HealthJuly 01, 2020

How to prepare for residency during COVID-19: What to expect

By: Brian Wu, MD, PhD

Figuring out how to prepare for residency training in 2020 begins with understanding what’s changed. Here’s a closer look.

During a normal year, the question of how to prepare for residency can be difficult enough to figure out. Now, with the world still in the midst of the COVID-19 pandemic, preparing for your next frontier in medical training is even tougher.

There's no doubt that residency is going to look vastly different from even a year ago, but knowing what to expect will help you make the transition more successfully.

The leap to virtual learning

One thing that hasn't changed during the COVID-19 pandemic? Residency remains a crucial time in medical education. It's a time during which new physicians are trained in their chosen areas of expertise and didactic learning is synthesized into hands-on clinical skills. However, the nature of this training has been changed by COVID-19, at least for residents in hard-hit areas.

One of the earliest and most drastic changes to medical education (at all levels) was the cancellation of on-site medical classes. These classes were largely replaced by various online sessions that took the form of recorded lectures, Zoom meetings or livestreaming. While some students don't feel like they're missing out on any necessary content, others worry that they're sacrificing the collaboration and discussion that only comes from a good on-site classroom experience. However, if you're in your final year of medical school and feeling ready to transition to residency, you probably have already experienced this shift to online educational formats and may not feel too bothered by this change.

That said, be prepared for the fact that conferences, which allow students the chance to present findings and learn from other students and physicians, and grand rounds are also now on online platforms. While this is considered safer for students due to lower risk of transmission, some students worry they're missing out on learning experiences.

Shifts in emphasis

MedPage Today notes that with the onset of the pandemic, policies regarding medical education requirements have been eased so that residents, fellows, physicians and others can help care for the surge of patients that many medical centers have experienced.

Hospitals in hard-hit areas can self-declare Pandemic Emergency Status, as defined by the Accreditation Council for Graduate Medical Education. This status allows hospitals "to accommodate the need for all physicians, including residents and fellows, to care for patients to the best of their abilities during this pandemic." This means that if you're a resident in a hospital with this status, you could be reassigned to work in an area such as the emergency department in order to help manage the influx of patients. Thus, flexibility and the ability to shift gears quickly are important qualities to cultivate as you prepare for residency.

However, MedPage Today also states that these changes have not been universal, and much depends on the area of the country in which the residency is taking place. For instance, the cardiology program at the Stanford University medical center in California has experienced profound changes, with a shift to "core rotations" in areas like the cardiac care unit and a lot of back-up support. This is in contrast to Duke University programs, which have avoided Pandemic Emergency Status and have proceeded with normal graduate medical education.

New levels of stress and anxiety

You should also be prepared for the possibility of increased stress as you begin your residency during the COVID-19 outbreak. In an interview with the American Medical Association, Dr. Anna Yap, a second-year resident in emergency medicine, said, "The shifts are harder than I cerebrally thought they would be. Having to wear personal protective equipment all the time is uncomfortable. The worry about, 'Am I going to get sick? Am I putting this on correctly? What if I do something wrong?'"

As a resident, I can personally attest that residency at this time has included a whole different level of anxiety, especially because I'm married and have a child, so I worry about exposing my family to the virus accidentally because of my work.

Possible financial benefits

While there are certainly potential downsides to becoming a resident during the COVID-19 pandemic, there's also some good news in the form of new possible financial benefits for residents. The AMA's National Physician Town Hall Questions on Residency explains that in response to the fact that doctors and residents have been on the front lines of the pandemic, the federal government has eased its historic restrictions on physician compensation. It is now possible for a hospital to offer hazard pay to both physicians and residents, although it's important to note that this is not an obligation.

According to a recent article in Physicians Practice, the U.S. House of Representatives has drafted the Heroes Act, a $3 trillion piece of legislation that would include $200 billion for hazard pay for essential workers. While this legislation is expected to move slowly through Congress, it's a good idea to keep an eye on this act.

You could also see potential benefits if you've accrued student loan debt for your medical education. The Coronavirus Aide, Relief and Economic Security (CARES) Act was signed into law on March 27, and the AMA notes that the CARES Act has the potential to financially benefit medical students because it includes provisions for student loan repayment, interest accrual and the ability to apply for Supplemental Educational Opportunity Grants.

No matter when it occurs, residency is one of the most important parts of your medical education, requiring a massive commitment of time, resources and energy. As you think about how to prepare for residency, keep in mind that the impact of COVID-19 has been significant and that it brings extra opportunities to care for patients and develop clinical skills even as other opportunities have been taken away.

I believe that those of us who are in residency during this critical time will emerge with a deeper, more nuanced understanding of healthcare and its central importance to individuals and society.

Brian Wu, MD, PhD
Lippincott Medicine
Lippincott is a leading international medical publisher of professional health information for practitioners, faculty, residents, students, and healthcare institutions with a full suite of essential medical products, from books and journals to digital solutions.
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