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Ganeshan G, Sekar H, Reilly S, Kuo C, Singh S, Michaels J, Yoong W. The effect of the COVID-19 pandemic on the mental health of obstetrics and gynaecology trainees: a world-wide literature review. J OBSTET GYNAECOL 2024; 44:2319791. [PMID: 38419407 DOI: 10.1080/01443615.2024.2319791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/10/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Coronavirus (COVID-19) pandemic has affected the training and wellbeing of obstetrics and gynaecology (O&G) trainees. The aim of this review is to offer a worldwide overview on its' impact on the mental health of O&G trainees, so that measures can be put into place to better support trainees during the transition back to the 'new normal'. METHODS Key search terms used on PubMed and Google Scholar databases include: mental health, COVID-19, O&G, trainees, residents. RESULTS Fifteen articles (cumulative number of respondents = 3230) were identified, of which eight employed validated questionnaires (n = 1807 respondents), while non-validated questionnaires were used in seven (n = 1423 respondents). Studies showed that COVID-19 appeared to exert more of a negative impact on females and on senior trainees' mental health, while protective factors included marriage/partner and having had children. Validated and non-validated questionnaires suggested that trainees were exposed to high levels of anxiety and depression. Their mental health was also affected by insomnia, stress, burnout and fear of passing on the virus. DISCUSSION This review analyses the global impact of COVID-19 on O&G trainees' mental health, showing a pervasive negative effect linked to fear of the virus. Limited psychological support has led to prolonged issues, hindering patient safety and increasing sick leave. The study underscores the urgency of comprehensive support, particularly in female-dominated fields. Addressing these challenges is crucial for future pandemics, highlighting the need to learn from past mistakes and prioritise mental health resources for trainee well-being during and beyond pandemics.
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Affiliation(s)
- G Ganeshan
- St George's International School of Medicine, Grenada, Caribbean
| | - H Sekar
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - S Reilly
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
| | - C Kuo
- St George's International School of Medicine, Grenada, Caribbean
| | - S Singh
- St George's International School of Medicine, Grenada, Caribbean
| | - J Michaels
- St George's International School of Medicine, Grenada, Caribbean
| | - W Yoong
- Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London, UK
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Kraus AC, Bui A, Malloy K, Morse J, Young OM. The COVID-19 pandemic and OBGYN residency training: We have a problem and it's not just masks. BMC MEDICAL EDUCATION 2024; 24:377. [PMID: 38580978 PMCID: PMC10998311 DOI: 10.1186/s12909-024-05364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 03/28/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The COVID-19 pandemic has left no one untouched. Resident trainees have been driven to reconsider virtually every component of their daily lives. The purpose of this pilot study is to evaluate the impact of the COVID-19 pandemic on Obstetrics and Gynecology (OBGYN) residency training and education. METHODS A cross-sectional pilot study was conducted between 2/2022 and 5/2022. A survey was created and distributed to OBGYN residents. The survey queried the effects of the pandemic on OBGYN residents' procedure skills training and mental health. RESULTS A total of 95 OBGYN residents across programs affiliated with each American College of Obstetricians and Gynecologists (ACOG) district participated in the survey. Among them, just over half (n = 52, 55%) self-identified as under-represented minorities. A significant majority, 80% (n = 81), felt their gynecological training was inadequate, with 70% of fourth-year residents expressing a lack of confidence in their ability to independently practice gynecology after graduation. This lack of confidence among fourth-year residents suggests a notable disparity in readiness for independent gynecological practice, linked to meeting ACGME requirements before completing their residency (p = 0.013). Among the residents who reported a negative impact of the pandemic on their mental health (n = 76, 80%), about 40% (n = 31) had contemplated self-harm or knew a colleague who considered or attempted suicide (p < 0.001). This issue was especially pronounced in residents experiencing burnout (n = 44, 46%), as nearly half (n = 19, 43%) reported suicidal thoughts or knew someone in their program who had such thoughts or engaged in self-harm (p = 0.048). CONCLUSIONS Residents expressed concerns about reduced hands-on gynecological training and doubts about their readiness for independent practice post-residency, highlighting the need for enhanced support through mentorship and revised training curriculums. Additionally, despite the availability of mental health resources to address pandemic-induced burnout, their underuse suggests a need for more accessible time for residents to use at their discretion and flexible training schedules that encourage mental health support resource utilization.
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Affiliation(s)
- Alexandria C Kraus
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3010 Old Clinic Building, Chapel Hill, NC, 27599, USA.
| | - Anthony Bui
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kimberly Malloy
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3010 Old Clinic Building, Chapel Hill, NC, 27599, USA
| | - Jessica Morse
- Division of Family Planning, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Omar M Young
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3010 Old Clinic Building, Chapel Hill, NC, 27599, USA
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Akerstrom M, Sengpiel V, Hadžibajramović E, Carlsson Y, Graner S, Andersson O, Jonsson M, Naurin E, Veje M, Wessberg A, Linden K. The COPE Staff study: Study description and initial report regarding job satisfaction, work-life conflicts, stress, and burnout among Swedish maternal and neonatal healthcare workers during the COVID-19 pandemic. Int J Gynaecol Obstet 2023; 162:989-997. [PMID: 36998146 DOI: 10.1002/ijgo.14772] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 04/01/2023]
Abstract
OBJECTIVE To describe the study design of the COPE Staff cohort study on working conditions for maternal and neonatal healthcare workers (MNHCWs), and present baseline data regarding job satisfaction, work-life conflicts, stress, and burnout. METHODS Between January and April 2021, 957 MNHCWs (administrative and medical staff) completed a baseline survey. Average levels of job satisfaction, work-life conflicts, stress, and burnout, and associations to perceived workload were assessed. RESULTS The average levels of job satisfaction, work-life conflicts, stress, and burnout were 68.6 (95% confidence interval [CI] 64.3-72.8), 42.6 (95% CI 37.3-48.0), 42.0 (95% CI 37.7-46.3), and 1.9 (95% CI 1.6-2.2), respectively. The respondents scoring above critical values indicating clinical burnout ranged between 3% and 18%, respectively, for the four burnout sub-dimensions. Women reported significantly higher levels of stress and burnout. Younger participants had lower job satisfaction and higher levels of work-life conflicts, stress, and burnout. Higher perceived workload was significantly associated with lower job satisfaction levels and higher levels of work-life conflicts, stress, and burnout. CONCLUSIONS Our results indicate associations between MNHCWs perceived workload and job satisfaction, work-life conflicts, stress, and burnout during the COVID-19 pandemic. Eighteen percent scored above critical values for exhaustion.
