Dermatology residents and COVID‐19: life behind the frontlines

The Coronavirus Disease 2019 (COVID‐19) pandemic outbreak in Italy completely changed patient access to healthcare systems and therefore the doctor–patient relationship, particularly during the national lockdown (11 March−18 May). Strict measures were implemented at our Dermatology Unit (University of Bologna) in order to prevent presymptomatic and asymptomatic transmission of the causative virus, severe acute respiratory syndrome–coronavirus‐2 (SARS‐CoV‐2¹) between and among patients and medical personnel. This situation dramatically changed our daily hospital‐based activities: the number of both outpatient visits and surgical procedures was drastically reduced, as only urgent and oncological visits were allowed.² Furthermore, a new system of teledermatology consultations for most of the noncritically ill patients in COVID‐19 wards and intensive care units was implemented, similar to those applied in other countries.³

The reorganization of our unit had a particularly heavy impact on medical residents. Although dermatology residents were not redeployed to support the overburdened COVID‐19 wards, their training was disrupted in many ways. The reduction of outpatient visits and elective surgical procedures, the cancellation of in‐person academic activities (teaching seminars and conferences), and the postponement of clinical rotations between the different hospitals within our region were the main challenges faced by our residency programme. These pandemic‐related problems were also observed in other hospitals and medical specialties, highlighting a dilemma that unites all the affected countries.⁴

Furthermore, residents were forced to observe stricter social distancing measures than those followed by the general population, placing a significant strain on residents' well‐being and morale.

Since 18 May, the outpatient activity of our Dermatology Unit has recommenced, as the SARS‐CoV‐2 pandemic in Italy seems to be slowing down. Nevertheless, in‐person academic and teaching activities are still suspended, and it is likely that the aforementioned difficulties will persist in the coming months. Nationwide recommendations regarding this crucial aspect of the Italian National Health Service have not yet been issued; nonetheless, several innovative solutions have become available, including virtual classrooms with online questions, academic teleconferences, telehealth outpatient clinics and the development of surgical videos.⁵

However, despite these difficulties, the 16 dermatology residents from our University Hospital in Bologna increased their scientific production over the past few months. Since 1 March, 23 scientific papers written by our staff were accepted by international journals, and an additional 28 are currently under review, several of which concern the COVID‐19 pandemic. Both the interest in investigating SARS‐CoV‐2 from the dermatological point of view and the greater time made available because of the reduction of clinical work played an important role in stepping up their productivity.

In conclusion, a great deal of flexibility was and will be required from medical residents during this unprecedented pandemic due to the working, academic and personal adversities. However, not all changes are necessarily bad, and the past few months have highlighted the possibility of increasing residents’ scientific production by providing them with more time to focus on this task.

Collaboration between residency programmes and medical organizations will be key to maintaining high‐quality clinical education and to achieve a new balance in the aftermath of the SARS‐CoV‐2 pandemic.

Acknowledgement

We thank the other dermatology residents of our Unit: D. Abbenante, M. Carpanese, F. Pepe, A. Filippini, Y. Merli, V. Evangelista, A. Guglielmo, F. Tartari, G. Veronesi, A. Di Altobrando, F. Filippi and R. La Cava