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Silvestre J, Nagpal A. A 10-year analysis of application and match rates for pain medicine training in the United States. PAIN MEDICINE (MALDEN, MASS.) 2024; 25:374-379. [PMID: 38613846 DOI: 10.1093/pm/pnae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/31/2024] [Accepted: 02/16/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVE We analyzed application and match rates for pain medicine training in the United States and hypothesized that there would be (1) greater growth in the number of training positions than applicants, (2) higher match rates among US allopathic graduates relative to non-US allopathic graduates, and (3) greater number of unfilled training positions over time. DESIGN Retrospective, cross-sectional study of all applicants for pain medicine training in the United States. METHOD National Resident Matching Program data were obtained over a ten-year period (2014-2023). Match rates and applicant-to-position ratios were calculated and compared over time with linear regression. Comparisons were made with chi-square tests. RESULTS Growth in the number of annual training positions (261-377, 44% increase) exceeded growth in the number of interested applicants (398-415, 4% increase) (P < .001). Annual applicant-to-training position ratios decreased (1.5-1.1, P < .001). The representation of US allopathic graduates among incoming pain medicine fellows decreased over the study period (73%-58%, P < .001) while US osteopathic graduates increased (9%-28%, P < .001).Match rates increased for both US allopathic graduates (71%-91%, P < .001) and non-US allopathic graduates (51%-81%, P < .001). From 2018 to 2023, US allopathic graduates (79%) had higher match rates than US osteopathic graduates (60%, P < .001) and international medical graduates (57%, P < .001). More available annual training positions went unfilled over the study period (2%-5%, P = .006). CONCLUSIONS Stagnant annual applicant volume and increasing number of available training positions have led to increasing match rates for pain medicine fellowship training. Fewer US allopathic graduates are pursuing pain medicine training. The increasing percentage of unfilled training positions warrants ongoing surveillance.
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Affiliation(s)
- Jason Silvestre
- Perelman School of Medicine, Philadelphia, PA 19104, United States
| | - Ameet Nagpal
- Medical University of South Carolina, Charleston, SC 29425, United States
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Gallagher RM. Pain Medicine Goes Digital: A Lamentation on COVID-19, the Printing Press, and the 21st Century. PAIN MEDICINE 2022; 23:431-432. [PMID: 32428212 PMCID: PMC7313808 DOI: 10.1093/pm/pnaa181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kaplan CA, Chan CC, Feingold JH, Kaye-Kauderer H, Pietrzak RH, Peccoralo L, Feder A, Southwick S, Charney D, Burka L, Basist M, Ripp J, Akhtar S. Psychological Consequences Among Residents and Fellows During the COVID-19 Pandemic in New York City: Implications for Targeted Interventions. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1722-1731. [PMID: 34380941 PMCID: PMC8603436 DOI: 10.1097/acm.0000000000004362] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To examine the psychological impact of the COVID-19 pandemic on medical trainees (residents and fellows) working at Mount Sinai Hospital (MSH) in New York City (NYC), the initial epicenter of the United States pandemic. METHOD The authors administered a survey to 991 trainees in frontline specialties working at MSH in NYC between April and May 2020. The instrument assessed symptoms of major depressive disorder, generalized anxiety disorder, COVID-19-related posttraumatic stress disorder, and burnout. Psychiatric screens were aggregated into 1 composite measure, and meeting criteria on any of the 3 scales was considered a positive screen for psychiatric symptoms. The survey also assessed COVID-19-related exposures, worries, coping strategies, and desired interventions. Multivariable logistic regressions were conducted to identify factors associated with psychiatric symptoms and burnout. RESULTS Of the 560 respondents (56.6% response rate), 29.7% screened positive for psychiatric symptoms and 35.8% screened positive for burnout. History of a mental illness, COVID-19-related duties and personal/career worries, and coping by substance use were associated with increased likelihood of screening positive for psychiatric symptoms. Positive emotion-focused coping and feeling valued by supervisors were associated with decreased likelihood. Internal medicine and surgical specialties, a history of mental illness, increased duty hours, duty-related worries, personal/career worries, coping via self-blame and venting, and coping via substance use were associated with higher odds of burnout. Feeling valued by supervisors was associated with decreased burnout odds. The most common crisis-related needs included access to personal protective equipment, food provisions, and financial support. CONCLUSIONS Psychological distress and burnout affected approximately one-third of trainees sampled during the height of the pandemic in NYC. As the pandemic surged beyond NYC, these findings suggest that interventions should include addressing basic needs, promoting leadership affirmation, moderating duty hours, supporting trainees financially, and enhancing mental health support.
