Experiences of early graduate medical students working in New York hospitals during the COVID-19 pandemic: a mixed methods study

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic presented the world with a sudden need for additional medical professionals. Senior medical students were identified as potential workers and many worldwide graduated early to serve as Junior Physicians in hospitals. The authors sought to identify factors that informed the decision to work, describe experiences in this capacity, and elucidate benefits for trainees. Methods The investigators conducted a mixed-methods observational cohort study of early medical graduates eligible to work as Junior Physicians at two New York medical centers in April/May 2020 during an initial surge in COVID-19 hospitalizations. Graduates were surveyed, and a sample of Junior Physicians participated in a focus group. Survey responses of those who worked were compared to those who did not. Focus group responses were transcribed, coded, and thematically analyzed. Results Fifty-nine graduates completed the study methods and 39 worked as Junior Physicians. Primary reasons for working included duty to help (39 [100%]), financial incentive (32 [82%]), desire to learn about pandemic response (25 [64%]), and educational incentive (24 [62%]). All had direct contact with COVID-19 patients, believed working was beneficial to their medical training, and were glad they worked. None contracted a symptomatic infection while working. Compared with non-Junior Physicians, Junior Physicians reported increased comfort levels in completing medical intern-level actions like transitions of care functions, such as writing transfer notes (P < 0.01), writing discharge orders (P = 0.01), and providing verbal sign out (P = 0.05), and they reported more comfort in managing COVID-19 patients. Sixteen themes emerged from the focus group and were placed into four categories: development of skills, patient care, safety, and wellness. Conclusions Senior medical students chose to work as Junior Physicians for both personal and educational reasons. Experiences were beneficial to trainees and can inform future innovations in medical education.

Health care workers’ experiences during the COVID-19 pandemic: a scoping review

“…HCWs living with children or elderly family members were particularly concerned [47,65,95,97,163,172]. In some cases, HCWs reported that they had introduced changes to their living situation to protect their loved ones, with some deciding to move out to ensure physical distance and minimise the risk of transmission [39,43,44,89,105,161]. Some HCWs reported sharing limited details about their COVID-19-related duties to decrease the anxiety and fear of their significant others [81].…”

“…With regard to the work environment, relationships with colleagues were mainly described as supportive and empowering, with various studies reporting the value of teamwork during the pandemic [47,51,52,67,71,77,83,91,97,98,108,134,148,151,161]. Challenges with regard to collegial relationships included social distancing (which hindered HCWs' interaction in the work place) [176] and working with colleagues one had never worked with before (causing a lack of familiarity with the work environment and difficulties to adapt) [79].…”

Impact of COVID-19 on Medical Education: Perspectives From Students

“…Other rigid prepandemic absence policies such as “blackout days” where students absolutely cannot request time off and absence limits (e.g., 2 days off during a 4-week rotation) should be reconsidered. While not promoting absenteeism, it is important to contrast missing a few days due to quarantine or illness with the encouraging feedback from 3-year MD programs 20 and students from the class of 2020 who graduated early, 21 which suggest that students can become competent residents with variable time in clinical rotations.…”

Reduction in final year medical students’ knowledge during the COVID-19 pandemic: Insights from an interinstitutional progress test

“…These doctors often provide urgent and emergency care or work in primary health care centers, often without supervision and the opportunity for further clinical training (Santos and Nunes, 2019). We recommend that an important priority in the near future is to ensure that there are systems for all newly graduated doctors that can allow them to continue with practical clinical teaching (Pravder et al, 2021).…”