By Pooja Jaeel, MD
As intern year comes to a close, it’s an understatement to say that nobody could have forewarned our interns that it would end like this. A global pandemic paired with mounting tensions of racial and systemic inequality pose a unique challenge to the young physicians who are navigating into their roles as clinicians. These challenges contextualize our roles as physicians within our society and highlight the importance of our roles as proponents of public health reform, as advocates for our most marginalized patients, and as role models of professionalism and compassion in a period of confusion and chaos.
While we are stewards of society’s health, we must not forget to be protectors of our own health and mental well-being. Therefore, in the final blog post in this series, our interns not only reflect on theirexperience of working during a pandemic, but also reflect on wellness techniques that have helped them in this unique time. Finally, they leave us with some wisdom to pass on to the next group of interns who will soon join the ranks in residency.
Jump to responses: Intern #1 | Intern #2 | Intern #3 | Intern #4
Intern 1
Where are you, both physically and clinically, in the time of COVID-19?
Since I was inpatient heavy on my schedule towards the end of the year, I have been working mostly at the main hospital for our program. Our program has tried to minimize instances where residents would have to go to different hospitals or clinic the same day to reduce exposure for everybody.
How has your intern year been affected by the pandemic?
Overall, our patient census has been lower than usual, which has allowed more time for teaching via Zoom sessions and self-learning. However, with the lower census, we have had less learning from patients themselves. All of our in-person didactics were either cancelled or transitioned to Zoom, which has hindered the learning. Our intern retreat was also cancelled, which historically has been one of the best retreats during residency.
Please describe how this pandemic has affected you personally and professionally.
The pandemic has made this year more stressful. We have had many patients, young and old, some with minimal co-morbidities, pass away from COVID-19. It has been challenging to keep up with the continuously changing health care and hospital policies. Personally, it has been hard not being able to visit my parents and other friends and family, especially in times like these.
Have you found any effective wellness strategies that have helped you during this time?
I have been using the Headspace app for meditation to help me relax after work. I have also been using Zoom to connect with family and friends.
What are you most looking forward to in the next 3-6 months?
I am looking forward for this pandemic to be over. It has been disheartening to see how many patients and families have been affected by this pandemic. Many of my patients and even some friends and family have lost jobs and are struggling financially.
What do you love about medicine?
I love how people in medicine have been so resilient during these times and continue to serve patients. Even though the whole situation has been very stressful, we have all held our nerve and are dedicated to treating patients like we were before this pandemic.
What do you dislike about medicine?
Dealing with social issues can be frustrating at times, especially when the patients are not willing to help themselves. I also don't like when patients leave AMA only to come back the same day or 1 to 2 days later.
What advice would you give to the new incoming interns, especially as they enter the hospital in the middle of a pandemic?
I would tell them that we are all in this together and that senior residents and faculty are here to guide them through these challenging times. The other thing I would tell them is to maintain a good work-life balance to cope with the stress that comes with residency.
Intern 2
Where are you, both physically and clinically, in the time of COVID-19?
Inpatient for the most part. Cardiac Care Unit and now medicine wards. I had a couple weeks off in between to sunbath on my patio. The sun is out in LA!
How has your intern year been affected by the pandemic?
There was actually a giant lull in our census in the beginning since the hospital was trying to minimize admissions and cancelled all elective procedures. It is picking back up now and I feel like our teaching services are seeing some very sick patients. Hematology-oncology and rheumatology seem to be the flavor of the month because many of these patients seem to have been lost at follow up in the past few months. It has been challenging because I feel like this is the sickest panel I’ve ever had, but rewarding in a way since this is all the weird stuff you hear about in medical school.
Please describe how this pandemic has affected you personally and professionally.
I’ve decided to not meet my family and friends outside of health care for now because I’m sure I have been exposed. At first, it was extremely lonely, but I have fallen into a routine in solitude. Currently, I am training for a marathon that I hope will still be taking place in the fall. Professionally, having more time alone has allowed me to focus on research and I’ve been very productive!
Have you found any effective wellness strategies that have helped you during this time?
Find a new hobby! I took up running and cooking.
What are you most looking forward to in the next 3 to 6 months?
Seeing my friends and family and trying all the restaurants I bookmarked on Yelp.
What do you love about medicine?
It’s a field of constant progress. During this time when the world is at a standstill, I can still wake up excited and looking forward to growth.
What do you dislike about medicine?
It creates a culture of migration. I am thinking about applying to fellowship and I would love to stay in LA, but realistically I know I have to be open to moving. We are often uprooted from our homes, leaving our friends and family behind, to pursue the next level of training.
What advice would you give to the new incoming interns, especially as they enter the hospital in the middle of a pandemic?
Try and do things for yourself to stay happy at home; you have to get a little creative. Work may be a little more stressful now given the pandemic and constant change in the hospital, so it’s more important than ever to stay healthy mentally.
Intern 3
Where are you, both physically and clinically, in the time of COVID-19?
Physically, in San Diego. Clinically, I was first on vacation then wards and night float.
How has your intern year been affected by the pandemic?
