Journal Article Annotations
2023, 2nd Quarter
Annotations by Jai Gandhi, MD
At the height of the COVID-19 pandemic, thirty-seven psychiatry residents across training years were involuntarily pulled off of their primary psychiatric rotations for one week or longer to serve on medical rotations at this study’s community hospital. A qualitative study of the experiences of sixteen of these psychiatry residents was conducted via structured and individual forty-five minute phone interviews. The interview data was organized into five different themes and yielded nineteen unique codes. Residents reported numerous concerns and complex and at times conflicting feelings. A sampling of these includes a lack of orientation prior to deployment, steep learning curves with treating critically ill patients, a sense of reward for contribution to a global health crisis, gratitude for public support, job satisfaction, leadership insensitivity, and frustration that faculty could refuse deployment while residents could not.
Strength and weaknesses:
There is no geographic diversity with this study, minimal demographic diversity with twelve of the interviewed sixteen residents identifying as Asian, and fourteen of sixteen respondents had families. There was a fair distribution of respondents across residency years. Nonetheless, this significantly limits generalizability of the study findings. The method of the interview via phone is impersonal, and the lack of use of video teleconference which may have yielded greater emotional resonance between interviewer and interviewee is not addressed in the study. Nonetheless, there have been few examinations of the subjective, and important, experiences of psychiatry residents deployed into medical settings. The social and ethical implications of these deployments can be better understood through the often-distressing experiences of residents described through this study.
C-L psychiatrists are uniquely positioned at the interface of medicine and psychiatry, and in many training settings often work with nearly every psychiatry resident within the training program. The unique stressors and complexity of working in medical settings may be better understood by C-L psychiatrists than their counterparts with less immediate exposure to diverse medical settings and to simultaneously recognize the depth of medical knowledge trainees at various stages of psychiatry training possess. This positions C-L psychiatrists to advocate for the type of preparation trainees may need prior to deployment into medical settings, and to liaison with their counterparts in medical leadership to ensure the appropriate protections are in place to minimize the negative impacts of deployment during pandemics. A bigger, and more important question for educational leadership, is whether or not it is ethical at all to deploy trainees – as opposed to faculty – into these settings during potentially lethal pandemics.