Otolaryngology Resident Wellness, Training, and Education in the Early Phase of the COVID-19 Pandemic

Abstract

Objective: To determine changes in the residency experience early in the COVID-19 pandemic and evaluate wellness measures among otolaryngology residents. Methods: A web-based survey was administered to U.S. otolaryngology residents. Responses to the Shirom-Melamed Burnout Measure (SMBM) and the Generalized Anxiety Disorder-7 scale were recorded along with data on burnout, demographics, wellness, sleep, training, and education. Results: 119 U.S. otolaryngology residents representing 27 of 42 states with otolaryngology residency programs responded to the survey. 24.4% (95% CI 17.0-31.8%) self-reported some level of burnout, while 10.9% met SMBM criteria for “clinically relevant” burnout. 51.3% experienced more stress, and 58.8% reported more anxiety during the COVID-19 pandemic. Compared to males, females had a higher prevalence of burnout (38.9% vs 12.3%, P = .001) and anxiety (75.9% vs 43.8%, P < .001). PGY-2s had a greater mean SMBM index (3.64) and higher rates of self-reported burnout (54.2%) than their counterparts at other levels of training. Residents reported less time spent in the hospital, lower surgical volume, and less procedural independence. Educational didactics, primarily via videoconference, were more frequent for 63.9% of respondents. Conclusion: While burnout among otolaryngology residents was low early in the COVID-19 pandemic, likely due to separation from the workplace environment, trainees had higher levels of anxiety and stress. The surgical experience was negatively impacted by the pandemic, but remote didactics and educational opportunities increased. These findings may inform otolaryngology residency programs on the need to promote resident wellness and aid in devising strategies to improve the educational experience during this unique global health crisis as well as in the long term.

COVID-19 and rhinological surgery

“…Chou and colleagues performed a survey of otolaryngology residents and reported that 98.3% of residents had decreased case volume and 43.7% had decreased surgical involvement. 74 Similarly, Murthy et. al's survey found 43% of respondents were not involved in any skull base procedures, even in COVID-19 negative patients, during the onset of the pandemic.…”

N95 vs Half‐face Respirator Wear in Surgical Trainees: Physiologic and Psychological Effects of Prolonged Use

“…One trainee participated in only the N95 arm due to scheduling conflicts and was therefore excluded from paired analyses. The average age of participants was 26.3 years with a standard deviation of 3.42 (range, [20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Pertinent preexisting conditions included mild asthma (8.7%), allergic rhinitis (26.1%), and prior diagnosis of headaches/migraines (30.4%).…”

“…[27][28][29][30] Studies from COVID-19 demonstrate increased mental strain on health care workers, with several highlighting a prevalence of distress, anxiety, and burnout in otolaryngology trainees. 30,31 It is of the utmost importance to take trainee well-being and personal preference into account when choosing mask wear, when N95 and HFR provide similar levels of protection. Our study highlights that HFRs may be associated with an increase in distress and anxiety levels in a population that is already facing alarming rates of burnout.…”

Otolaryngology in the face of A pandemic

“… 57 In web-based surveys, residents reported spending less time in the hospital, decreased clinical duties, lower surgical volume, and having less procedural independence than before the pandemic. 58 , 59 Additionally, 55% of residents felt that the pandemic had a negative impact on their ability to secure a job or fellowship after training. 59 Over time, hybrid models were developed to combine both virtual and in-person education.…”

“…68 Some of the highest increases in subspecialty publications were rhinology and laryngology (51% and 72%, respectively). 58 However, other types of research were negatively impacted during the pandemic including the majority of animal studies and clinical trials being halted at its onset. 69 , 70 In a survey of American rhinologists, 36% of 71 respondents reported their otolaryngology research labs were not able to continue employing hired personnel with full salary due to loss of funding.…”