Medical residents are doctors-in-training. Should they treat coronavirus patients?

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A manual extraction of the coronavirus inside the Pennsylvania Department of Health Bureau of Laboratories. March 6, 2020. Photo credit: Governor Tom Wolf (CC BY 2.0).

As hospitals brace for a spike in coronavirus patients, a debate is brewing over possible ways to increase numbers of medical professionals.

On today’s Daily Dose, Dr. Michael Wilkes, a professor of medicine and global health at UC Davis, talks about a big problem hospitals are facing: Should medical residents be involved in the fight against COVID-19? 

Medical residents are doctors-in-training, says Wilkes. After students graduate from medical school, they apply for additional training that’s called a hospital residency, which can take three to six years. Residents are considered full-time employees but are supervised by faculty members (attending physicians). Once their residencies are completed, they take their board certification exam, which allows them to practice medicine without supervision. 

What are the arguments against having residents be involved in treating coronavirus patients?

Residents need to be supervised because they are trainees, which could increase their exposure to COVID-19, Wilkes says. This risk is compounded by the lack of  virus testing, which also applies to medical professionals

In other cases, he says residents might not have enough training – or  confidence. Some have reported feeling ostracized and being treated “like pariahs by neighbors.” 

What are the arguments for involving residents?

“This most certainly will not be the last epidemic, and they need to get trained. They need to learn how to manage resources in an environment where there are limited resources. They need to learn infection control. They need to learn how to use personal protective equipment,” says Wilkes.

Beyond hard skills, he argues residents need to learn how to manage patients:

“Residency is not just about learning new knowledge and learning procedures – how to do things or remove things or open things up. It really is about learning about professionalism, and attitudes, and behaviors, and this idea of dedication.”

Wilkes believes it’s part of a resident’s medical duty to join the battle against COVID-19.

“Yes, it involves some risk, but this is what we've all signed onto. And this is what we need to (as faculty and attendings) model for our residents. And soon when we retire, they're going to be the ones standing at the plate, and they need to be able to to handle that responsibility.”  

Has this issue come up before?

“[In] every single epidemic this has come up, as far back as we can determine. In the 1950s, 10% of each medical school class would be infected by TB [tuberculosis]. But choose your epidemic. Yellow fever, Spanish flu, AIDS – those on the frontlines have been at increased risk.”