Examining the impact of COVID-19 on a unique population: medical residents

What is the impact of COVID-19 on the mental health of Canadian medical residents? Thanks to a grant from the Canadian Institutes of Health Research (CIHR), we might be one step closer to answering this question, and developing an improved response to meet the mental health needs of this unique group.

Dr. Jennifer Phillip and Dr. Katerina Nikolitch

Medical residents are doctors who participate in supervised medical training before becoming specialized, independently-working physicians. Residents are involved in all areas of health care and work in a variety of settings, such as hospitals, emergency rooms, and mental health centres, among others. While caring for patients they’re learning on the job, engaging in structured training, academic assessments, and might also be teaching or doing their own research. 

It can be stressful at the best of times.

“Medical residents have been on the frontlines providing care during this pandemic and they are at increased risk for negative mental health outcomes as a result,” says Dr. Jennifer Phillips, the nominated principal applicant of the grant proposal. Thanks to the new funding, Phillips and her team are able to take a close look at the specific issues, needs, and mental health impacts of COVID-19 on medical residents.

Phillips is a scientist in the Mood Disorders Research Unit at The Royal’s Institute of Mental Health Research (IMHR), affiliated with the University of Ottawa, and an assistant professor in the Department of Psychiatry at University of Ottawa. Her research interests are in clinical neuroscience with a focus on depression and suicide prevention. 

The yearlong study is a partnership between Phillips and Dr. Katerina Nikolitch, a psychiatrist and clinical investigator in The Royal’s Mood and Anxiety program. Co-applicants from The Royal also include Dr. Zachary Kaminsky, Dr. Rebecca Robillard, and Dr. Jeanne Talbot, and residents Dr. Khashayar Shariati, Dr. Esther Carefoot, and Dr. Maurice Sani.

The first part of the study will use an online survey to identify the proportion of residents who are experiencing concerning mental health symptoms. 

The team will also be using AI (artificial intelligence) technology to collect data from residents’ public social media posts. This will allow them to go back in time (so to speak) and identify whether or not their mental health has changed as the pandemic has progressed. 

“We want to know whether or not the mental health burden has increased for medical residents since the onset of the pandemic,” says Phillips. “We know that under usual conditions residents experience depression, burnout, and suicidal ideation at higher rates than practicing physicians… what’s unique here is actually trying to determine how best to serve their mental health needs.”

The team will also be interviewing medical residents from the University of Ottawa to find out whether existing mental health services are appropriate, and whether they are encountering any barriers to seeking help. The obstacles preventing residents – and other physicians – from seeking help can be significant. Some worry about reaching out for help for fear of being judged. There are also concerns about confidentiality and professional consequences.  

The study will also look at how COVID-19 has impacted residents’ training. 

“Some residents may be doing quite well, but nearly all of them have had their training impacted,” says Phillips. “These are the next generation of physicians in Canada, so it is very important for us to be able to provide information on the impact of that disruption to their training.”

Medical residents make up a significant part of the Canadian health care system. According to Resident Doctors of Canada (RDoC), a not-for-profit organization that represents over 10,000 resident doctors across Canada, there is one medical resident for every five active physicians.

The hope is, of course, that research findings will translate into new strategies to support medical residents, or at the very least, provide a better understanding of their mental health needs during a challenging time.

“It is a unique population whose mental health needs have perhaps been overlooked in the past, and so with or without coronavirus, it’s a very good time to engage in this important research.”  

Medical residents who are interested in participating in this study should contact Dr. Maurice Sani at csani@toh.ca.

The following individuals are part of the research team that will examine the impact of COVID-19 on the mental health of Canadian medical residents:

Dr. Esther Carefoot
University of Ottawa

Dr. Caroline Gérin-Lajoie
Canadian Medical Association (Ottawa)

Dr. Zachary Kaminsky
Institute of Mental Health Research affiliated with the University of Ottawa

Dr. Anne Konkle
University of Ottawa

Dr. Katerina Nikolitch
University of Ottawa

Dr. Jennifer Phillips
Institute of Mental Health Research affiliated with the University of Ottawa

Dr. Rebecca Robillard
Institute of Mental Health Research affiliated with the University of Ottawa

Dr. Cyrus Maurice Sani
University of Ottawa 

Christopher Simon
Canadian Medical Association (Ottawa)

Dr. Khashayar Shariati
University of Ottawa

Dr. Edward Spilg
University of Ottawa

Dr. Jeanne Talbot
University of Ottawa

Dr. Lorne Wiesenfeld
University of Ottawa