A. General demographics:
255 (59%) residents of the total 430 in the institute responded to the survey. Specifically, participation rate among SRs was 74% (121/164) compared with 50% among NSRs (134/266). Full details of participation rates per individual residency programs are provided in table 1
Of the participants 123 (48.2%) were males, with a most common age range of 24-27 years (62%), 90 (35.3%) were first year residents, 134 (52.5%) non-surgical residents and 121 (47.5%) were surgical residents.
B. The effect of the pandemic on the clinical settings and teaching programs:
When comparing changes in the clinical settings between surgical and non-surgical programs, the proportion of NSRs reporting lock-down of the clinic sometimes was significantly higher than the SRs group (42.5% vs 26.4%, respectively; p = .007). Similarly, the proportion reporting a decrease in the staff working in the clinic (52.2% vs 29.8%; p < .001), the proportion reporting limited personal protective equipment (PPE) (71.6% vs 56.2%; p = .01), and the proportion reporting a delay in patients’ visitation to the clinic or emergency department due to fear of getting infected (57.5% vs 39.7%; p = .005) was higher among non-surgical residents. A significant difference was also detected in the effect on the number of on-call duties per month (p < .0001), with the most common answer in both groups being a “no change” (50.7% and 64.5%, respectively), while the second most common answer was an “increase” for the NSRs group (35.8% vs 11.6%), and a “decrease” for the SRs group (24% vs 13.4%).
As for the effect on the teaching programs, the proportion of NSRs reporting a shift toward online learning was significantly higher than that of the SRs group (53% vs 30.1%; p < .001).
And finally, the proportion of NSRs reporting participating in nasopharyngeal swab sampling for patients was also significantly higher than that of the SRs group (67.1% vs 34.7%; p < .0001).
Comparisons are provided in Table 2, figure A and B.
C. The effect of the pandemic on residents’ personal life and mental health:
First of all, a significant difference in gender between the two groups was detected, with the NSRs group having a higher proportion of females (60% vs 43.8%; p = .016).
When comparing the effect of the pandemic on the personal life of residents between the both groups, the proportion of residents reporting getting infected by COVID- 19 was significantly higher in the SRs group (9.9% vs 3.7%; p = .048). In addition, 113 (84%) residents in the NSRs group, and 98 (81%) residents in the SRs group reported a direct contact with COVID-19 cases. A statistically significant difference was found when they were asked about their relation to those infected people (patients, a co-worker, or both) (p = .020), with the most common answer in both groups being “both” (66.4% and 49%), while the second most common answer was “patients” (20.4% and 24.5%), and “co-workers” (26.5% and 13.3%).
When asked about being updated about this pandemic protocol, a significant difference was also found (p = .004), with the most common answer in the NSRs group being “yes” (59% vs 38% , and the most common answer in the SRs group being “Not always” (44.6% vs 30.6% ), while the remaining in both groups account for the “No” answer (10.4% vs 17.4%). In addition, the proportion of residents who reported being trained to protect themselves against the virus spread was significantly higher in the NSRs group (56.7% vs 37.2%; p = .002). Similarly, the proportion of residents who reported being trained to protect others against the virus spread (54.5% vs 40.5%; p = .026) was also significantly higher in the NSRs group.
Regarding the effect on the residents’ mental health, when testing the internal consistency of the Likert-type questions addressing mental health, a Cronbach’s alpha of .802 (Good) was found.
When asked about feeling anxious about the pandemic based on a 4-point Likert scale, the median was 2 (2-3 IQR) in the NSRs group, vs 2 (1-2 IQR) in the SRs group, and the distribution of the two groups differed significantly (p = .044), but on the other hand the effect size was found to be small (r = 0.13). In addition, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; p = .012)
As for the fear of getting infected, when asked on the 4-point Likert scale, the median was 2 (1-3 IQR) in the NSRs group, vs 2 (1-2 IQR) in the SRs group, and the distribution of the two groups differed significantly as well (p = .049), however the effect size was found to be small (r = 0.123)
Comparisons are found in Table 3 and figure C.
D. Effect of the pandemic on the surgical training program:
When SRs were asked about a reduction in the number of elective surgeries, 63 (52.1%) provided a positive answer.
In addition, in a multiple-selection question, 84 (69.4%) reported a decreased in the number of surgical cases they can participate and practice on, 43 (35.5%) reported a decrease in contact with the consultants, 62 (51.2%) reported a decrease in teaching sessions, and finally 16 (13.2%) had an answer of “none of the above”. Results are presented in Figure D.