Emergency medicine resident productivity during the SARS-CoV-2 disease 2019 (COVID-19) pandemic

Abstract

Background

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) pandemic disrupted medical education in many care settings, including the Emergency Department (ED). It is unclear what effects these changes have had on resident training and clinical productivity.

Objective

The purpose of this study is to determine Emergency Medicine (EM) resident productivity in the ED during the COVID-19 pandemic.

Methods

This was a retrospective observational study at an academic medical center with an EM residency program. Data were collected from the electronic medical record from 7/1/2017–10/31/2021. The primary outcome was patients per hour (PPH). Postgraduate year (PGY) 1 and 2 shifts were included. Analysis included descriptive statistics (mean ​± ​standard deviation), correlation testing, and multivariate linear regression.

Results

Overall, PGY1 residents saw fewer PPH than PGY2 residents (1.00 ​± ​0.12 vs 1.40 ​± ​0.13 ​PPH, p ​< ​0.001). During academic year (AY) 2019–2020, there was a trend towards lower resident productivity compared to pre-COVID (2017–2019) that was statistically significant at the PYG2 level (PGY1 0.96 ​± ​0.13, p ​= ​0.06; PGY2 1.31 ​± ​0.10 ​PPH, p ​= ​0.004). This difference resolved over the course of AY 2020–2021. Multivariate linear regression showed association of resident productivity with patient volume, month of residency, and year of residency.

Conclusion

The period surrounding the COVID-19 pandemic showed a trend towards decreased resident productivity during AY 2019–2020, which proved transient and resolved during AY 2020–2021. Resident productivity was associated with both month of training and ED volume. Additional research is needed to describe the long-term effects on the training environment during COVID-19 on physician productivity.