Table 2. Resident quotes.

Themes: Subthemes	Resident quotes
Theme 1: Trainee Experiences	I think the hardest part as a medical trainee is identifying when it is time to reach for help. I do not know how you would implement it really, but some sort of a mandatory check- in. There are resources that are available as rescue resources, but I feel like a lot of the time by the time those are being utilized it is already kind of past the point … we have our Office of Learner Well-Being and Success, but you have to reach out to them … right after this I'm going to my program director meeting that I do once a year [to look] at all my evaluations and everything that's going on … That’s twice a year, but we could easily have an equivalent, mental health and wellbeing check in. It could be the same thing. Five minutes … there's maybe five screening questions and then it makes the resident for the first time look at themselves and say, oh, maybe I'm not doing so hot right now. That would be helpful. I do not think it would be difficult to roll out. [Resident #3]   A day off as a day for your mental health and wellness. Having a couple of more flex days in the year would be very helpful … Especially for people who were from away; they could not go home and see family [there] needs to be some loose mechanisms put in place [where] they are not getting any academic penalties, [and can] take some time away, [and] ways to make it up through another means. [Resident #4]
Changes in the Nature, Volume, and Scope of Work	Our discipline turned into an emergency basis only … we ended up seeing cases that are a lot more complex and stuff, because people were presenting later with more serious issues … we ended up seeing even advanced cancers that we haven't even really seen in years. [Resident #6]   The types of patients that you are treating were just the sickest of the sick because people were avoiding coming to the hospital and waiting until it was too late … whenever we would have a healthcare shut down … within a month you would get this huge influx. You just get slammed with all these super, super sick patients. [Resident #3]   Because of the backup in the healthcare system, the lack of primary care, we are all feeling that. My work and my on-call duties have increased exponentially … The volume of patients that we see, especially on call, it has increased threefold … clinics, they are much harder to schedule, the volume is higher, but they are much harder to schedule and then you have issues with the technology and everything and then you are so busy. You have all these conflicting things coming at you, not that they were not there before, but that they seemed worse now. [Resident #2]
Changes in Work-Life Balance Positive Change	Most of us felt as though we had never really had any time to explore interests or do anything that was not academic … I actually picked up a bunch of new practices and wellness things throughout that break and many of my friends did as well. [Resident #2]   The extracurricular stuff … like a master's program. That is something I did a couple of years ago during the first wave when I just had all this free time, because I was not at work as much … I never would have signed up for that had I not had that period of time to just take some time and think about my career goals. [Resident #3]
Limited Learning Experiences Lack of Networking and Informal Learning The Need to Acquire Specific Competencies	A lot of our learning, at least in my specialty, really comes from sitting next to someone and reviewing scans in live time … We did not really get that … usually, when they review a case, they will say, oh, this is common exam knowledge or this is something that comes up on the exam all the time … We could not even do our regular rotations … everything was shut down and just emergency only. That went on for a very long time … so we really lost our normal curriculum … We did not watch seniors. We did not have any senior residents. We were really our own island … it takes a village … even the technologist teaches a lot and other residents from other disciplines when we are on call and we are talking to them. But all of a sudden going to this no contact or limited contact … unfortunately, sometimes learning goes to the back when it comes to a public health emergency. [Resident #6]   I was not able to go to any conferences in the first year. That was an entire year of not networking. People were able to do virtual electives and things like that, but in terms of actually being able to travel the opportunities were fairly slim and same with being able to do elective rotations. [Resident #5]   No networking. You're basically unable to communicate effectively with your colleagues on a day-to-day basis, socially. I mean, everyone could basically still talk about the task at hand, but there's all this subtle [stuff] that you have in between patient interactions and outside of work that add to your development as a physician. And really add to, I don't know, your growth as a person or whatever. [Resident #1]   …all of a sudden, we were not hitting benchmarks …I went and spoke to the program director and was told this is a phenomenon [within my discipline]. For your particular year, all across Canada, you are all on average 6 months behind where other cohorts were. [Resident #6]
Lack of Group Cohesion	Since we were new residents, we felt very disconnected from our resident group … How you would have gotten that support from your group would be through your [in-person] academic events schedule. Throughout the week you would meet up and you would get to have a chat after they are finished, or for social events, and we have neither … we didn't even have that informal 30 minutes together a week to chat, talk about an upcoming exam, or talk about how things are. [Resident #2]   One of the main things [that] affected our group, is group cohesiveness … before we'd all work in the reading room together and stuff. When we went to these solo, just only coming in to do call, and trying to social distance from each other … you end up really almost losing sight of the other people who are working alongside you. This is a real negative thing. [Resident #6]
Theme 2: Trainee Adjustment and Adaption to Changes	The pandemic has been challenging for everybody, but I will say that leaders in the program have appreciated that it has been challenging and they have made it very clear that should anybody need any additional support or resources that would be possible. So, there has been kind of like an overarching message of support which I think is really important. [Resident #5]   I had a lot more formal debriefs with staff than I ever had before the pandemic. Over a night on call that might have been considered … but nowadays we are a lot more like, let’s debrief. How do you feel about ___? And talking about it to bring other scenarios in. [Resident #3]
Theme 3: Positive Impacts on Postgraduate Trainees’ Future Learning and Career Emotional Intelligence   Empathy and Compassion	I have had to care for a lot of people who are COVID-positive and you'd have to fully gown up here. Patients are coming from different backgrounds, you still have to maintain a certain amount of distance with the gown and stuff if they are not going to mask up or if they are not able to mask up. I think learning how to still be compassionate without relying on a lot of the physical touch and cues and proximity. I think that has been a positive. [Resident #2]   I think it was obvious as a provider in the pandemic when we are in this together I felt like I had the same fear as the patients. So I felt like I was on the ground with them and I could understand where they were coming from … It helps me kind of relate to patients on that level and hopefully my future practice I'll be able to apply that. I think it gives me a bit more of an understanding of patient behavior and patients’ decisions in ways that I can help patients in the future. [Resident #3]
Improved Culture of Trainee Health and Safety	… you just do not call in sick unless you are dying. Now with public health measures, if you have a cough you do not come in to work. We have been forced to learn how to deal with people taking sick days and changing our culture around it. Not “guilting” people around it. [Resident #3]   One thing that I have taken back from working during the pandemic is just being aware of looking after myself … I think it has really encouraged us to just take a step back and say, could this be COVID? Or could this be X, Y, and Z? What do I have to wear in order to protect myself? [Resident #5]
More Experience, Exposure, and Skill Ownership/Leadership	I would say the pandemic has really forced us to take a lot more ownership into our own education. For example, when academic sessions shut down, it was one of our residents that kind of got things going, bought our own zoom accounts, said let's go, we're going to do this, things became like that too. So residents claimed a lot of the roles that we didn't have in the past. We have had to take a lot more agency and leadership within ourselves, which has been an important thing. [Resident #3]
Importance of Virtual Technology	Our learning recovered completely and actually surpassed from anything it ever was …  Since the pandemic hit and we got virtual learning on the go, we have been doing [regular journal clubs] every single month [and] have actually continued that to this day … [and with] a virtual component now, way more people are tuning in every day. We’re getting much more engagement from staff positions and everything because it is just so much easier to tune in for journal club at 8 PM. If you have small kids, you can still tune into journal clubs. [Resident #3]