Being a young physician during the pandemic – a hard lesson to learn

Young physicians in Brazil and Ireland are struggling with anxiety disorder even months after working in clinical practice during the pandemic.

Anxiety disorder after early transition to clinical practice

Young physicians in Brazil and Ireland are struggling with anxiety disorder even months after working in clinical practice during the pandemic.

During the recent coronavirus pandemic, junior physicians (average age between 25 and 27 years) in Brazil and Ireland suffered from anxiety disorder due to an early transition to clinical practice. Instead of being glad to enter the workforce earlier than anticipated, young physicians felt depressed carrying a lot of responsibilities in the field and had to overcome difficulties by themselves during the time of the global pandemic. Rushing newly graduated physicians earlier to clinical practice is considered unfortunate for building their professional socialization skills and for shaping their identity roles.

Therefore, the medical education system should adapt to the recent pandemic by fully preparing undergraduates and postgraduates and not hurrying them into service untrained. Curricular designers should develop an up-to-date curriculum, planning pandemic awareness and supporting the transition for the new generation of physicians.

We simply were not prepared for this

“When it started (the pandemic) I was cautious with my choices as a physician because I didn’t have complete practical experience...”, says one of the interviewed junior physicians cited in a recent study by Montagna and colleagues.

According to the study, young professionals had enough theoretical knowledge, but lacked hands-on experiences especially in managing serious cases of coronavirus patients. This resulted in uncertainty and doubts. Moreover, they were hesitantly working within the hospital hierarchy because many of them were unfamiliar with it.  While ‘new’ physicians on the one hand are trying to grow professionally, on the other hand, they are being oppressed by the current situation and are only supervised occasionally by senior colleagues.

“We were nervous because we were taking care of people´s lives”, another young fellow explained, “So we were trying to treat them as best as possible, and we were afraid to do something because I don’t know ... to do anything that didn’t work out.”

Professional life in the pandemic means suffering on all sides

Young physicians had to work long shifts and extended workloads. They became more stressed about having only short rests. They haven’t had the chance to experience other clinical problems because they were all focused on the coronavirus patients.  For this reason, they also refused to meet their families and friends fearing that they could transmit the virus to them. It is such a heartbreaking situation especially for young physicians who have family waiting for them at home.

Furthermore, PPE and masks became a great barrier for communication. Some patients have hearing problems, especially the elderly.

One young physician explained during the course of the study: “There was a patient who was deaf and we … I don’t know sign language and I don’t even know if he knew right, and then sometimes I had to take off my mask and talk to see if he did some lip-reading. But that was difficult, this communication with him, and I think it was even more difficult due to Covid-19.”

Thus, young physicians often failed to empathize with patients. The connection with and balance of the physician-patient-relationship were unclear because young physicians tightened their time with patients explaining their health condition to them.  As cases of coronavirus kept rising from time to time, special demands of the patients were also increasing. However, young professionals were pressured and had to build boundaries for themselves to take safety measures avoiding the risk of infection. Thus, physicians failed to develop trust with their patients, which resulted in fear and anxiety on both sides.

What do we learn from the young physicians’ experiences?

These young physicians were deployed to a serious and complex scenario without having any related experience. They feared contracting coronavirus themselves and risking their own lives. Some of them were depressed even months after they had to jump in at the deep end of clinical practice.

In conclusion, the study demonstrated that young physicians entering clinical practice during the COVID-19 pandemic were primarily affected in different aspects of their professional socialization.The findings of this study are expected to change undergraduate and postgraduate curricular design. To support the transition of young professionals from university to active service, the authors suggest the implementation of appropriate interventions especially during the time of the pandemic. (ab)

  1. Montagna E et al., Transition to clinical practice during the COVID-19 pandemic: a qualitative study of young doctors´ experiences in Brazil and Ireland. BMJ Open 2021; 11: e053423.  doi:10.1136/bmjopen-2021-053423