Covid Peak and Delaying residency start.

[libertyyne]

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If Covid-19 will peak in June, teaching hospitals should consider delaying the start of new medical residents

The #Covid19 epidemic is forcing everyone to make hard choices. Pushing off the start date for new medical residents might be one such choice.

www.statnews.com

Thoughts?

 

[AMEHigh]

That article is just the opinion of 2 residents and I completely disagree.

So when all the graduating residents leave they think it’s a good time to not have anyone replace them? That makes absolutely no sense. Obviously we’ll see how things go but my program already said they plan to start things on time it’s just tbd in regards to any changes for orientation.

Everyone will have to adapt since we’re in unprecedented times but I don’t think purposefully decreasing the physician work force at this time is a good idea at all.

 

[WhereMyLiberalsAt]

“Even now, medical students across the country are trying to help by providing child care and groceries to exhausted medical personnel. Students at Harvard Medical School are compiling a Covid-19 curriculum and infographics on the most up-to-date information. There are innumerable ways for graduating medical students to help besides through training.”

Our school had some amazing matches this year!

-Nanny at MGH
-Chauffeur at BIDMC
-Personal shopper at JH
-InstaCart at Mayo (rumored but saw it on Twitter)

 

[InternistDO]

Given that my friends and I already have signed contracts with very definite start dates in June/July and that this would upend not only residency start dates but fellowship start dates by either preventing people from graduating or alternatively completely trashing the staffing of the teaching services...ain’t gonna happen. Too much is in motion at this point to delay things now.

 

[Modstopizdy]

If given the option I would jump on the chance to delay residency until things calm down. It's almost farcical how much med students on SDN are underestimating the risk of this thing to their own health. They see mortality rates by age group among the general population and it's like they completely forget their basic microbiology. Infectious dose exists, and basic logic as well as empirical evidence coming out of China and Italy shows that healthcare workers should have and do have worse outcomes than age and health matched members of the general population. Have fun with the rest of your life if your pulmonary and renal function is shot after getting a serious case of this. The healthcare workers in Asia and Canada who had to go on permanent disability with ruined lungs from SARS are already forgotten, your ruined lungs will also be forgotten with SARS2 after a cursory "thank you for your service, now get lost as we move on and enjoy our lives."

As to contracts and fellowship start dates, they can suck it. The country is on lockdown and on the verge of economic collapse, people are risking their lives and safety rules are going out the window. This is a black swan event that rolls around maybe once in a lifetime, if that. The last thing that should be held sacrosanct while everything else is going to hell is a bunch of paperwork and fellowship schedules.

 

[Dro133]

If given the option I would jump on the chance to delay residency until things calm down. It's almost farcical how much med students on SDN are underestimating the risk of this thing to their own health. They see mortality rates by age group among the general population and it's like they completely forget their basic microbiology. Viral dose exists, and basic logic as well as empirical evidence coming out of China and Italy shows that healthcare workers should have and do have worse outcomes than age and health matched members of the general population. Have fun with the rest of your life if your pulmonary and renal function is shot after getting a serious case of this.

As to contracts and fellowship start dates, they can suck it. People are risking their lives and safety rules are going out the window, the last thing that should be held sacrosanct while everything else is going to hell is a bunch of paperwork and fellowship schedules.

Have to agree with this. Plus, aren't physicians and nurses on the front lines completely overwhelmed as it is without having to hand-hold residents brand new interns through their first month of training? Fellowship start dates don't have to be set in stone...

 

[InternistDO]

If given the option I would jump on the chance to delay residency until things calm down. It's almost farcical how much med students on SDN are underestimating the risk of this thing to their own health. They see mortality rates by age group among the general population and it's like they completely forget their basic microbiology. Viral dose exists, and basic logic as well as empirical evidence coming out of China and Italy shows that healthcare workers should have and do have worse outcomes than age and health matched members of the general population. Have fun with the rest of your life if your pulmonary and renal function is shot after getting a serious case of this.

As to contracts and fellowship start dates, they can suck it. People are risking their lives and safety rules are going out the window, the last thing that should be held sacrosanct while everything else is going to hell is a bunch of paperwork and fellowship schedules.

I'm not saying it's not dangerous, or that I'm looking forward to inhaling a huge dose of virus while reusing my N95 for a week straight. I'm just saying that it doesn't matter what a couple of residents say in an op-ed, or what some med students preach about on SDN. We're all gonna start July 1st, except for some people in the NYC area who are going to start even sooner.

Obviously I'd love to exist in a world where the ACGME and the NRMP came together and said "for the sake of resident well being and patient safety we're going to look into a safe way to transition in our new intern class this year"--but given their track record I think I'll get my lease set up for this summer anyway.

 

[Modstopizdy]

I'm not saying it's not dangerous, or that I'm looking forward to inhaling a huge dose of virus while reusing my N95 for a week straight. I'm just saying that it doesn't matter what a couple of residents say in an op-ed, or what some med students preach about on SDN. We're all gonna start July 1st, except for some people in the NYC area who are going to start even sooner.

