The COVID-19 pandemic has put tremendous pressure on healthcare systems worldwide and placed significant physiological and psychological strain on Healthcare workers (HCWs). Infectious disease (ID) specialists and trainees were on the first line in treatment of COVID-19 patients and this may have impacted their training.
We conducted a national survey among French ID trainees to assess their role during the first wave (March to May 2020) of the COVID-19 pandemic, and its impact on their medical training.
An online survey was sent by mail on 28 May 2020 to all French ID trainees via the French network of young ID doctors (ReJIF).
We received responses 130 out of the 320 ID trainees contacted by email (response rate 40.6%). All years of training and geographical regions were represented (Supplementary data).
Around 90% of respondents (117/130) reported having participated in a COVID-19 related activity, of whom 34% had to move to a medical department other than their previous or usual place of work (supplementary data). The roles reported by ID trainees were: management of patients hospitalized for COVID-19 (90/117: 77%), being on call in a COVID-19 ward (73/117: 62%), management of ambulatory COVID-19 patients and carrying out of nasopharyngeal swabs for COVID-19 diagnosis (56/117: 48%), contact tracing by phone (22/117: 19%), follow-up consultation by phone (16/117: 14%) and COVID-19 research activities (38/117: 33%). Among the respondents, only 13 reported being tested positive for SARS-CoV-2 (13/130: 10%) and 8 reported that they continued to work while infected. None of them were hospitalized. Only 20% of respondents were afraid of being infected with SARS-CoV2, whereas 66% (86/130) were afraid of infecting people around them (Fig. 1 ).
Fig. 1.
Impact of COVID-19 on infectious disease trainees (Lickert scale).
Three-quarters (94/130) of the ID trainees who responded to the survey considered that the COVID-19 had disrupted their clinical and theoretical training. About 60% (78/130) perceived the COVID-19 crisis as an opportunity for them to increase their infectious disease knowledge and skills as regards: management of a health crisis (34/130: 26%), management of an emerging infectious disease (26/78), research activities (10/78), management of a respiratory infection (10/78), and hygiene measures (4/78).
To the sentence “I felt useful in managing the crisis” (on a six-point Likert scale), the assessment was ‘agree’ and ‘strongly agree’ for three-quarters of respondents (97/130, 75%). About half of the ID trainees answered that they worked more than usual during the crisis and felt more tired than during another internship (67/130, 52%) (Fig. 1). A majority of respondents (64%) reported that the potential role of trainees in the management of this kind of crisis consisted in management of hospitalized patients, and 10% of the respondents said that this role was research activities and medical training.
Our results show that a vast majority of ID trainees respondents participated in a COVID-19 activity during the first wave of the COVID-19 pandemic in France. Most of them felt useful in managing the crisis, although they sometimes felt stressed, and worked more than usual. The COVID-19 pandemic is likely to have caused psychological distress in ID trainees as well as other healthcare providers [1]. In particular, trainees were concerned that they might contract the illness and expose family members at home who were potentially more vulnerable. Studies from other specialty trainees reported high work-related anxieties linked to inadequate supply of personal protective equipment (PPE) and risk of contaminating oneself and one's colleagues [2], [3], [4]. However, these concerns did not emerge in our study, which could be explained by the fact that the ID trainees’ COVID units experienced no shortage of PPE and also because they were more aware of COVID-19 transmission mechanisms and therefore felt sufficiently protected.
A negative aspect of the crisis was the disruption of their teaching programs. In-person teaching conferences were widely replaced by live or recorded virtual conferences or canceled altogether. Recently published studies from other medical trainee have reported a negative impact on education and training [2], [3], [4]. In the case of ID, management of a pandemic could be considered as part of the trainees’ medical training; however and surprisingly enough, only 60% perceived the COVID crisis as a learning opportunity.
COVID research projects emerged quickly in France with about 40 COVID therapeutic clinical trials registered in April 2020 [5]. This enthusiasm for research also had an impact on ID trainees, because 33% of them had COVID-19 research activities and 13% would like to be more involved in research during a future pandemic.
All in all, the first wave of pandemic had a significant impact on ID trainees, who reported significant changes in their clinical responsibilities and course of training. Based on this survey, and in collaboration with the Trainee Association of ESCMID, a similar survey targeting European ID trainees is currently ongoing, the objective being to assess the impact and perception of ID trainees on a European scale.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments.
Funding
None
Disclosure of interest
The authors declare that they have no competing interest.
Footnotes
Supplementary data associated with this article can be found, in the online version, at https://doi.org/10.1016/j.idnow.2020.12.010.
Online supplement. Supplementary data
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