The COVID-19 pandemic has undeniably impacted many aspects of our daily lives, whether that be missing out on social gatherings, not being able to interact with loved ones, or losing jobs. Within the field of healthcare in particular, hospitals were forced to cancel non-urgent surgeries, reduce patient visits, and rely heavily on telemedicine, which is the delivery of healthcare using electronic information and technology.
What is OBGYN?
Resident physicians are doctors in training to work toward a medical license. They have completed their medical degree and work under the guidance of another doctor already licensed in that field, usually an attending physician. A study titled “The COVID-19 pandemic and OBGYN residency training: We have a problem and it’s not just masks” focused on residents in OB-GYN training, short for obstetrics and gynecology, who have been particularly impacted by the pandemic (1). Obstetrics deals with providing care during pregnancy, childbirth, and postpartum, while gynecology deals with providing general reproductive and women’s healthcare.
How COVID-19 Impacted Training From The OBGYN Resident Perspective
Many OB-GYN residents have missed out on valuable time working with patients in person due to primarily having virtual learning and being unable to participate in various hands-on experiences like gynecologic surgeries. A study was done nationwide from February to May 2022 to learn about the experiences of OB-GYN residents during COVID-19. A 28-question anonymous survey was sent through email and social media, asking about residents' age, race, work changes, education, test scores, and mental health. The survey looked at how COVID-19 affected their schedules, surgeries, and stress levels, as well as what resources were available to help. Most residents who responded were between 25-34 years old and identified as an underrepresented minority. The results showed big challenges in education and mental health during the pandemic.
According to the study, only about 21% of residents felt that their obstetrics training had been negatively affected. On the other hand, about 80% of residents felt their gynecology training had been negatively affected.
Another study, "A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic,” explains why residents felt more prepared with obstetrics than gynecology (2). The study tells us that even during a pandemic, people give birth in hospitals, meaning the residents could still work on their obstetrics training. However, the number of people visiting a hospital for gynecological procedures decreased significantly, meaning residents had much less opportunity for training.
The ACGME is the Accreditation Council for Graduate Medical Education. They give residents their medical licenses once they are done with residency. The ACGME has requirements every resident has to complete before getting their medical license. PGY stands for "post-graduate year," meaning that a PGY4 resident is in their fourth year of residency.
According to this survey, 25% of PGY4 residents said they could not complete all the procedures ACGME required to get their license (3). The study extended this question to residents in their first year, second year, third year, and fourth year. About 42% of the residents did not know if they could finish their ACGME requirements in time. Also, 65% of the residents did not think they could use their gynecology skills without additional help (3).
The survey highlighted the pandemic's toll on OB-GYN residents' mental health.
Many worked over 80 hours per week due to increased patient loads and staff shortages, exceeding ACGME limits and leading to burnout. Burnout, which is prolonged psychological exhaustion, impacted job performance and led to suicidal thoughts for some. According to the survey, 32.6% of residents experienced or knew someone with suicidal thoughts or attempts.
While most institutions offered mental health resources, only 29.4% of residents used them (4). The findings underscore a strong link between burnout and negative mental health impacts during the pandemic.
The COVID-19 pandemic caused challenges for OB-GYN residency programs, but it also highlighted potential improvements that can be made. Establishing working groups can bring residents together and healthcare leaders to cooperate in studying a particular problem and enhance relationships through group work. Better simulation training and mentorship can ensure residents build confidence and skills even during the pandemic.
An additional study found that simulation-based training in residency improves doctor’s surgical accuracy significantly (5). Programs can also provide flexible education formats or schedules for residents, allowing them to focus on their well-being and balance work and personal lives. Mental health services and other resources should be used more by residents, which can be improved by providing anonymous counseling or guaranteed time for therapy. Improving the conditions for residents can enhance their performance and job satisfaction and increase confidence in their abilities, which can result in better healthcare for patients.
Study Limitations
Some of the limitations of this study include low response rates, bias in the selection of the people taking the survey, and the fact that it was observed over a short period. However, this survey serves as a major starting point in addressing needed improvements for residency programs.
So what does this mean for us? More research is still needed to fully determine the impact certain changes would have on residents and their training, but this is a crucial step towards developing more efficient programs for better healthcare. Bringing changes to residency programs to account for the rigorous training and work hours, as well as providing residents with more time to manage stress and workload in healthy ways is important. This will allow them to learn and develop skills without harming their health. A healthcare professional can only successfully help others if they themselves are not overworked or experiencing constant exhaustion.
References
(1) Kraus, A. C., Bui, A., Malloy, K., Morse, J., & Young, O. M. (2024). The
COVID-19 pandemic and OBGYN residency training: We have a problem and it's not just masks. BMC medical education, 24(1), 377. https://doi.org/10.1186/s12909-024-05364-8
(2) Sonnenfeld, M. M., Nozaki, A. M., Genova, A. S., Ristow, J. R. W., Moura, T. F.,
Cabral, R. P., Garcia, J. V. A., Guimarães, C. A., Oliveira, A. L. M. L., & Francisco, R. P. V. (2023). A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic. Um estudo do cenário atual da residência em obstetrícia e ginecologia durante a pandemia de
COVID-19. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 45(7), e377–e383. https://doi.org/10.1055/s-0043-1772181
(3) Accreditation Council for Graduate Medical Education (ACGME). ACGME duty-hour requirements per specialty [Internet]. [cited 2025 Jan 2]. Available
from:https://www.acgme.org/globalassets/pfassets/publicationspapers/dh_dutyho ursummary2003-04.pdf
(4) Nigam J, Barker M, Cunningham T, Swanson N, Chosewo C. Vital signs: Health worker–perceived working conditions and symptoms of poor mental health - quality of Worklife Survey, United States, 2018–2022 [Internet]. Centers for Disease Control and Prevention; 2023 [cited 2025 Jan 2]. Available from: https://www.cdc.gov/mmwr/volumes/72/wr/mm7244e1.htm
(5) Kyriacou S. The effectiveness of surgical simulation in orthopaedic teaching and training [Internet]. 2023 [cited 2025 Jan 2]. Available from: https://mededpublish.org/articles/9-150#:~:text=In%20terms%20of%20assessing
%20the,et%20al.%2C%202016).
Authors & Affiliations
It's eye-opening to see how COVID-19 impacted OB-GYN residency training. The long-term effects on patient care and physician confidence should be studied further. What solutions do you think would help future residents in similar situations?
The ACGME licensing requirements were tough to meet during the pandemic—42% of residents weren’t sure if they could complete them on time! How should medical boards address these unprecedented disruptions?
Wow, 80% of residents felt their gynecology training was negatively affected during the pandemic! How can medical education programs adapt to ensure training remains comprehensive during crises?
I have a question for the authors, or other smart people in the comments! What changes to residency do you think would most improve the training of future doctors?
This article sheds opened my eyes to the immense challenges OB-GYN residents faced during COVID-19, from reduced hands-on training to severe burnout. The stats on mental health are especially alarming—it's crucial that we prioritize better support systems and adapt residency programs to ensure future physicians receive both the training and care they need. Thought-provoking read, and I hope we've fixed this post COVID!