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Affiliation(s)
- Carly A. Kaplan
- C.A. Kaplan is a medical student, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Chi C. Chan
- C.C. Chan is assistant professor of psychiatry, Icahn School of Medicine at Mount Sinai, New York, and research health scientist, James J. Peters Veterans Affairs Medical Center, Bronx, New York
| | - Jordyn H. Feingold
- J.H. Feingold is a psychiatry resident, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Halley Kaye-Kauderer
- H. Kaye-Kauderer is a psychiatry resident, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert H. Pietrzak
- R.H. Pietrzak is associate professor of psychiatry and public health, Yale School of Medicine, New Haven, Connecticut, director, translational psychiatric epidemiology laboratory, Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, West Haven, Connecticut, and adjunct professor of psychiatry and environmental medicine and public health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lauren Peccoralo
- L. Peccoralo is associate dean for faculty well-being and resilience and associate professor of medicine, general internal medicine, and medical education, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
| | - Adriana Feder
- A. Feder is director for research, Center for Stress, Resilience, and Personal Growth, co-director, Ehrenkranz Laboratory for the Study of Human Resilience, and associate professor of psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
| | - Steven Southwick
- S. Southwick is professor emeritus of psychiatry, Yale School of Medicine, New Haven, Connecticut, and adjunct professor of psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dennis Charney
- D. Charney is Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and president for academic affairs, Mount Sinai Health System, New York, New York
| | - Larissa Burka
- L. Burka is a registered nurse, Mount Sinai Hospital, Mount Sinai Health System, New York, New York
| | - Madeleine Basist
- M. Basist is a third-year internal medicine resident, Mount Sinai Hospital, Mount Sinai Health System, New York, New York
| | - Jonathan Ripp
- J. Ripp is senior associate dean for well-being and resilience, chief wellness officer, and professor of medicine, medical education and geriatrics and palliative medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
| | - Saadia Akhtar
- S. Akhtar is associate dean for trainee well-being and resilience and associate professor of emergency medicine and medical education, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York
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Purvis T, Newmark J, Brenner GJ, Brodnik D, Kohan L. Pain Education Innovations During a Global Pandemic. PAIN MEDICINE 2021; 22:1891-1896. [PMID: 34411245 DOI: 10.1093/pm/pnab254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Taylor Purvis
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Jordan Newmark
- Department of Anesthesiology, Alameda Health System, Oakland, California.,Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Gary J Brenner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.,Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Lynn Kohan
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
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Barreveld AM, Hogans BB, Katzman JG. Leaning in and Teaching on: Pain Educators Report Innovations During a Global Pandemic. PAIN MEDICINE 2021; 22:1711-1712. [PMID: 34289069 DOI: 10.1093/pm/pnab220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Antje M Barreveld
- Department of Anesthesiology, Tufts University School of Medicine, Pain Management Services, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Beth B Hogans
- Education, Geriatric Research Education and Clinical Center, VA Maryland Health Care System, Baltimore, Maryland.,Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Joanna G Katzman
- Department of Psychiatry and Behavioral Sciences, College of Population Health and College of Nursing, University of New Mexico Pain Center, Albuquerque, New Mexico.,Project ECHO, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