Obviously I'd love to exist in a world where the ACGME and the NRMP came together and said "for the sake of resident well being and patient safety we're going to look into a safe way to transition in our new intern class this year"--but given their track record I think I'll get my lease set up for this summer anyway.

I wasn't targeting you or anyone in particular with my post, it just seems that the overall vibe on the medical students section of SDN is pretty airheaded when it comes to this disease. The attendings and residents are treating it as a serious personal risk, but for some reason the med students are just itching to jump into the flames without a fire jacket and to me it's bizarre. But I agree, we will start on July 1 whether we want to or not, my post was just a rant as to why we should not want to.

 

[OneTwoThreeFour]

I'm not saying it's not dangerous, or that I'm looking forward to inhaling a huge dose of virus while reusing my N95 for a week straight. I'm just saying that it doesn't matter what a couple of residents say in an op-ed, or what some med students preach about on SDN. We're all gonna start July 1st, except for some people in the NYC area who are going to start even sooner.

Obviously I'd love to exist in a world where the ACGME and the NRMP came together and said "for the sake of resident well being and patient safety we're going to look into a safe way to transition in our new intern class this year"--but given their track record I think I'll get my lease set up for this summer anyway.

I can't even imagine what that "safe way to transition" would be-keep the graduating residents beyond their class graduation? What would they be paid? What about their signed contracts elsewhere or their right to now work? The system is created to have new people on July 1; without new interns to start many hospitals will collapse. I get the trepidation of starting while COVID is happening but somebody has to be there to take care of the patients, even if it is a July 1 intern.

 

[RangerBob]

I think the best solution is to graduate all med students early and start internship a month early to allow some transition. But that creates a lot of licensing and bureaucratic issues. But it would give a temporary surge in physicians and give time for interns to more comfortably get up to speed.

Let’s be honest. Graduating residents aren’t going to delay graduation. They’ve signed jobs at hospitals. Hospitals that need them. And hospitals won’t graduate current residents and delay new interns start dates. They need residents/interns to function (sometimes-there are whole debates about how efficient resident teams really are).

Everyone has an idea of how to best handle things. There will be a lot of second guessing. We’ll find out later we were wrong about a lot of things and should’ve done it differently. But in the meantime we put one foot in front of the other and do our best.

 

[ciestar]

Im not even done with rotations yet lol
My school said graduation will NOT be happening early and my program said they wont be starting us early.

That said.. if i was told starting residency would be delayed, i wouldnt be too upset about that either.

 

[InternistDO]

I wasn't targeting you or anyone in particular with my post, it just seems that the overall vibe on the medical students section of SDN is pretty airheaded when it comes to this disease. The attendings and residents are treating it as a serious personal risk, but for some reason the med students are just itching to jump into the flames without a fire jacket and to me it's bizarre. But I agree, we will start on July 1 whether we want to or not, my post was just a rant as to why we should not want to.

IDK, I'd say my class is pretty divided into "ready to start tomorrow" and "I'd rather not start at all without PPE".

But to me stressing about it does nothing helpful--we're all going to be treating patients with COVID regardless of whatever bravado we post on SDN or Reddit so I'm just accepting it. I've had more dangerous jobs than this, at least now I'm getting paid enough to live in a cool city while doing it.

I can't even imagine what that "safe way to transition" would be-keep the graduating residents beyond their class graduation? What would they be paid? What about their signed contracts elsewhere or their right to now work? The system is created to have new people on July 1; without new interns to start many hospitals will collapse. I get the trepidation of starting while COVID is happening but somebody has to be there to take care of the patients, even if it is a July 1 intern.

Oh I agree with you, we'll be starting July 1st (actually I have classmates starting in a few weeks). Which is fine with me--I have loans to pay off and I'd like to move into my new apartment. But it would be nice for an accreditation body to say something warm and fuzzy about us anyway haha.

 

[OnePunchBiopsy]

Not going to happen.

 

[LADoc00]

This is funny...really funny. No, I 100% guarantee they wont delay your start date so you can kick it at home watching Netflix on your Peloton bike.

No, no little grasshoppers, you will start on time or earlier and I know exactly where you are all going..

 

[akwho]

Lol at the best of times they squeeze every last drop of underpaid labor out of the newly minted M.D.'s. They may even use the crisis to squeeze a few last drops out of you that you didn't even know you had. Residency don't care. Hospitals are paying wartime wages to RN's/NP's/PA's they will relish some cheap resident labor in times like these.

 

[samac]

Honestly, I signed my lease to move in June. If I don't start on time I'll definitely financially feel it. Might as well start and get it over with. Though I am psych and not internal so I'm sure I feel a little differently. Our inpatient months are at a lower acuity facility that at this time doesn't have the COVID patients, though that could change by July.

 

[akuko2]

PPE or not I need to start on time or I'm broke. I have much better life insurance than I do health insurance.