I was impacted both positively and negatively. On the positive end, I feel that I have had a simpler routine at the end of each workday, since there have been less options for post-work activities. I was surprised that this actually brought a lot of peace and rest to my life. I got into a pretty good workout routine and morning schedule with my husband. On the negative side, I have really missed spending time outside of work with my co-interns. That being said, I feel grateful that we have not been impacted by an overwhelming surge of COVID patients, like so many other places in the nation. My thoughts are with the frontline workers in those areas.
Please describe how this pandemic has affected you personally and professionally.
Personally, I think it has made me recognize the reality of how little control we have over things. This recognition has been pretty scary at times. Other times realizing my own lack of control has been, to some extent, liberating, allowing me to focus on only the things I can control.
Professionally, this has challenged me to be more engaged on a national and international scale with public health updates. It has also brought about a deep empathy in me for the patients who are in the hospital who cannot have visitors. I have been affected deeply by their loneliness and longing for their loved ones. It has created a drive in me to be more connected when I get to be with them on pre-rounds and afternoon check-ins.
Have you found any effective wellness strategies that have helped you during this time?
Yes! I have loved going on runs and have found that daily workout routines have brought significant peace and stability during a time of so much unknown. I have also re-started reading for pleasure and have loved diving deep into some great new books!
What are you most looking forward to in the next 3 to 6 months?
I am most looking forward to becoming a senior! I cannot believe intern year is already (almost) over. I have been reflecting on the seniors I've had this past year—behaviors I want to imitate and new ideas I can bring to rounds and my team dynamic. I feel so privileged to work with next year's interns.
What do you love about medicine?
I love that we get to work with people and have personal connections to patients. Even during a time as crazy as a pandemic, we continue to have the privilege of meeting and caring for humans. I love this.
What do you dislike about medicine?
I dislike the variability in the schedule. As intern year comes to a close, I have been craving weekends more and more. I had a "golden" weekend last weekend and was amazed by what a great change it was to my schedule. Then the next week, I started on nights and the schedule was mixed up again. I wish we could have a more regular schedule in order to better plan in advance and have regularity to our time with loved ones.
What advice would you give to the new incoming interns, especially as they enter the hospital in the middle of a pandemic?
There are so many unknowns coming into intern year—not to mention now that the interns are starting during a pandemic! I think it is best to take each day all on its own. Just take one day at a time and celebrate any positive days, wins, or happy moments. Spend your time off doing something that you find fun and relaxing and don't be afraid to share vulnerabilities with co-interns. Everyone feels nervous and insecure; you're not alone.
Intern 4
Where are you, both physically and clinically, in the time of COVID-19?
My second vacation started right when shelter-in-place in the Bay area was enacted. Since then, I’ve been at our affiliate academic center for one month of wards, covering for another intern in ICU back at my community program for two weeks, and now on a consult service.
How has your intern year been affected by the pandemic?
The pandemic has posed some interesting challenges. I wish the vacation plans I had set up hadn’t fallen through, but I’m still lucky to have visited my family for a few days. I did two more weeks of ICU than I was originally scheduled for, which I didn’t mind since I am interested in critical care. Otherwise, to be honest, I don’t think intern year has been too negatively impacted at all.
Please describe how this pandemic has affected you personally and professionally.
I’m a pretty social person who prefers socializing in person, so it’s been hard to not do that. I’m not too great with staying in touch over the phone, so it’s kind of difficult for me to feel interested in participating in “virtual happy hours.” I’m also bummed that there is only five more weeks left of intern year and all my close prelims and transition year residents are leaving so soon. Professionally, there has been a lapse in focus on the normal residency education, but I think that part is slowly getting picked back up.
Have you found any effective wellness strategies that have helped you during this time?
I’ve been meaning to get back into running, and thankfully one of my friends started a “Social Distancing Running” group with Nike Run Club. Every two weeks, there’s a new challenge and it’s been a nice motivation to get out there and run. I’ve also downloaded a couple of apps like Headspace and signed up for a few free classes online. But mostly, it’s connecting with the other residents and talking with our program leadership that has been keeping me sane.
What are you most looking forward to in the next 3 to 6 months?
The new and better “normal.” This is an enormous wake up call that exposed so many flaws in the healthcare system; race and health disparities; public health policies; economic policies; etc. I’m looking forward to how we will learn and move forward with this lesson.
What do you love about medicine?
During the COVID pandemic, I love the resounding support we’ve been getting from the community. We have had an endless supply of food donated from local restaurants. We’ve had a handful of residency faculty and housestaff family members make us home cooked meals. We’ve had some pretty awesome companies donating their items to us as well. To be honest, I kind of feel guilty from all these free perks when I don’t feel like we are doing anything differently than our normal day to day.
What do you dislike about medicine?
The absolute worst part of the pandemic is the “no visitors” policy in the hospital. It’s incredibly heartbreaking for everyone involved. I spend much more of my time giving daily phone updates to family members than I did before. I’m happy to do so, but it’s just not the same for either the family nor the patient. Everyone is worried, and it’s an extra layer of complexity for us as physicians to quell their understandably heightened anxieties.
What advice would you give to the new incoming interns, especially as they enter the hospital in the middle of a pandemic?
The number one thing our residency cares about is our safety. They will not make us work if we feel unsafe. We have enough PPE. The attendings will do what they can to protect us and will not place us in unnecessary harm. Everyone was feeling anxious, and some still are, but the level of support the residency program provides us is incredible. I feel safe, cared for, and looked after.