Akhavan Arvin R, Zhan Tiannan, Lall Michelle D, Barton Melissa A, Reisdorff Earl J, Hu Yue-Yung, Bilimoria Karl Y, Lu Dave W
Department of Emergency Medicine University of Washington Seattle Washington USA.
Department of Surgery Northwestern University Chicago Illinois USA.
AEM Educ Train. 2024 Mar 20;8(2):e10955. doi: 10.1002/aet2.10955. eCollection 2024 Apr.
The COVID-19 pandemic was disruptive for trainees and may have affected career decisions for some learners. This study examined the impact of the pandemic on emergency medicine (EM) resident perceptions of their mental health, perceptions of personal safety, and career choice regret.
This was a cross-sectional survey study administered following the 2021 American Board of Emergency Medicine In-Training Examination (ITE). Survey measures included suicidal ideation (SI), COVID concerns in terms of infection prevention and control (IPC) training, COVID risk to self and/or COVID risk to family, and COVID-related career regret. COVID concerns were compared by gender and race/ethnicity using Pearson's chi-square tests. Multivariable logistic regression models were used to test the association between SI and COVID concerns, resident characteristics, and program characteristics.
A total of 6980 out of 8491 EM residents (82.2%) from 244 programs completed the survey. Only 1.1% of participants reported insufficient training in COVID IPC practices. Participants were concerned about COVID risk to themselves (40.3%) and to their families (63.3%) due to their job roles. These concerns were more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); senior residents (vs. PGY-1, PGY-2 residents); and residents who were married or in relationships (vs. single or divorced). A total of 6.1% of participants reported that COVID made them reconsider choosing EM as their career. Career regret in this cohort was higher than that in the proportion (3.2%) expressing career regret in the 2020 ITE ( < 0.001). Career regret was more common among women or nonbinary (vs. men); all other races/ethnicities (vs. non-Hispanic Whites); and senior residents (vs. PGY-1, PGY-2 residents). The overall SI rate was 2.6%, which did not differ from that of the 2020 sample of EM residents (2.5%, = 0.88).
Many EM residents reported concerns about COVID risks to themselves and their families. Although the rate of SI remained unchanged, more EM residents reported career regret during the COVID pandemic.
新冠疫情对住院医师培训造成了干扰，可能影响了一些学员的职业决策。本研究调查了疫情对急诊医学（EM）住院医师心理健康认知、个人安全认知以及职业选择遗憾的影响。
这是一项横断面调查研究，在2021年美国急诊医学委员会住院医师培训考试（ITE）之后进行。调查指标包括自杀意念（SI）、对新冠疫情在感染预防与控制（IPC）培训方面的担忧、自身感染新冠的风险和/或家人感染新冠的风险，以及与新冠相关的职业选择遗憾。使用Pearson卡方检验按性别和种族/民族比较对新冠疫情的担忧。采用多变量逻辑回归模型来检验自杀意念与对新冠疫情的担忧、住院医师特征和项目特征之间的关联。
来自244个项目的8491名急诊医学住院医师中有6980名（82.2%）完成了调查。只有1.1%的参与者报告在新冠感染预防与控制实践方面培训不足。参与者因工作角色担心自身感染新冠的风险（40.3%）以及家人感染新冠的风险（63.3%）。这些担忧在女性或非二元性别者（与男性相比）、所有其他种族/民族（与非西班牙裔白人相比）、高年级住院医师（与PGY-1、PGY-2住院医师相比）以及已婚或有伴侣的住院医师（与单身或离异者相比）中更为常见。共有6.1%的参与者报告新冠疫情使他们重新考虑选择急诊医学作为职业。该队列中的职业选择遗憾高于2020年ITE中表示有职业选择遗憾的比例（3.2%）（<0.001）。职业选择遗憾在女性或非二元性别者（与男性相比）、所有其他种族/民族（与非西班牙裔白人相比）以及高年级住院医师（与PGY-1、PGY-2住院医师相比）中更为常见。总体自杀意念发生率为2.6%，与2020年急诊医学住院医师样本的发生率（2.5%）无差异（P = 0.88）。
许多急诊医学住院医师报告担心自身和家人感染新冠的风险。尽管自杀意念发生率保持不变，但在新冠疫情期间有更多急诊医学住院医师报告有职业选择遗憾。
