Medical Education Gone Viral During the COVID-19 Pandemic

BACKROUND: Education and medical training were heavily impacted by the COVID-19 pandemic. Exposed to stress and burnout, many trainees, including medical students and residents, exhibited psychiatric symptoms, such as anxiety, depression, and suicidal ideation. In contrast, others were asymptomatic. A better understanding of clinical variability among medical trainees exposed to overwhelming stress could be helpful for planning and navigating future emergencies.  OBJECTIVES: To elucidate the role of vulnerability and resilience of young medical students and residents during the COVID-19 pandemic, we conducted a pilot study by psychiatric interview of both symptomatic and asymptomatic students and residents from three Southern California universities.  Formal IRB approval was not sought due to the pilot nature, urgency, and the supportive nature of the intervention; however, all participants provided informed consent prior to the interviews. METHODS: Screening for early signs of anxiety, depression, and suicidal ideation was completed by using semi-structured psychiatric interviews based on DSM-5 criteria. The Consolidated Criteria for Reporting Qualitative Research (COREQ), a 32-item checklist designed to promote explicit and comprehensive reporting of qualitative research studies, was utilized. In general, the trainees who harbored second thoughts about their suitability for the medical profession exhibited more symptoms of mental distress compared to the students and residents who believed they were “meant” to be physicians.  RESULTS: Our findings suggest that doubts about the practice of medicine may be associated with increased psychiatric distress during crisis situations, although further controlled research is needed to clarify causality, as this was a small, non-controlled pilot study that did not control for confounding variables such as pre-existing mental health status, personality traits, or academic performance. Conversely, problem identification and early treatment may mitigate the emergence of psychiatric symptoms. CONCLUSIONS: Our pilot study is in line with larger studies that looked at preexisting emotional distress as a deterrent to an adequate response during disasters.