Dataset Information

Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey.

ABSTRACT:

Background

Internal medicine (IM) residency is a notoriously challenging time generally characterized by long work hours and adjustment to new roles and responsibilities. The COVID-19 pandemic has led to multiple emergent adjustments in training schedules to accommodate increasing needs in patient care. The physician training period, in itself, has been consistently shown to be associated with vulnerability with respect to mental well-being. The impact of the COVID-19 pandemic on the experience of IM trainees is not well established.

Objective

Characterize the impact of the COVID-19 pandemic on trainee clinical education, finances, and well-being.

Methods

We developed a survey composed of 25 multiple choice questions, 6 of which had an optional short-answer component. The survey was distributed by the American College of Physicians (ACP) to 23,289 IM residents and subspecialty fellows. We received 1,128 complete surveys and an additional 269 partially completed surveys.

Results

The majority of respondents reported a disruption in their clinical schedule (76%) and a decrease in both didactic conferences (71%) and protected time for education (56%). A majority of respondents (81%) reported an impact on their well-being with an increase in their level of burnout and 41% of respondents reported a decrease in level of direct supervision. Despite these changes, the majority of trainee respondents (78%) felt well prepared for clinical practice after graduation.

Conclusions

These results outline the vulnerable position of internal medicine physicians in training. Preserving educational experiences, adequate supervision, and humane work hours are essential in protecting trainees from mental illness and burnout during global emergencies.

SUBMITTER: St-Pierre F

PROVIDER: S-EPMC10666403 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Publications

Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey.

St-Pierre Frederique F Petrosyan Romela R Gupta Arjun A Hughes Stephen S Trickett John J Read Susan S Van Doren Vanessa V Zeveney Andrew A Shoushtari Christiana C

BMC health services research 20231122 1

<h4>Background</h4>Internal medicine (IM) residency is a notoriously challenging time generally characterized by long work hours and adjustment to new roles and responsibilities. The COVID-19 pandemic has led to multiple emergent adjustments in training schedules to accommodate increasing needs in patient care. The physician training period, in itself, has been consistently shown to be associated with vulnerability with respect to mental well-being. The impact of the COVID-19 pandemic on the exp ...[more]

PMID: 37993947

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Project description:BackgroundGeneral internal medicine (GIM) careers are increasingly viewed as challenging and unsustainable.ObjectiveWe aimed to assess academic GIM worklife and determine remediable predictors of stress and burnout.DesignWe conducted an email survey.ParticipantsPhysicians, nurse practitioners, and physician assistants in 15 GIM divisions participated.Main measuresA ten-item survey queried stress, burnout, and work conditions such as electronic medical record (EMR) challenges. An open-ended question assessed stressors and solutions. Results were categorized into burnout, high stress, high control, chaos, good teamwork, high values alignment, documentation time pressure, and excessive home EMR use. Frequencies were determined for national data, Veterans Affairs (VA) versus civilian populations, and hospitalist versus ambulatory roles. A General Linear Mixed Model (GLMM) evaluated associations with burnout. A formal content analysis was performed for open-ended question responses.Key resultsOf 1235 clinicians sampled, 579 responded (47 %). High stress was present in 67 %, with 38 % burned out (burnout range 10-56 % by division). Half of respondents had low work control, 60 % reported high documentation time pressure, half described too much home EMR time, and most reported very busy or chaotic workplaces. Two-thirds felt aligned with departmental leaders' values, and three-quarters were satisfied with teamwork. Burnout was associated with high stress, low work control, and low values alignment with leaders (all p < 0.001). The 45 VA faculty had less burnout than civilian counterparts (17 % vs. 40 %, p < 0.05). Hospitalists described better teamwork than ambulatory clinicians and fewer hospitalists noted documentation time pressure (both p < 0.001). Key themes from the qualitative analysis were short visits, insufficient support staff, a Relative Value Unit mentality, documentation time pressure, and undervaluing education.ConclusionsWhile GIM divisions overall demonstrate high stress and burnout, division rates vary widely. Sustainability efforts within GIM could focus on visit length, staff support, schedule control, clinic chaos, and EMR stress.

Dataset Information

Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey.

Background

Objective

Methods

Results

Conclusions

Publications

Impact of the COVID-19 pandemic on internal medicine training in the United States: results from a national survey.

Similar Datasets

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