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Purpose: To quantify the extent to which internal medicine (IM) residents provided care for patients with COVID-19 and examine characteristics of residency programs with or without plans (at some point) to exclude residents from COVID-19 care during the first 6 months of the pandemic.

Method: The authors used data from a nationally representative, annually recurring survey of U.S. IM program directors (PDs) to quantify early (March-August 2020) resident participation in COVID-19 care. The survey was fielded from August to December 2020. PDs reported whether they had planned to exclude residents from COVID-19 care (i.e., PTE status). PTE status was tested for association with program and COVID-19 temporal characteristics, resident schedule accommodations, and resident COVID-19 cases.

Results: The response rate was 61.5% (264/429). Nearly half of PDs (45.4%, 118/260) reported their program had planned at some point to exclude residents from COVID-19 care. Northeastern U.S. programs represented a smaller percentage of PTE than non-PTE programs (26.3% vs 36.6%; P = .050). PTE programs represented a higher percentage of programs with later surges than non-PTE programs (33.0% vs 13.6%, P = .048). Median percentage of residents involved in COVID-19 care was 75.0 (interquartile range [IQR]: 22.5-100.0) for PTE programs, compared with 95.0 (IQR: 60.0-100.0) for non-PTE programs ( P < .001). Residents participated most in intensive care units (87.6%, 227/259) and inpatient wards (80.8%, 210/260). Accommodations did not differ by PTE status. PTE programs reported fewer resident COVID-19 cases than non-PTE programs (median percentage = 2.7 [IQR: 0.0-8.6] vs 5.1 [IQR: 1.6-10.7]; P = .011).

Conclusions: IM programs varied widely in their reported plans to exclude residents from COVID-19 care during the early pandemic. A high percentage of residents provided COVID-19 care, even in PTE programs. Thus, the pandemic highlighted the tension as to whether residents are learners or employees.

Titel:	Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers.
Autor/in / Beteiligte Person:	Martin, SK ; Finn, KM ; Kisielewski, M ; Simmons, R ; Zaas, AK
Zeitschrift:	Academic medicine : journal of the Association of American Medical Colleges, Jg. 97 (2022-11-01), Heft 11, S. 1683-1690
Veröffentlichung:	Philadelphia, PA : Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins ; <i>Original Publication</i>: [Philadelphia, Pa. : Hanley & Belfus, c1989-, 2022
Medientyp:	academicJournal
ISSN:	1938-808X (electronic)
DOI:	10.1097/ACM.0000000000004800
Schlagwort:	Humans United States epidemiology Pandemics Surveys and Questionnaires Internship and Residency COVID-19 epidemiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Acad Med] 2022 Nov 01; Vol. 97 (11), pp. 1683-1690. <i>Date of Electronic Publication: </i>2022 Jul 05. MeSH Terms: Internship and Residency* ; COVID-19* / epidemiology ; Humans ; United States / epidemiology ; Pandemics ; Surveys and Questionnaires References: Mayo Foundation for Medical Education and Research v United States, 562 US 44 (2011). ; Catalanotti JS, Amin AN, Caverzagie K, et al. Balancing service and education: An AAIM consensus statement. Am J Med. 2017;130:237–242. ; Redberg RF, Katz M, Steinbrook R. Internal medicine and COVID-19. JAMA. 2020;324:1135–1136. ; Association of American Medical Colleges. Important guidance for medical students on clinical rotations during the coronavirus (COVID-19) outbreak. https://www.aamc.org/news-insights/press-releases/important-guidance-medical-students-clinical-rotations-during-coronavirus-covid-19-outbreak . 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Residency Program Responses to Early COVID-19 Surges Highlight Tension as to Whether Residents Are Learners or Essential Workers.