LAUSR

Background: The COVID-19 pandemic has had significant repercussions on US medical students preparing to enter the residency match, both personally and professionally. The objective of this study was to explore these repercussions and assess perceived barriers imposed by the pandemic on medical students applying to residency in 2020. Methods: This is a cross-sectional study of all applicants invited and choosing to interview at a single emergency medicine residency. Applicants answered a standardized question (“what were the biggest barriers to you this year as a result of COVID, whether personally or professionally?”) which was asked by one of two faculty members who, between them, interviewed 100% of applicants at the residency program. Faculty members entered applicant responses into a standardized Excel spreadsheet and deidentified the data. Data was then reviewed and categorized by trained, blinded investigators using grounded theory methodology. Data reviewers were not involved in the interview process, nor were they involved in candidate selection. Basic demographic information was obtained, including geographic region of medical school and sex. Data were analyzed using descriptive statistics and Fisher Exact. The study was reviewed by the IRB and found to be exempt. Results: Over 900 applications were received, and 199 applicants interviewed for positions in the residency program. Applicants were chosen through routine methods, and this study had no impact on candidate selection. 32.2% of interviewees were female, 67.3% were male, and 1 was not recorded. In terms of impact on their professional lives, over a third of students felt that their education had lagged as a result of the pandemic (36.7%), and 22.1% expressed concern for inability to perform at their audition rotations. In their personal lives, the biggest impacts of COVID-19 were feelings of isolation (36.3%), feelings of frustration and helplessness (9%), concerns about personal safety (4.5%), and general fear and worry (4%). Male and female applicants responded similarly in all categories except in feelings of frustration and helplessness, in which female applicants were much more likely to express those feelings than male applicants (18.8% vs. 4.5%, p=0.002). Conclusions: Medical students applying to residency perceive significant personal and professional disruption as a result of the COVID-19 pandemic. The most common personal barrier reported was isolation, while impact on education was the biggest professional concern. Women expressed feelings of frustration and helplessness more frequently than men.