Uncertainty, Exhaustion Hardest Part for Trainees, Faculty

COVID-19 has made “uncertainty” the common condition in pediatric residency and fellowship programs.

“I am proud of the way my residents have handled this uncertainty,” says Stacey Chittle Shubeck, MD, Director, Internal Medicine/Pediatrics Residency Program and Section Head of Ambulatory Pediatrics at Beaumont Children’s Hospital in Royal Oak, MI. “They come to work every day wondering if they will get sick and, even worse, wondering if they will bring the virus home to their loved ones.”

Dr. Chittle Shubeck (right) with Dr. Christie Youssef at drive-by graduationIt is draining mentally and physically, leading to concerns about the mental health and resilience of trainees and faculty, says Nicole Shilkofski, MD, MEd, Associate Professor of Pediatrics, Vice Chair of Education and Residency Program Director in the Department of Pediatrics at Johns Hopkins University School of Medicine.

“All of us depend on socialization and feeling like ‘we’re all in this together’,” she says. “Social isolation is being felt in spades by trainees. They’re working in close quarters with people in the hospital, but often they’re going home alone. There’s no one to debrief with after work.”

Dr. Chittle Shubeck says she worries about the long-term impact of stress.

“The residents worked long shifts and witnessed so many deaths,” she says. “There was so much fear. It seemed so unfair to me that such young doctors were asked to work in these conditions.”

Three of Dr. Chittle Shubeck’s 18 residents were diagnosed with COVID-19. One was particularly ill, and both of his parents also were infected and hospitalized.

“The lowest point for my entire program came when this resident’s father coded and passed away in our hospital,” she says.

“After the code was called, I stood in that hallway, outside the door, taking in the war zone — health care workers covered head to toe in full PPE [personal protective equipment], ventilators and medical equipment crowding the hallways. I looked at the faces of the nurses, attendings, and residents who had been involved in the care of my resident’s father. The heartbreak and exhaustion were evident on every face. There was not a dry eye in the hallway. This had hit too close to home for all of us. It was truly the hardest moment of my career as program director.”

Dr. Shilkofski agrees that the experiences from COVID-19 are life-changing.

“It’s been a tough time for our country and world, but especially for people on the front lines,” she says. “At the end of the day, around the world, this has brought us together as a medical community.”

Photo: Dr. Chittle Shubeck (right) with Dr. Christie Youssef at drive-by graduation