Pediatric Resident Perspectives on the Impact of COVID-19 on Training

Abstract

OBJECTIVES At the onset of the coronavirus disease 2019 pandemic, disruptions to pediatric care and training were immediate and significant. We sought to understand the impact of the pandemic on residency training from the perspective of pediatric residents. METHODS We conducted a cross-sectional survey of categorical pediatric residents at US training programs at the end of the 2019–2020 academic year. This voluntary survey included questions that explored the impact of the coronavirus disease 2019 pandemic on resident training experiences, postresidency employment plans, and attitudes and perceptions. Data were analyzed by using descriptive statistics and mixed-effects regression models. We performed a sensitivity analysis using respondents from programs with a >40% response rate for questions regarding resident attitudes and perceptions. RESULTS Residents from 127 of 201 training programs (63.2%) completed the survey, with a response rate of 18.9% (1141 of 6032). Respondents reported multiple changes to their training experience including rotation schedule adjustments, clinic cancellations, and an increase in the use of telemedicine. Respondents also reported inconsistent access to personal protective equipment and increased involvement in the care of adult patients. Graduating resident respondents reported concerns related to employment. Respondents also noted a negative impact on their personal wellness. CONCLUSIONS Responding residents reported that nearly every aspect of their training was impacted by the pandemic. Describing their experiences may help residency program and hospital leaders supplement missed educational experiences, better support residents through the remaining months of the pandemic, and better prepare for extraordinary circumstances in the future.

COVID-19 Pandemic Impact on Pediatricians Entering the Pediatric Workforce

“…Our findings are supported by a survey-based study of 291 pediatric residency graduates from 2019 showing that over 50% of graduates entering the workforce perceived that their post residency employment was impacted by the COVID-19 pandemic. 4 It is unsurprising that a year later, and in light of the continued pandemic, pediatricians registering for the general pediatrics certifying examination, including many 2020 pediatric residency graduates, continued to indicate that their employment was affected by the pandemic. Studies from other residency specialties, such as surgery and plastic surgery, and pediatric subspecialties, such as pediatric gastroenterology, also indicate a negative impact on employment by the COVID-19 pandemic on some graduates.…”

“…The COVID-19 pandemic has disrupted healthcare broadly, including the training of over 9,100 categorical pediatric residents across 212 training programs in the United States. 1 , 2 , 3 , 4 In both inpatient and outpatient settings, clinical volumes dropped dramatically during the pandemic, resulting in fewer in-person patient encounters, a change in the range of diagnoses seen, and, at some programs, redeployment to care for adults. 3 , 5 , 6 , 7 Hospital financial constraints due to decreased patient volume, 8 , 9 potential attrition of physicians retiring early, 10 and the pediatric subspecialty deficit may have impacted potential positions available during the pandemic, and, in turn, may have impacted career and employment decisions of pediatricians entering the workforce.…”

Where Do We Go from here? Post-pandemic Planning and the Future of Graduate Medical Education

“…Research describing the impact of the COVID-19 pandemic on trainee experiences and competencies is beginning to materialize [ 1 – 6 ]. Studies have indicated similar trends of decreased clinical exposures and training, regardless of specialty, including redeployments, cross-coverage for sick call, outpatient clinic cancellations, fewer inpatient shifts, and increased telemedicine encounters [ 1 , 3 , 6 – 8 ]. Decreased visits coupled with trainee redeployment from usual rotations have resulted in decreased clinical exposure [ 1 – 3 ].…”

“…Studies have indicated similar trends of decreased clinical exposures and training, regardless of specialty, including redeployments, cross-coverage for sick call, outpatient clinic cancellations, fewer inpatient shifts, and increased telemedicine encounters [ 1 , 3 , 6 – 8 ]. Decreased visits coupled with trainee redeployment from usual rotations have resulted in decreased clinical exposure [ 1 – 3 ]. Formal educational activities were also impacted due to shifts in clinical needs, social distancing regulations, and resident illnesses, requiring programs to quickly act to reformat their educational programs and utilize virtual tools in an attempt to preserve their existing curricula [ 1 , 4 , 9 , 10 ].…”

“…We have seen a wealth of innovation in education throughout the pandemic, and as we look toward the future, educational experts have suggested many of these innovations that should outlast the pandemic [ 18 ]. Some studies have sought to evaluate learners’ and educators’ impressions on educational experiences, but these studies varied, with some reporting an overall negative impact on education and others highlighting the benefits of innovation in medicine and education [ 3 , 5 , 7 , 9 ]. To the best of our knowledge, no studies have compared educator and trainee perceptions on the pandemic’s impact on medical training, including the specific effects on skills, productivity, teaching, and learning preferences.…”