Dr Mallika Kaushal reports on the experience of postgraduate residents working across different specialties in various hospitals in New Delhi during COVID, and asks what can be done to support trainees at this time.
In the annals of history of medicine, 2020 will be recounted as the year when the world faced an unprecedented, global battle with the COVID-19 pandemic. India, one of the most populous countries in the world, is also suffering a huge impact as a result of it. Despite facing innumerable physical and psychological challenges, healthcare personnel are playing an indispensable role during this continued crisis. As a result, the prevalence of anxiety, stress, depression, insomnia etc. is on the rise in frontline healthcare workers amidst the ongoing pandemic.1,2
The postgraduate trainees constitute a unique, vulnerable group of young doctors who are at the forefront of managing the COVID-19 patients in the middle of their training period. In December 2020, a questionnaire-based online survey was conducted amongst sixty postgraduate residents across different specialties in various hospitals in New Delhi, India, regarding their experience of working in a COVID-19 dedicated hospital. The participants were between 23-30 years of age, out of which 38 (63.3%) were females. The doctors were posted in intensive care unit (49, 81.7%), wards (9, 15%) and casualty or emergency (2, 3.3%), respectively. Out of 60 participants, 19 (31.7%) had tested positive for COVID-19 in 2020.
Forty eight (80%) doctors felt stressed about working in a COVID-19 dedicated hospital, out of which 30 (50%) doctors also felt afraid of working in such a setting. Fifty eight (96.7%) doctors felt worried about the risk of transmitting coronavirus infection to their family members. Sixteen (26.7%) doctors reported loss of appetite, 27 (45%) reported insomnia, 14 (23.3%) reported palpitations and 41 (68.3%) reported mood fluctuations in the last six months. Fifteen (25%) doctors also consulted an experienced professional to deal with the stress caused by the pandemic. All except one participant (59,98.3%) reported that the academic teaching and specialty based clinical training were suffering amidst the ongoing pandemic. Eight (13.3%) doctors had also considered quitting their academic course at some point during the last six months.
The participants reported various activities to deal with the stress, including talking to family and friends, exercise, meditation, hobbies like cooking, painting, reading, listening to music, dancing etc, and watching televisions shows. The young doctors further recommended that more emphasis should be laid on their academic teaching in the form of online classes, clinical skills training sessions with appropriate social distancing, clinical rotation to non-COVID areas of the hospitals etc. The increasing workload and resultant fatigue can be tackled by recruitment of more doctors and improving the doctor to patient ratio. Routine psychological assessment and counselling should become a part of their training curriculum.
In the author’s opinion, we should acknowledge the psychological impact of COVID-19 pandemic on our young doctors and take timely, necessary actions to address their concerns.
- Sharma R, Saxena A, Magoon R, Jain MK. A cross-sectional analysis of prevalence and factors related to depression, anxiety, and stress in health care workers amidst the COVID-19 pandemic. Indian J Anaesth [serial online] 2020 [cited 2020 Dec 14];64:242-4. Available from: https://www.ijaweb.org/text.asp?2020/64/16/242/295812
- Jain A, Singariya G, Kamal M, Kumar M, Jain A, Solanki RK. COVID-19 pandemic: Psychological impact on anaesthesiologists. Indian J Anaesth [serial online] 2020 [cited 2020 Dec 14];64:774-83. Available from: https://www.ijaweb.org/text.asp?2020/64/9/774/294078
Dr Kaushal is presently working as a Senior Resident in Department of Anaesthesiology, Pain Medicine and Critical Care in All India Institute of Medical Sciences, New Delhi, the premier medical college and hospital in India. She has experience in working in a COVID-19 dedicated intensive care unit and operation theatre.