Resident physicians report on COVID-19 impacts

The COVID-19 pandemic has had many deleterious consequences for health care workers, including the challenges of caring for severely ill patients. Resident physicians, in particular, may have been affected by physical as well as psychological consequences of the pandemic. At present, data are sparse on the perceptions, coping strategies and mental health of residents during COVID-19.

Researchers from Florida Atlantic University's Schmidt College of Medicine explored these issues through data from its community-based academic residency programs in the southeast United States. They administered multiple-choice online anonymous surveys to assess resident perceptions, coping strategies and self-reported levels of depression, anxiety and stress experienced during the early phase of the pandemic.

Results of the original research, published in the Southern Medical Journal, showed that 88.1 percent of residents felt they were likely or very likely to become infected with COVID-19. If infected, 28.8 percent felt that their illness would be serious or very serious. With respect to depression, anxiety and stress, all the mean scores were in the normal range. For depression, residents in emergency medicine and surgery reported higher levels. The trainees' top three strategies to cope with COVID-19 included acceptance, self-distraction, and use of emotional support. The three least used strategies included behavioral disengagement, substance use and denial.

"The residents we surveyed in our programs reported effective coping strategies during the early phase of the COVID-19 pandemic," said Allison H. Ferris, M.D., director, internal medicine residency program, and chair, Department of Medicine, FAU Schmidt College of Medicine. "It seems important and timely to continue to explore perceptions, coping strategies and mental health of residents as they play essential roles serving our patients and communities. Such information may be helpful to future residents and residency program directors as our trainees are the pipeline of future physicians and inevitably will face many challenging circumstances as they serve on the frontlines of health care."

The survey included FAU residents in four specialties: internal medicine, surgery, emergency medicine and psychiatry. Researchers used the Brief COPE questionnaire, which included 28 items to assess coping strategies. They also measured dimensions of depression, anxiety and stress using the validated 21-item Depression, Anxiety, Stress Scale (formally recognized as the DASS-21).

"Further research is needed to better understand the challenges that residents face and the resources they need as new members on the frontline of the health care workforce, so that program leaders can proactively support them in an evidence-based and thoughtful manner," said Sarah K. Wood, M.D., senior author, professor of pediatrics, vice dean for medical education, and chair of the Department of Women's and Children's Health, FAU Schmidt College of Medicine.

The authors note that this survey was conducted in May 2020 at the time when U.S. deaths from COVID-19 surpassed 100,000. In Florida, however, the first peak was in July 2020, a second peak was January 2021, and a third and highest peak was August 2021. The authors note that it is plausible that the responses may have been different had the residents been surveyed at a later time when cases and deaths were peaking in Florida.

"We believe the most plausible interpretation of the data to be that, during the U.S. epidemic of the COVID-19 pandemic, these residents reported effective coping strategies, namely, acceptance, self-distraction, and use of emotional support," said Michael DeDonno, Ph.D., first author, a research psychologist and an associate professor in FAU's College of Education and Schmidt College of Medicine.