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Affiliation(s)
- Magnus Akerstrom
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Emina Hadžibajramović
- Region Västra Götaland, Institute of Stress Medicine, Gothenburg, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ylva Carlsson
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Centre of Perinatal Medicine and Health, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sofie Graner
- Department of Medicine, Center for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
- BB Stockholm, Danderyd Hospital, Stockholm, Sweden
| | - Ola Andersson
- Department of Clinical Sciences Lund, Paediatrics, Lund University, Lund, Sweden
- Department of Neonatology, Skåne University Hospital, Malmö, Sweden
| | - Maria Jonsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Elin Naurin
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Malin Veje
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Wessberg
- Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Matsui Y, Yao S, Kumode T, Tanino K, Mizuno R, Ogoshi Y, Honma S, Murakami T, Kan T, Nakajima S, Harada T, Oh K, Nakamura T, Konishi H, Arii S. Surgeons' involvement in COVID-19 treatment: a practice by a regional core hospital in Japan to avoid physician burnout. BMC Health Serv Res 2023; 23:28. [PMID: 36635725 PMCID: PMC9834681 DOI: 10.1186/s12913-023-09042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND To prevent task accumulation on certain divisions, our institution developed a unique system of allocating inpatient treatment of COVID-19 patients to doctors who were not specialized in respiratory infections. The objective of this study was to investigate whether surgeons can be involved in the COVID-19 inpatient treatment without negatively affecting patient outcome, and how such involvement can affect the wellbeing of surgeons. METHODS There were 300 patients diagnosed with COVID-19 and hospitalized from January to June 2021, and 160 of them were treated by the redeployed doctors. They were divided into 3 groups based on the affiliation of the treating doctor. Patient characteristics and outcomes were compared between the groups. In addition, the impact of COVID-19 duty on participating surgeons was investigated from multiple perspectives, and a postduty survey was conducted. RESULTS There were 43 patients assigned to the Department of Surgery. There were no differences in the backgrounds and outcomes of patients compared with other groups. The surgeon's overtime hours were significantly longer during the duty period, despite no change in the number of operations and the complication rate. The questionnaire revealed that there was a certain amount of mental and physical burden from the COVID-19 duty. CONCLUSION Surgeons can take part in inpatient COVID-19 treatment without affecting patient outcome. However, as such duty could negatively affect the surgeons' physical and mental wellbeing, further effort is needed to maintain the balance of fulfilling individual and institutional needs.
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Affiliation(s)
- Yugo Matsui
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Siyuan Yao
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takashi Kumode
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Keisuke Tanino
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Ryosuke Mizuno
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Yusuke Ogoshi
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Shusaku Honma
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Teppei Murakami
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takatsugu Kan
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Sanae Nakajima
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takehisa Harada
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Koji Oh
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of General Internal Medicine, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Takehiro Nakamura
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of Diabetes and Endocrinology, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Hiroki Konishi
- grid.415419.c0000 0004 7870 0146COVID-19 Task Force, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan ,grid.415419.c0000 0004 7870 0146Department of General Internal Medicine, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
| | - Shigeki Arii
- grid.415419.c0000 0004 7870 0146Department of Surgery, Kobe City Medical Center West Hospital, Kobe, Hyogo Japan
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Brulin E, Henriksson K, Landstad BJ. An impaired learning environment: Resident physicians' experience of the transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Front Psychol 2023; 13:1090515. [PMID: 36687854 PMCID: PMC9853888 DOI: 10.3389/fpsyg.2022.1090515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Extensive studies regarding the COVID-19 pandemic have shown negative effects on physicians-in-training. Besides a high workload, their learning environment has been affected. A quality learning environment is vital for residents' physician's clinical development and also their health. Nevertheless, few studies have explored this. The aim of this study was to explore resident physicians' experiences of transition to pandemic care during the first wave of the COVID-19 pandemic in Sweden. Method In this qualitative study, 12 Swedish resident physicians were interviewed using a semi-structured interview guide. They were interviewed between June and October of 2020 and asked to reflect on the pandemic and, more specifically, the first wave. The empirical material was analysed using qualitative content analysis. The analysis resulted in one theme and four categories. Results The theme identified was An impaired learning environment which signifies the disruptions the resident physicians experienced during the first wave of the pandemic. The four categories, Professional role insecurity, High expectations but little influence, Stagnant clinical development, and Professional growth through experience, describe in what way the learning environment was impacted.
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Affiliation(s)
- Emma Brulin
- The Department of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Bodil J. Landstad
- The Department of Health Sciences, Mid Sweden University, Östersund, Sweden,The Unit of Research, Education and Development, Östersund Hospital, Östersund, Sweden,*Correspondence: Bodil J. Landstad, ✉
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