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Emergency medicine resident perspectives on well-being during COVID-19: a qualitative study
  1. Anish Agarwal1,2,
  2. Hareena Sangha2,
  3. Amanda Deutsch2,
  4. Anthony Spadaro2,
  5. Rachel Gonzales1,2,
  6. Jacob Goldenring2,
  7. Mira Mamtani2,
  8. Lauren W Conlon2,
  9. Kevin Scott2
  1. 1 Center for Digital Health, Penn Medicine, Philadelphia, Pennsylvania, USA
  2. 2 Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Anish Agarwal, Emergency Medicine, University of Pennsylvania, Philadelphia 19104, Pennsylvania, USA; anish.agarwal{at}


Background Emergency medicine (EM) clinician well-being has been negatively impacted throughout the COVID-19 pandemic. Resident physicians are particularly vulnerable yet less is known about their perspectives.

Methods The objective of this study was to use qualitative methods to understand EM residents’ perspectives on well-being during COVID-19. EM residents at an urban, academic institution in the USA were recruited via email and participated in virtual, semi-structured interviews between November 2020 and February 2021. Interviews were conducted by a trained qualitative researcher, recorded, transcribed and de-identified by a third party vendor. All transcripts were double coded by two trained study team members using thematic analysis to identify the themes and interviews were stopped when no new themes emerged.

Results Seventeen semi-structured interviews were conducted until thematic saturation was reached with residents in their first 4 years of training: 6 postgraduate year (PGY)-1 (35%), 6 PGY-2 (35%), 2 PGY-3 (12%) and 3 PGY-4 (18%). Five themes were identified: (1) isolation from peers in training contrasting with a collective call to action, (2) desire for increased acknowledgement and structured leadership support, (3) concerns about personal needs and safety within the clinical environment, (4) fear of missed educational opportunities and lack of professional development and (5) need for enhanced mental and physical health resources.

Conclusions This qualitative study elucidated factors inside and outside of the clinical environment which impacted EM resident well-being. The findings suggest that programme and health system leadership can focus on supporting peer-to-peer and faculty connections, structured guidance and mentorship on resident career development and develop programmes which bolster resident on-shift support and acknowledgement. These lessons can be used by training programmes to better support residents, but the generalisability is limited due to the single-centre design and participation.

  • COVID-19
  • education
  • teaching
  • teaching

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Data availability statement

Data are available on reasonable request.

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  • Handling editor Ellen J Weber

  • Twitter @agarwalEM, @TSpadaro91

  • Contributors The authors report no external funding source for this study. The authors declare they have no competing interests. The study/data/abstract have not been presented and this paper has not been published online or in print and is not under consideration elsewhere. AA conceived the study and designed the trial. AA supervised the conduct of the trial and data collection. HS, AS and KS provided advice on study design and analysed the data. AA drafted the manuscript, and all authors contributed substantially. AA takes responsibility for the paper as a whole and is the guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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