scholarly journals Interns’ perspectives on impacts of the COVID-19 pandemic on the medical school to residency transition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ariel S. Winn ◽  
Matthew D. Weaver ◽  
Katherine A. O’Donnell ◽  
Jason P. Sullivan ◽  
Rebecca Robbins ◽  
...  

Abstract Background The COVID-19 pandemic resulted in disruptions to medical school training and the transition to residency for new post-graduate year 1 resident-physicians (PGY1s). Therefore, the aim of this study was to understand the perspectives of United States PGY1s regarding the impact of the pandemic on these experiences. Our secondary aims were to understand how desire to practice medicine was impacted by the pandemic and whether PGY1s felt that they were able to meaningfully contribute to the COVID-19 response as students. Method We conducted a national, cross-sectional study of PGY1s who had recently graduated from medical school in 2020. A survey was distributed to PGY1s from across specialties, in programs distributed throughout the United States. It included questions about medical school training during the pandemic, impact on graduation timing and transition to internship, concerns about caring for patients with COVID-19, desire to practice medicine, and ability to meaningfully contribute to the pandemic. Findings are presented using descriptive statistics and univariate logistic regression models. Results 1980 PGY1s consented to participate, 1463 completed the survey (74%), and 713 met criteria for this analysis. 77% of PGY1s reported that the pandemic adversely affected their connection with their medical school communities, and 58% reported that the pandemic impeded their preparation for intern year. 4% of PGY1s reported graduating medical school and practicing as an intern earlier than their expected graduation date. While the majority of PGY1s did not have a change in desire to practice medicine, PGY1s with concerns regarding personal health or medical conditions (OR 4.92 [95% CI 3.20–7.55] p < 0.0001), the health or medical conditions of others in the home (OR 4.41 [2.87–6.77], p < 0.0001]), and PGY1s with children (OR 2.37 [1.23–4.58], p < 0.0001) were more likely to report a decreased desire. Conclusions The COVID pandemic disrupted the social connectedness and educational experiences of a majority of PGY1 residents in a sample of trainees in United States training programs. Those with health concerns and children had particularly challenging experiences. As the current and subsequent classes of PGY1s affected by COVID-19 proceed in their training, ongoing attention should be focused on their training needs, competencies, and well-being.

2020 ◽  
Vol 65 (10) ◽  
pp. 710-720
Author(s):  
Claire de Oliveira ◽  
Tomisin Iwajomo ◽  
Tara Gomes ◽  
Paul Kurdyak

Background: Recent research found that physicians who completed medical school training at top-ranked U.S. medical schools prescribed fewer opioids than those trained at lower ranked schools, suggesting that physician training may play a role in the opioid epidemic. We replicated this analysis to understand whether this finding holds for Ontario, Canada. Methods: We used data on all opioid prescriptions written by Ontario physicians between 2013 and 2017 from the Narcotics Monitoring System. Using the Corporate Provider Database and ICES Physician Database, which contain medical school of training, we linked patients who filled opioid prescriptions with their respective prescribing physician. Available data on Canadian medical school rankings were obtained from Maclean’s news magazine. We used regression analysis to assess the relationship between number of opioid prescriptions and medical school ranking. Results: Compared to the United States, average annual number of opioid prescriptions per physician was lower in Ontario (236 vs. 78). Unlike the United States, we found little evidence that physicians trained at lower ranked medical schools prescribed more than their top-ranked school counterparts after controlling for specialty and location of practice. However, primary care physicians trained at non-English-speaking foreign schools prescribed the most opioids even after excluding opioid maintenance therapy–related prescriptions. Conclusion: The role of medical school training on opioid prescribing patterns among Ontario physicians differs from that in the United States likely due to greater homogeneity of curricula among Canadian schools. Ensuring physicians trained abroad receive additional pain management/addiction training may help address part of the opioid epidemic in Ontario.


