How COVID-19 Is Impacting Residency Education: The Residents’ Perspective

The COVID-19 outbreak hit the health care community especially hard and residents are no exception. With this in mind, these resident panelists share their experiences in this unprecedented time, including how their programs are adjusting, their duties to patients and other observations on their daily lives.

Q: What changes and/or processes are being implemented by your residency program in light of the COVID-19 outbreak? How has this changed your day-to-day activities as a resident?

A:

Elizabeth Ansert, DPM shares that her program now has a very academic focus that includes daily meetings with various attendings. 

“With elective cases cancelled by the state and clinics trying to limit the exposure of patients and residents, emphasis is shifting to research and more traditional styles of learning,” says Dr. Ansert.

Spruha Magodia, DPM relates that her program switched to a “skeleton crew” to reduce the number of residents at the hospital on a daily basis and that clinic is now only two days per week. 

“Residents cover the hospital as a small team with backup for trauma cases and a COVID-19 backup as well in case any team member becomes sick,” acknowledges Dr. Magodia. 

Dr. Ansert notes she has had a similar experience with less team members from her residency program working at the program’s hospital. Specifically, she notes that one resident each week takes calls and another resident is designated as a backup. Other residents are covering add-on cases as necessary, according to Dr. Ansert.

She adds that additional precautions are in place at her hospital system, including symptom checks for employees before entering the hospital; personal protective equipment (PPE) distributed each day; more frequent hand washing; and instructions to limit contact.

Ulyana Kulish, DPM adds that the residents at her program had additional PPE training and that they are communicating with non-emergent patients via telemedicine. Dr. Kulish says schedules have been adjusted to minimize resident to resident contact as well. 

“Our program is very resident-driven so we encourage each other to use this time to improve our academics or work on research projects,” adds Dr. Kulish. 

Dr. Magodia relates that she sees her hospital making quite a few changes to prepare for a spike in COVID-19 cases. She is also aware of podiatric residents at other residency programs who have been asked to cover non-podiatric services or help in screening tents.

“We are mentally prepared for this scenario as well and will do what is necessary to accommodate any changes,” maintains Dr. Magodia.

Q: What concerns do you have from an educational standpoint about the impact of the COVID-19 outbreak on your residency training?

A:

Both Dr. Ansert and Dr. Magodia cite a concern over possible loss of surgical motor skills due to not being in the operating room. Explaining that these skills require physical practice, both panelists relate they and their co-residents are using suture boards or other home practice methods to make the best of the situation. 

“Surgery simply has to be performed in order to gain confidence and achieve finesse,” adds Dr. Magodia. “But we are facing this loss with as much grace as we can.”

Residents are using their time wisely to enrich their learning under the circumstances.

“This time has allowed residents to study and get through academic material in a more traditional way through reading, watching webinars and listening to podcasts,” says Dr. Ansert. “Under normal circumstances, these means of learning may have taken much longer to accomplish with our schedule.”

Dr. Magodia agrees. She says she feels fortunate that her residency program routinely places a large focus on academics. Currently, she shares that residents are continuing academic meetings with attending faculty present and grand rounds. They are also partaking in student-lead presentations of pertinent podiatric topics and working on research assignments, according to Dr. Magodia. 

Dr. Kulish continues to say that although their schedules are different from before the pandemic, she feels strongly about doing her part to “flatten the curve” and not exposing patients and staff to the virus unnecessarily. 

Q: What concerns do you have personally as a health care provider during this challenging time?

A:

“Personally, I am concerned with passing on the COVID-19 virus unknowingly,” shares Dr. Ansert. “Since most patients do not show symptoms for a long time, it is difficult to know who is a carrier.”

She explains that residents have been educated on how to minimize risk but acknowledges it is still a possibility. All of the resident panelists cite worries regarding risk to friends and family as well.

Dr. Kulish expresses concern about patients who are not seeking truly necessary care during the quarantine.

“I’m worried that due to lack of public education, preventable conditions are going undiagnosed or untreated,” explains Dr. Kulish.

Dr. Magodia says there is knowledge of colleagues in other states testing positive for COVID-19. Health and safety are at the forefront of many residents’ minds, she notes.

“The city we live in is quiet and the streets are empty,” says Dr. Magodia. “Walking to the parking lot at 5 a.m. every morning has me looking over my shoulder more now than ever before.” 

Q: Please feel free to share any other related thoughts.

A:

“A lot of people are talking about the physical aspect of this pandemic,” says Dr. Ansert. “However, the mental and emotional components are often disregarded. These aspects are just as important as physical health.” 

She stresses the importance of residents taking care of their mental health under these circumstances as well. 

Dr. Magodia agrees.

“These are trying times for the global population as a whole but being at a hospital gives one a particular perspective,” notes Dr. Magodia. “I hope hospitals and residency programs support the well-being of their residents not only during this time but afterward as well.” 

Health care is a team approach, says Dr. Kulish, and although residency training looks different right now, she believes everyone is able to learn from each other and support one another during this difficult time. 

Dr. Bernstein is the Director of the Podiatric Residency Program at Bryn Mawr Hospital in Bryn Mawr, Pa. He is a Fellow of the American College of Foot and Ankle Surgeons.

Dr. Ansert is a first-year podiatric surgery resident at a hospital in the northeastern United States.

Dr. Kulish is a first-year podiatric surgery resident at Cedars Sinai Medical Center in Los Angeles.

Dr. Magodia is a third-year podiatric surgery resident at Temple University Hospital in Philadelphia.