Two years in: COVID-19's impact on the world’s youngest doctors

When COVID-19 prompted US medical schools to graduate their 4th-year students early and place them on the frontlines, author and reporter Emma Goldberg sought to capture a crucial moment in healthcare.

Goldberg went on to write Life on the Line: Young Doctors Come of Age in a Pandemic, which follows the journeys of six NYU medical school graduates as they enter the workforce in the epicenter of a public health crisis.

While treating patients just days after graduation is far from the standard course of action for new doctors, Goldberg’s subjects took the challenge in stride. Similarly, new physicians around the world graduated into unprecedented circumstances that would test their resolve and define their careers.

Educational and occupational impacts

The pandemic significantly influenced the quality of education and training that medical students received. According to a review published by the Postgraduate Medical Journal, studies from almost every continent reflect modifications in training and subsequent changes in physicians’ career progression.^[]

COVID-19’s impact on training was mentioned in 65.5% of the sources in the review, and eight studies revealed a negative impact. However, 13 sources noted a significant impact but did not present the impact as positive or negative. A closer look at the data showed that 72.9% of surgical residents—who were heavily represented in the source studies—reported adverse effects on clinical training due to COVID-19.

On top of losing clinical practice time, the review found that medical students involved in research reported increased disruptions. Examinations and assessments were postponed or canceled, paving the way for what students called a “worse” educational experience than they would have had if COVID-19 wasn’t a factor.

About half of the studies that reported on this issue showed that students had concerns about meeting logbook requirements and reaching a certain level of competency in their designated fields. Junior medical staff also expressed concerns related to fellowship planning and career progression.

Despite these challenges, many trainees stayed flexible and resilient, using any additional time to acquire more theoretical knowledge and engage in self-directed study. Still, the pandemic called into question many trainees’ career paths.

Interpersonal challenges

On top of educational and career-related crises, new physicians working on the frontlines experienced an array of difficulties ranging from mental health issues to interpersonal conflicts.

One qualitative study published by Cambridge University’s Global Mental Health took a look at the experience of 13 new doctors in Pakistan during the onset of COVID-19.^[] From a series of interviews with nine male doctors and four female doctors, researchers found that working on the frontlines caused pandemic anxiety among the doctors.

The fear of contracting the virus and enduring lockdowns, quarantines, and social distancing was enough to cause severe psychological distress among doctors. But that distress was compounded by struggles in interpersonal relations.

Some doctors reported arguing with loved ones about working in such dangerous conditions. Even though the doctors were needed on the frontlines, their loved ones sometimes pressured them to quit to reduce the risk of contracting the virus.

Coupled with the lack of organizational readiness for the challenges presented by COVID-19 (eg, inadequate PPE and senior staff shortages), the emotional side effects of working on the frontlines caused direct disturbances to new doctors’ interpersonal and social lives.

Love in a pandemic

The many struggles inherited by new physicians who shouldered the Herculean task of working during COVID-19 were remedied by the presence of a particularly strong force: Love.

Global Mental Health found that new doctors on the frontlines who felt loved and appreciated by their families saw a reduction in pandemic anxiety. Their work also felt more meaningful. Respect from community, appreciation, and support from loved ones inspired new motivation for young doctors living in Pakistan to willingly risk their safety on the frontlines.

That motivation led to a stronger sense of commitment to service. Some new doctors felt that by working during a public health crisis, they gave back to their communities. Others reported feeling gratification that reached far beyond occupational fulfillment.

Even with the support of loved ones, young doctors on the frontlines of the pandemic still had to navigate substantial hardships. In an interview published by the American Medical Association, Emma Goldberg spoke to the courage and passion embodied by new doctors while treating patients with COVID-19 who were critically ill.^[]

"What struck me is that none of the doctors who I was speaking with for this book at all expressed any regret about doing the work that they did," she continued, "and it didn't make any of them question wanting to pursue these careers in medicine."