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Hamilton WG, Loper NR, Abdel MP, Springer BD, Chen AF. Adult Hip and Knee Reconstruction Education during the COVID-19 Pandemic. J Arthroplasty 2021; 36:S395-S399. [PMID: 33581973 PMCID: PMC7825893 DOI: 10.1016/j.arth.2021.01.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/21/2020] [Accepted: 01/12/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic caused an abrupt disruption in residency and fellowship training, with most in-person teaching ceasing in March 2020. The AAHKS (American Association of Hip and Knee Surgeons) Board of Directors quickly initiated an online lecture series named the Fellows Online COVID-19 AAHKS Learning initiative. The purpose of this study is to illustrate the impact that this educational platform had on residents and adult hip and knee reconstruction fellows. METHODS Between March 31, 2020 and June 25, 2020 an online educational platform was simultaneously developed and delivered. Adult hip and knee reconstruction fellows and residents were invited to participate in the free, live, online education sessions. Faculty from well-respected institutions from around the United States volunteered their time to host the initiative, choosing topics to present, ranging from hip (13 lectures) and knee (9 lectures), to practice management/miscellaneous (12 lectures). Attendee registrations were tracked via the online platform and the maximum number of attendees per session was recorded. A survey was administered to attendees for feedback. RESULTS Thirty-four, 1-hour virtual lectures were delivered in real time by 79 different faculty members from 20 different institutions. A total of 4746 registrations for the 34 lectures were received, with 2768 registrants (58.3%) attending. The average attendance was 81 viewers per session (range 21-143), with attendance peaking mid-April 2020. A survey administered to lecture participants showed that 104/109 (95.4%) attended live lectures and 93/109 (85.3%) watched recorded sessions. About 92.5% of attendees responded that they wanted the lectures to continue after clinical responsibilities resumed. CONCLUSION Amid a pandemic with cessation of in-person training, AAHKS delivered a robust virtual training alternative, exposing residents and fellows to a variety of renowned faculty and topics. Attendance with the program was very high, along with continued interest to continue this initiative. These worldwide lectures may lead to future opportunities in virtual residency and fellowship education.
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Affiliation(s)
- William G. Hamilton
- Anderson Orthopaedic Research Institute, Alexandria, VA,Reprint requests: William G. Hamilton, MD, Anderson Orthopaedic Research Institute, 2501 Parker’s Lane Suite 200, Alexandria, VA 22306
| | | | | | - Bryan D. Springer
- OrthoCarolina Hip and Knee Center, Atrium Musculoskeletal Institute, Charlotte, NC
| | - Antonia F. Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Lee DW, Deer T. Pain Fellows Survey: COVID-19 Impact on the Training and Job Market. PAIN MEDICINE 2021; 22:3106-3109. [PMID: 33983446 PMCID: PMC8194570 DOI: 10.1093/pm/pnab165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- David W Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA
| | - Timothy Deer
- The Spine and Nerve Center of the Virginias, Inc., Charleston, WV, USA
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Knox N, Lee CS, Moon JY, Cohen SP. Pain Manifestations of COVID-19 and Their Association With Mortality: A Multicenter Prospective Observational Study. Mayo Clin Proc 2021; 96:943-951. [PMID: 33722397 PMCID: PMC7764470 DOI: 10.1016/j.mayocp.2020.12.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/24/2020] [Accepted: 12/21/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To determine the prevalence and breakdown of pain symptoms among patients with coronavirus disease 2019 (COVID-19) infection admitted for nonpain symptoms and the association between the presence of pain and intensive care unit (ICU) admission and death. PATIENTS AND METHODS In this multicenter prospective study, data on the intensity and type of pain were collected on 169 patients with active severe acute respiratory syndrome coronavirus 2 infection at 2 teaching hospitals in the United States and Korea and on 8 patients with acute pain at another large teaching hospital between February 1, 2020, and June 15, 2020. RESULTS Sixty-five of 169 patients (38.5%) reported an active pain condition. Among the 73 patients with pain, the most common pain symptoms were headache (n=22; 30.1%), chest pain (n=17; 23.3%), spinal pain (n=18; 24.7%), myalgia (n=13; 17.8%), abdominal