVID-19 exposure is likely to have had a significant impact on frontline doctors. Aim - To understand the impact of COVID-19 on the wellbeing and training of junior doctors at a tertiary, London Hospital. Methods - A mixed methods study was undertaken with an initial online survey three weeks after the peak of the COVID-19 surge; followed by a series of focus groups. Results - Of 541 junior doctors, 161 responded to the questionnaire, and 10 participated in focus group sessions Over a third (34%; n=47) were concerned about the risk to personal health, 71% (n=102) had impaired sleep and many changed their lifestyles to adapt. Almost 40% felt the pandemic had an adverse impact on their careers, including their ability to complete training requirements, leading to an inevitable need to extend training. There was a reluctance to show or share any personal anxiety or vulnerability at work, hence participation in organised psychological support/ debrief sessions and online resources were considered unhelpful. Conclusion - Employers need to recognise the impact of COVID-19 on the wellbeing of doctors and implement strategies to effectively support staff. The development of safe, timely, and confidential psychological support strategies may be of benefit to doctors. National training leads will need to closely supervise training changes appreciating both the variation in expectations and adaption required across different specialties and grades.

Foundation doctors’ perspectives on the impact of the COVID-19 pandemic and lessons for the future

“…This led to a reduced sense of hierarchy and the whole team, from the consultants to foundation doctors, were learning and growing together. 4 During ward rounds, foundation doctors were involved in checking local hospital and societal guidelines and informing other team members about the most up-to-date guidelines. The work by Coia and West emphasises the importance of autonomy, belonging and competence as key for wellbeing and motivation at work, and this change in the team dynamic helped enhance full engagement from foundation doctors.…”

“…Some elective services were cancelled and many clinics became telephone or virtual clinics, resulting in reduced learning opportunities in certain specialties. 4 Minimisation of patient interaction also resulted in reduced bedside teaching on clinical signs, examination skills and practical skills. Visitors of patients were also limited and we experienced less communication with both the patient and their families.…”

“…2 The pandemic posed several challenges to foundation doctors (Fig 1). 3,4 Here, as foundation doctors, we reflect on the impact of the pandemic on our training, learning, wellbeing and career prospects. We discuss how the pandemic offers both challenges and opportunities, allowing us to adopt novel technologies and learn lessons that we can take forward to improve foundation training for the future.…”

The Experience of a Single NHS England Trust on the Impact of the COVID-19 Pandemic on Junior and Middle-Grade Doctors: What Is Next?

“…This is further worsened by social factors: moving out of homes to reduce risk of transmission or restricting contact with vulnerable family [ 9 ]. Furthermore, emergency COVID-19 rotas and redeployment, unclear treatment guidelines or escalation plans, reduced training opportunities, and increased patient mortality have precipitated burnout in an already overstretched workforce [ 10 ].…”

Redeployment and training of healthcare professionals to Intensive Care during COVID-19: a systematic review

“…The impact of redeployment on staff wellbeing has also been identified. Redeployed staff have expressed concern in relation to their safety, the impact of their work on family members (including infecting them with the virus) and their own training and career progression (Salem et al, 2020; Vera San Juan et al, 2021).…”