US Pediatric Residents’ Experiences Completing Training During COVID-19

Frintner MP, Kornfeind K, Haftel H

Presented at the 2021 Pediatric Academic Societies Annual Meeting

Background: COVID-19 has greatly impacted the US healthcare system, likely including pediatric residents graduating in 2020 during the final months of training and career transitions.

Objective: Examine the impact of COVID-19 on US graduating residents’ 1) training experiences and 2) careers.

Methods: Data from the 2020 AAP Annual Survey of Graduating Residents, a random sample across US programs (response=48%; analytic sample=481). Surveys were completed April 30-Sept, 75% by July 31. Respondents were asked: if they cared for children with COVID-19 during training, changes to their training, and impact of COVID-19 on search for next position and career. Chi-square examined variations in training experiences by region of residency training (Northeast-NE, Midwest-MW, South-S, West-W).

Results: 60% of residents reported caring for any children with COVID-19 infection (median=4); the patient care setting for most residents (76%) was the inpatient ward. 20% were asked to provide care to adult patients. 37% worked with a resident infected with COVID-19. Residents from NE programs were more likely to care for a child (77% vs 52% MW, 53% S, 61% W, p<.001) or work with a resident with COVID (49% vs 31% MW, 31% S, 36% W, p<.01) and be asked to provide care to adults (48% vs 8% MW, 10% S, 4% W, p<.001).

Training Impact: Most (85%) experienced decreased time in direct patient care and 53% reported fewer hours worked per week. Most report increased remote learning (95%) and self-study activities (88%) and cancelled or shortened elective or ambulatory rotations (76%). Use of telehealth to provide care increased from 10% before the pandemic to 76% during (Figure). Residents in the West were more likely than those in other regions to report occasional or often use of telehealth during the pandemic (93% vs 75% NE, 75% MW, 71% S, p<.01).

Career Impact: Half were moderately (24%) or very (27%) concerned about the impact of COVID-19 on their post-residency position. 42% were moderately (21%) or very (21%) concerned about being prepared for the ABP exam. Among residents going into general pediatrics, 15% reported a job of interest was pulled off the market, 16% reported an offer was modified or withdrawn, and 18% that a job wouldn’t start at scheduled time.

Conclusion: In 2020, COVID-19 altered the final months of residency with less time in training and patient care and more remote experiences including telehealth. While NE graduates were especially impacted by the timing and location of the pandemic, in 2021 residents across the US may be similarly impacted.