or pelvic pain (n=13; 17.8%), arthralgia (n=11; 15.1%), and generalized pain (n=9; 12.3%). Those reporting headache as their main symptom were less likely to require ICU admission (P=.003). Acetaminophen or nonsteroidal anti-inflammatory drugs were prescribed to 80.8% (n=59), opioids to 17.8% (n=13), adjuvants to 8.2% (n=6), and ketamine to 5.5% (n=4) of patients with pain. When age 65 years and older and sex were controlled for in multivariable analysis, the absence of pain was associated with ICU admission (odds ratio, 2.92; 95% CI, 1.42 to 6.28; P=.004) and death (odds ratio, 3.49; 95% CI, 1.40 to 9.76; P=.01). CONCLUSION Acute pain is common during active COVID-19 infection with the most common manifestations being headache, chest pain and spine pain. Individuals without pain were more likely to require intensive care and expire than those with pain. Reasons why pain may be associated with reduced mortality include that an intense systemic stimulus (eg, respiratory distress) might distract pain perception or that the catecholamine surge associated with severe respiratory distress might attenuate nociceptive signaling.
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Affiliation(s)
- Nigel Knox
- Department of Anesthesiology, Westchester Medical Center, New York Medical College, Westchester, NY
| | - Chang-Soon Lee
- Department of Anesthesiology, Seoul National University, Seoul, Korea
| | - Jee Youn Moon
- Department of Anesthesiology, Seoul National University, Seoul, Korea; Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD
| | - Steven P Cohen
- Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD; Department of Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD; Department of Physical Medicine & Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Anesthesiology, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
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9
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Kohan L, Durbhakula S, Zaidi M, Phillips CR, Rowan CC, Brenner GJ, Cohen SP. Changes in Pain Medicine Training Programs Associated With COVID-19: Survey Results. Anesth Analg 2021; 132:605-615. [PMID: 33177326 DOI: 10.1213/ane.0000000000005314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is a public health crisis of unprecedented proportions that has altered the practice of medicine. The pandemic has required pain clinics to transition from in-person visits to telemedicine, postpone procedures, and cancel face-to-face educational sessions. There are no data on how fellowship programs have adapted. METHODS A 17-question survey was developed covering topics including changes in education, clinical care, and psychological stress due to the COVID pandemic. The initial survey was hosted by Qualtrics Inc and disseminated by the Association of Pain Program Directors on April 10, 2020, to program directors at Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowships. Results are reported descriptively and stratified by COVID infection rate, which was calculated from Centers for Disease Control and Prevention data on state infections, and census data. RESULTS Among 107 surveys distributed, 70 (65%) programs responded. Twenty-nine programs were located in states in the upper tertile for per capita infection rates, 17 in the middle third, and 23 in the lowest tertile. Nearly all programs (93%) reported a decreased workload, with 11 (16%) reporting a dramatic decrease (only urgent or emergent cases). Just more than half of programs had either already deployed (14%) or credentialed (39%) fellows to provide nonpain care. Higher state infection rates were significantly associated with reduced clinical demand (Rs = 0.31, 95% confidence interval [CI], 0.08-0.51; P = .011) and redeployment of fellows to nonpain areas (Rs = 0.30, 95% CI, 0.07-0.50; P = .013). Larger program size but not infection rate was associated with increased perceived anxiety level of trainees. CONCLUSIONS We found a shift to online alternatives for clinical care and education, with correlations between per capita infection rates, and clinical care demands and redeployment, but not with overall trainee anxiety levels. It is likely that medicine in general, and pain medicine in particular, will change after COVID-19, with greater emphasis on telemedicine, virtual education, and greater national and international cooperation. Physicians should be prepared for these changes.
