With the move from medical school to residency a few weeks away for tens of thousands of new physicians, this is transition unlike any that has preceded it—in both the practical and clinical sense.
In the midst of a pandemic, many residents have questions and concerns about beginning training. AMA member Elizabeth Southworth, MD, who will join the ob-gyn residency program at Michigan Medicine in the coming weeks sheds light on what those concerns may be.
Lack of recent clinical experience
In mid-March as the COVID-19 pandemic took hold, the Association of American Medical Colleges (AAMC) called for a suspension of activities that involve students interacting with patients. While the interruption had a more significant impact on third-year medical students who were in the midst of their clinical rotations, it also affected fourth-year students, some of whom were getting valuable final lessons prior to beginning residency.
“In a usual year, residents have about a month and a half of clinical downtime,” Dr. Southworth said. “This year, a lot of us were pulled back in early March. A lot of my anxieties or apprehensions are related to getting back in the clinical setting. It’s been so long since I’ve been able to sit down and talk to a patient, let alone examine a patient. Hopefully it will be like riding a bike, and we’ll just fall back into it pretty quickly.”
Personal and patient safety
Residency programs and the AMA have put an emphasis on trainee safety throughout the pandemic, and that has extended to the transition of new residents on the wards. Dr. Southworth and her cadre of incoming residents have been participating in weekly grand rounds, via video conference. Many of those meetings have detailed issues about returning to a normal patient flow.
“I have yet to be tested for COVID,” Dr. Southworth said. “Not that there’s a reason for me to be tested, but there’s the question mark of is that something that may happen early or how are all the different programs handling it? Should we get tested before we start? Is there any utility to that? Or is the plan to maintain a high level of precaution and utilize PPE appropriately and properly from the start?
I do feel comfortable knowing that the program I’m heading to has a plan and they are going to share how we fit into that as we go through orientation.”
Access to facilities and learning opportunities
Going into a surgical specialty, Dr. Southworth expressed some concerns that are typical for any medical student transitioning to residency—how will it feel when you hold the scalpel?
That question is further complicated by access to facilities; while elective surgeries, which were postponed as the pandemic peaked, are largely back on the docket, many of the aspects of training that give residents a dress rehearsal for procedures are not.
“A lot of the simulation centers and the high fidelity clinical simulation labs are not fully operational yet because you still see so many medical schools not fully open,” Dr. Southworth said. The AMA has curated a selection of resources to assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.
