Dark Clouds With Silver Linings: Resident Anxieties About COVID-19 Coupled With Program Innovations and Increased Resident Well-Being

Abstract

Background The COVID-19 pandemic forced numerous unprecedented systemic changes within residency programs and hospital systems. Objective We explored how the COVID-19 pandemic, and associated changes in clinical and educational experiences, were related to internal medicine residents’ well-being in the early months of the pandemic. Methods Across 4 internal medicine residency programs in the Northeast United States that have previously participated in the iCOMPARE study, all 394 residents were invited to participate in a study with open-ended survey prompts about well-being approximately every 2 weeks in academic year 2019–2020. In March and April 2020, survey prompts were refocused to COVID-19. Content analysis revealed themes in residents’ open-ended responses to 4 prompts. Results One hundred and eighty-six residents expressed interest, and 88 were randomly selected (47%). There were 4 main themes: (1) in early days of the pandemic, internal medicine residents reported fear and anxiety about uncertainty and lack of personal protective equipment; (2) residents adapted and soon were able to reflect, rest, and pursue personal wellness; (3) communication from programs and health systems was inconsistent early in the pandemic but improved in clarity and frequency; (4) residents appreciated the changes programs had made, including shorter shifts, removal of pre-rounding, and telemedicine. Conclusions COVID-19 introduced many challenges to internal medicine residency programs and to resident well-being. Programs made structural changes to clinical schedules, educational/conference options, and communication that boosted resident well-being. Many residents hoped these changes would continue regardless of the pandemic’s course.