Psychological Consequences Among Residents and Fellows During the Covid-19 Pandemic in New York City

Implications for Targeted Interventions

Bibliographic Data

ID21612871
AuthorsCarly A Kaplan (Icahn School of Medicine at Mount Sinai, corresponding author), Chi C Chan (Icahn School of Medicine at Mount Sinai), Jordyn H Feingold (0000-0002-4658-1520, Icahn School of Medicine at Mount Sinai), Halley Kaye-Kauderer (Icahn School of Medicine at Mount Sinai), Robert H Pietrzak (0000-0002-5561-6414, National Center for PTSD), Lauren Peccoralo (0000-0002-7233-1381, L. Peccoralois associate dean for faculty well-being and resilience and associate professor of medicine, general internal medicine, and medical education, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.), Adriana Feder (0000-0003-2931-310X, A. Federis director for research, Center for Stress, Resilience, and Personal Growth, co-director, Ehrenkranz Laboratory for the Study of Human Resilience, and associate professor of psychiatry, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.), Steven Southwick (Icahn School of Medicine at Mount Sinai), Dennis Charney (D. Charneyis Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and president for academic affairs, Mount Sinai Health System, New York, New York.), Larissa Burka (L. Burkais a registered nurse, Mount Sinai Hospital, Mount Sinai Health System, New York, New York.), Madeleine Basist (M. Basistis a third-year internal medicine resident, Mount Sinai Hospital, Mount Sinai Health System, New York, New York.), Jonathan Ripp (0000-0001-8681-0095, J. Rippis senior associate dean for well-being and resilience, chief wellness officer, and professor of medicine, medical education and geriatrics and palliative medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.), Saadia Akhtar (0000-0003-4835-8725, S. Akhtaris associate dean for trainee well-being and resilience and associate professor of emergency medicine and medical education, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.)
Year2021
Volume96
Issue12
Pages1722-1731
Publication date2021-12-01
Open AccessNo
TypeARTICLE
VenueAcademic Medicine (JOURNAL)
Journal identifiersISSN: 1040-2446 • E-ISSN: 1938-808X
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1097/acm.0000000000004362
PMID34380941
OpenAlexW3190074549
LanguageEN
Citations received5
References cited62

PURPOSE: To examine the psychological impact of the COVID-19 pandemic on medical trainees (residents and fellows) working at Mount Sinai Hospital (MSH) in New York City (NYC), the initial epicenter of the United States pandemic. METHOD: The authors administered a survey to 991 trainees in frontline specialties working at MSH in NYC between April and May 2020. The instrument assessed symptoms of major depressive disorder, generalized anxiety disorder, COVID-19-related posttraumatic stress disorder, and burnout. Psychiatric screens were aggregated into 1 composite measure, and meeting criteria on any of the 3 scales was considered a positive screen for psychiatric symptoms. The survey also assessed COVID-19-related exposures, worries, coping strategies, and desired interventions. Multivariable logistic regressions were conducted to identify factors associated with psychiatric symptoms and burnout. RESULTS: Of the 560 respondents (56.6% response rate), 29.7% screened positive for psychiatric symptoms and 35.8% screened positive for burnout. History of a mental illness, COVID-19-related duties and personal/career worries, and coping by substance use were associated with increased likelihood of screening positive for psychiatric symptoms. Positive emotion-focused coping and feeling valued by supervisors were associated with decreased likelihood. Internal medicine and surgical specialties, a history of mental illness, increased duty hours, duty-related worries, personal/career worries, coping via self-blame and venting, and coping via substance use were associated with higher odds of burnout. Feeling valued by supervisors was associated with decreased burnout odds. The most common crisis-related needs included access to personal protective equipment, food provisions, and financial support. CONCLUSIONS: Psychological distress and burnout affected approximately one-third of trainees sampled during the height of the pandemic in NYC. As the pandemic surged beyond NYC, these findings suggest that interventions should include addressing basic needs, promoting leadership affirmation, moderating duty hours, supporting trainees financially, and enhancing mental health support

Burnout · Duty · Mental health · Pandemic · Psychological distress · Psychological intervention · COVID-19 and healthcare impacts · COVID-19 and Mental Health · Healthcare professionals’ stress and burnout

Tools

Open DOIOpen Access