Rabin Elaine, Willis James, Alexander Dorian, Steinberg Eric, Chung Arlene, Kulkarni Miriam, He Chen, Parikh Saumil
Department of Emergency Medicine Icahn School of Medicine at Mount Sinai Mount Sinai Hospital New York New York NY USA.
Department of Emergency Medicine SUNY Downstate College of Medicine, SUNY Downstate Medical Center Brooklyn NY USA.
AEM Educ Train. 2020 Oct 28;4(4):340-346. doi: 10.1002/aet2.10523. eCollection 2020 Oct.
Emergency medicine residency program directors (PDs) in areas hit hardest by the initial U.S. COVID-19 pandemic surge faced novel and rapidly evolving organizational, educational, and resident wellness challenges. Despite variations in residency size, hospital setting, and patient population, PDs from eight residencies in "the epicenter" found uniformity in many of the lessons learned. Here we present those lessons and suggestions for high-yield preparation for running a residency during a surge. Of particular importance were frequent, transparent communication and stepwise staffing plans. Illness of residents and other staff occurred early and were substantially reduced as personal protective equipment protocols tightened. Wellness was compromised by anxiety and illness, with varying timelines. New, rich educational opportunities emerged. All programs declared ACGME pandemic status but remained able to maintain some educational offerings. Planning ahead for future surges can significantly reduce the real-time burden for residency leadership, which is particularly important as clinical demands on leadership may also increase with a surge.
在美国最初新冠疫情激增期间受影响最严重地区的急诊医学住院医师培训项目主任，面临着全新且迅速演变的组织、教育和住院医师健康方面的挑战。尽管住院医师培训规模、医院环境和患者群体存在差异，但来自“疫情中心”八个住院医师培训项目的主任在许多经验教训中发现了一致性。在此，我们呈现这些经验教训以及在疫情激增期间高效运营住院医师培训项目的准备建议。尤为重要的是频繁、透明的沟通以及逐步的人员配置计划。住院医师和其他工作人员的患病情况较早出现，随着个人防护装备协议收紧，患病情况大幅减少。健康受到焦虑和疾病的影响，且时间线各不相同。新的、丰富的教育机会出现了。所有项目都宣布进入美国研究生医学教育认证委员会（ACGME）规定的疫情状态，但仍能够维持一些教育活动。提前为未来的疫情激增做准备可以显著减轻住院医师培训领导层的实时负担，这在疫情激增时对领导层的临床需求可能也会增加的情况下尤为重要。