2021 ◽  
Author(s):  
Shuya Pan ◽  
Chia-Chen Yang ◽  
Jiun-Yi Tsai ◽  
Chenyu Dong

BACKGROUND The outbreak of COVID-19 has spurred increasing anti-Asian racism and xenophobia in the United States, which can compromise the psychological well-being among Asian people. The impact of racial discrimination fueled by a global pandemic on the well-being remains unclear. This study is a novel attempt to empirically examine how racial discrimination during COVID-19 would be associated with depression among Asians in the United States. OBJECTIVE We investigated three discrimination-related variables, including experience of discrimination, worry about discrimination, and social media exposure to racism-related information during COVID-19, and aimed to examine how three variables were related to depression among Asians in the United States. METHODS A cross-sectional online survey was conducted. A total of 222 people (Mage = 33.53, SD = 11.35; 46.40% female) who identified themselves as Asian or Asian American and resided in the United States completed the questionnaire. RESULTS Our study showed that only experience of discrimination was significantly associated with depression among US Asians (β=.29, P =.002), whereas worry about discrimination ((β=.13, P=.128) and social media exposure to racism-related information ((β=.09, P=.209) were not. Meanwhile, our study also suggested that those who were younger (β=-.17, P=.021), not married (β=-.15, P=.046), infected by COVID-19 (β=.23, P=.001) and whose income were affected because of the pandemic (β=.13, P=.046) were more vulnerable to depression. CONCLUSIONS The present study provides preliminary evidence about the impact of racial discrimination during COVID-19 on mental health among Asian people. Based on our findings, future research could advance the understanding of incident-induced discrimination in relation to the well-being by identifying moderators that may buffer or exacerbate the influence of such racial discrimination. Practically, developing effective and tailored interventions to address different demographic groups’ needs in a timely fashion is much-need to help Asians cope with racial discrimination during an unprecedented global health crisis.


2020 ◽  
Author(s):  
Francesco Rigoli

Research has shown that stress impacts on people’s religious beliefs. However, several aspects of this effect remain poorly understood, for example regarding the role of prior religiosity and stress-induced anxiety. This paper explores these aspects in the context of the recent coronavirus emergency. The latter has impacted dramatically on many people’s well-being; hence it can be considered a highly stressful event. Through online questionnaires administered to UK and USA citizens professing either Christian faith or no religion, this paper examines the impact of the coronavirus crisis upon common people’s religious beliefs. We found that, following the coronavirus emergency, strong believers reported higher confidence in their religious beliefs while non-believers reported increased scepticism towards religion. Moreover, for strong believers, higher anxiety elicited by the coronavirus threat was associated with increased strengthening of religious beliefs. Conversely, for non-believers, higher anxiety elicited by the coronavirus thereat was associated with increased scepticism towards religious beliefs. These observations are consistent with the notion that stress-induced anxiety enhances support for the ideology already embraced before a stressful event occurs. This study sheds light on the psychological and cultural implications of the coronavirus crisis, which represents one of the most serious health emergencies in recent times.


2021 ◽  
Vol 35 ◽  
pp. 100848
Author(s):  
Ganesh M. Babulal ◽  
Valeria L. Torres ◽  
Daisy Acosta ◽  
Cinthya Agüero ◽  
Sara Aguilar-Navarro ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 772-773
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Connie Bales ◽  
Julie Locher

Abstract Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.


1979 ◽  
Vol 39 (1) ◽  
pp. 69-85 ◽  
Author(s):  
Philip R. P. Coelho ◽  
James F. Shepherd

Differences in regional prices and wages are examined for the United States in 1890, together with the relationship between the cost of living and city size, and the determinants of regional industrial growth. Results indicate that regional cost-of-liying differences were sufficiently large so that money wages cannot be used for purposes of comparing the economic well-being of wage earners across regions. Except for the South, money wages and the cost of living were positively correlated. The relative differences in money wages, however, were greater; consequently real wages in high wage-price areas were generally higher.


2018 ◽  
Vol 115 (28) ◽  
pp. 7290-7295 ◽  
Author(s):  
Noreen Goldman ◽  
Dana A. Glei ◽  
Maxine Weinstein

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.


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