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Affiliation(s)
- Lynn Kohan
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | | | | | | | - Cody C Rowan
- From the Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Gary J Brenner
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Steven P Cohen
- Departments of Anesthesiology & Critical Care Medicine, Neurology and Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Physical Medicine & Rehabilitation and Anesthesiology, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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10
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Gallagher RM. The Social Forces Healing Patients with Painful Conditions: What Happens After COVID-19? PAIN MEDICINE 2021; 22:239-242. [PMID: 33484145 PMCID: PMC7928671 DOI: 10.1093/pm/pnaa486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Cohen SP, Hooten WM, Phillips CR. The Neglect of Educational Issues During the COVID-19 Pandemic. PAIN MEDICINE (MALDEN, MASS.) 2020; 21:1736-1737. [PMID: 32585007 PMCID: PMC7337878 DOI: 10.1093/pm/pnaa196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Steven P Cohen
- Department of Anesthesiology, Neurology and Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, Maryland
- Department of Anesthesiology and Physical Medicine and Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - W Michael Hooten
- Department of Anesthesiology and Perioperative Medicine, Mayo School of Medicine, Rochester, Minnesota
| | - Christopher R Phillips
- Anesthesiology Service, Department of Surgery, Naval Medical Center-San Diego, San Diego, California, USA
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Sneyd JR, Mathoulin SE, O'Sullivan EP, So VC, Roberts FR, Paul AA, Cortinez LI, Ampofo RS, Miller CJ, Balkisson MA. Impact of the COVID-19 pandemic on anaesthesia trainees and their training. Br J Anaesth 2020; 125:450-455. [PMID: 32773215 PMCID: PMC7377727 DOI: 10.1016/j.bja.2020.07.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/26/2020] [Accepted: 07/05/2020] [Indexed: 01/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] has dislocated clinical services and postgraduate training. To better understand and to document these impacts, we contacted anaesthesia trainees and trainers across six continents and collated their experiences during the pandemic. All aspects of training programmes have been affected. Trainees report that reduced caseload, sub-specialty experience, and supervised procedures are impairing learning. Cancelled educational activities, postponed examinations, and altered rotations threaten progression through training. Job prospects and international opportunities are downgraded. Work-related anxieties about provision of personal protective equipment, and risks to self and to colleagues are superimposed on concerns for family and friends and domestic disruption. These seismic changes have had consequences for well-being and mental health. In response, anaesthetists have developed innovations in teaching and trainee support. New technologies support trainer–trainee interactions, with a focus on e-learning. National training bodies and medical regulators that specify training and oversee assessment of trainees and their progression have provided flexibility in their requirements. Within anaesthesia departments, support transcends grades and job titles with lessons for the future. Attention to wellness, awareness of mental health issues and multimodal support can attenuate but not eliminate trainee distress.
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Affiliation(s)
- John R Sneyd
- Peninsula Medical School, University of Plymouth, Plymouth, UK.
| | - Sophie E Mathoulin
- Department of Anaesthesia, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | | | - Vincent C So
- Department of Anaesthesiology, Queen Mary Hospital, Hong Kong; Department of Anaesthesiology, University of Hong Kong, Hong Kong
| | - Fiona R Roberts
- Department of Anaesthesia, St Vincent's University Hospital, Dublin, Ireland
| | - Aaron A Paul
- Department of Anaesthesia, Alfred Hospital, Melbourne, Australia
| | - Luis I Cortinez
- Department of Anesthesia, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Russell S Ampofo
- Department of Education, Training and Examinations, Royal College of Anaesthetists, London, UK
| | - Caitlynn J Miller
- Department of Anesthesiology, University of Texas Health Science Centre at Houston, Houston, TX, USA
| | - Maxine A Balkisson
- Department of Anaesthesia and Critical Care, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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