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Introduction: We sought to describe the range of emergency medicine (EM) resident physicians’ perceptions and experiences of working and training during the initial coronavirus 2019 (COVID-19) pandemic surge at two, large-volume, urban training hospitals in Brooklyn, New York. Methods: A total of 25 EM resident physicians who worked at either of two large emergency departments (ED) from March 15–April 11, 2020 participated in semi-structured interviews conducted in July and August 2020. Interviews were conducted by the authors who were also emergency medicine resident physicians working in the ED during this time. We asked open-ended questions to residents about their experiences and emotions at work and outside of work, including their relationship with co-workers, patients, and their community. The interviews were audio-recorded and transcribed. We then conducted a thematic analysis to identify, classify, and define themes from interview transcripts. Iterative commonalities and differences between interview response themes were grouped to create a broadly applicable narrative of the residents’ perceptions and experiences of working and training during this initial wave of a novel pandemic. Interviewees also responded to a demographics survey. Results: Study participants described four major aspects of their perceptions and experiences of working and training during the stated time, including emotional challenges such as anxiety and feeling underappreciated; protective thoughts, including camaraderie, and sense of duty; workplace challenges such as limited knowledge surrounding COVID-19 and a higher volume of acute patients; and adaptive strategies including increased communication with ED administrators. Conclusion: Emergency medicine residents have a unique perspective and were key frontline hospital responders during a prolonged disaster and mass triage event within a local health system. Considering the chronic case and mortality fluctuations and new variants of COVID-19, as well as the anticipation of future infectious disease pandemics, we believe it is important for key decision-makers in resident education, hospital administration, and all levels of public health management to inform themselves about residents’ emotional and workplace challenges when establishing hospital and residency program disaster protocols.

Racism in medicine affects patients, trainees, and practitioners and contributes to health care inequities. An effective strategy to actively oppose the structural racism ingrained in the fabric of medicine is to intentionally and systematically address diversity, equity, and inclusion (DEI) in medical education and research. As part of ARMED MedEd, a new longitudinal cohort course in advanced research methods in medical education, sponsored by the Society for Academic Emergency Medicine, the leadership team deliberately included a nested DEI curriculum. The goal of the DEI curriculum is to reduce bias in development, recruitment, and implementation of education research studies to promote equity and inclusion in medical education, research, and ultimately, patient care. A team of medical educators with expertise in DEI developed curricular elements focusing on DEI in education research. The two major components are a didactic curriculum (including implicit bias training) to teach researchers to consider equity as they design studies and a consultative service to refine research protocols to address lingering unintended bias. A dedicated focus on DEI can be incorporated into an advanced education research methodology course to raise awareness and provide tools to avoid bias in research design and implementation of interventions. Over time, the network of education researchers who are trained in DEI awareness will grow and provide equitable offerings to their learners to mitigate health inequities.

Social determinants of medical education are the most impactful aspects of recruiting, retaining, and producing the next generation of a diverse physician workforce. We can use the same framework well known to describe social determinants of health to identify social determinants that impact medical education learners and their ability to enter the workforce and succeed to completion. Efforts aimed at recruitment and retention should not exist in isolation and must be matched with those that continuously assess and evaluate the learning environment. The development of a climate where all can bring their full selves to learn, study, work, and care for patients is critically important in the creation of a learning environment where every participant can grow and thrive. If we are to address the need to diversify the workforce, we must be intentional with strategic plans, which includes addressing the social determinants that are prohibitive for some of our learners. [ABSTRACT FROM AUTHOR]

Introduction: We sought to describe the range of emergency medicine (EM) resident physicians' perceptions and experiences of working and training during the initial coronavirus 2019 (COVID-19) pandemic surge at two, large-volume, urban training hospitals in Brooklyn, New York., Methods: A total of 25 EM resident physicians who worked at either of two large emergency departments (ED) from March 15-April 11, 2020 participated in semi-structured interviews conducted in July and August 2020. Interviews were conducted by the authors who were also emergency medicine resident physicians working in the ED during this time. We asked open-ended questions to residents about their experiences and emotions at work and outside of work, including their relationship with co-workers, patients, and their community. The interviews were audio-recorded and transcribed. We then conducted a thematic analysis to identify, classify, and define themes from interview transcripts. Iterative commonalities and differences between interview response themes were grouped to create a broadly applicable narrative of the residents' perceptions and experiences of working and training during this initial wave of a novel pandemic. Interviewees also responded to a demographics survey., Results: Study participants described four major aspects of their perceptions and experiences of working and training during the stated time, including emotional challenges such as anxiety and feeling underappreciated; protective thoughts, including camaraderie, and sense of duty; workplace challenges such as limited knowledge surrounding COVID-19 and a higher volume of acute patients; and adaptive strategies including increased communication with ED administrators., Conclusion: Emergency medicine residents have a unique perspective and were key frontline hospital responders during a prolonged disaster and mass triage event within a local health system. Considering the chronic case and mortality fluctuations and new variants of COVID-19, as well as the anticipation of future infectious disease pandemics, we believe it is important for key decision-makers in resident education, hospital administration, and all levels of public health management to inform themselves about residents' emotional and workplace challenges when establishing hospital and residency program disaster protocols.