Nearly 30% of fellows and residents at a New York-based hospital screened positive for at least one psychiatric disorder during the city’s pandemic peak in the spring of 2020. Data detailing the pandemic’s consequences for that group was presented during the 2021 International Conference on Physician Health.
Those results come via an electronic survey sent out during April and May of 2020 to health care workers at Mount Sinai Hospital.
“We know that trainees are already at a high risk for burnout and psychological distress, making them a really interesting and important group to study,” said Carly Kaplan, a medical student and research assistant at the Icahn School of Medicine at Mount Sinai.
Learn about research from the AMA finding that half of health workers reported burnout amid COVID-19.
Burnout and psychological disorders
Survey respondents included 560 residents and fellows in front-line specialties at Mount Sinai.
The survey assessed burnout, for which 35.8% of resident and fellow respondents screened positive.
“Increased work hours were associated with increased odds of burnout,” Kaplan said. “This is a really well-documented phenomenon that those who work more hours are often more burned out, whether or not you are in a pandemic. Still, it’s important to note because there were about 20% of trainees who had increased work hours during this time.”
The survey also looked at psychological disorders. Nearly 30% of respondents screened positive for one psychiatric disorder—19.1% for depression, 17.5% for anxiety and 13.3% for PTSD.
Discover AMA resources on caring for our caregivers during COVID-19.
Concerns and coping
Kaplan divided survey respondents’ worries into three categories: personal, career and duty-related worries. Those who reported worries in any of those categories were more likely to report both burnout and psychological symptoms.
Physician residents and fellows also were asked about coping strategies. The top coping strategies were self-distraction (65.8% of respondents), use of emotional support (44.3%) and venting (38.8%). Nearly 9% said they were coping by substance use.
“On a slightly more positive note, there were factors we found that were protective against developing psychological symptoms and burnout,” Kaplan said. “Specifically, positive emotional-focused coping was associated with a decreased likelihood of screening positive for psychiatric symptoms. Likewise, reporting that you felt valued by your immediate supervisors was significantly associated with lower risk of psychiatric symptoms and burnout.”
Read about five solutions to help ease physicians’ COVID-19 burnout.
Interventions
Residents and fellows were asked about interventions that they thought would be beneficial during the time. Respondents said adequate personal protective equipment (PPE), scrub access and food availability were among the interventions that would be constructive. Two out of three respondents also said they would benefit from increased financial support.
The study’s goal was to give graduate medical education leaders actionable methods to help residents and fellows. Kaplan listed several during her presentation, including:
- Advocate for trainees’ basic needs including access to PPE, scrubs and food.
- Avoid increasing trainee work hours.
- Advocate for crisis pay to financially support trainees and show appreciation
- Make direct efforts to communicate and demonstrate trainee value through town halls, direct messaging and acts of appreciation
- Bolster mental health services, particularly those aimed at maladaptive coping while enhancing adaptive coping skills.
Learn more with the AMA about the tools available to help doctors hit hard by COVID-19 stress.
