INSIDE WVSMA
Editor ’ s Letter
Sharing Memories of Completing Residency During a Pandemic
Linda S . Nield , MD
GUEST AUTHORS : Felistia N . Crowder , MD Jason T . Stemple , MD
Four years ago this month , West
Virginia ( WV ) was the last state in the nation to report its first case of COVID-19 , but by the last quarter of 2020 , WV was in the category of states with the highest age-adjusted death rates for the virus . 1 The intense risks and safety precautions and patient numbers created a unique environment for physicians in training . In March 2023 , two medical students shared their experiences during the height of the pandemic , and now , in March 2024 , two pediatricians reflect on completing their residencies at this unprecedented time .
Dr . Felistia “ Nikki ” Crowder graduated from her pediatrics residency program in 2023 .
“ Starting residency during the early throws of the pandemic was much different than what I expected ,” she said . “ An unexpected situation was the inadequate volume and variety of patient care encounters . Initially , there were fewer patients admitted to the hospital due to strict isolation practices at the time , and there were atypically small numbers of cases of respiratory syncytial virus ( RSV ) bronchiolitis . In my second year of residency , I was not feeling confident about managing breadand-butter bronchiolitis since I had minimal exposure to it as an intern . In contrast , patient volumes soared in the newborn nursery and neonatal intensive care unit due to the surge in births . In the clinic , I had to adapt to virtual visits . While telemedicine allowed for better access to care , there were sporadic issues with technology and appropriately assessing an uncooperative toddler through a computer screen . Regarding resident education , transitioning to virtual learning was a challenge , along with maintaining resident wellness activities . Despite all the challenges , I believe my colleagues adapted and supported one another during the unique circumstance . Adaptability and flexibility were skills that were gained during the pandemic that have subsequently made us better doctors today .”
Dr . Jason Stemple also graduated from pediatrics residency in 2023 and shares similar reflections to Crowder .
“ I began residency in July 2020 , following a long break after my virtual Match Day in March and virtual medical school graduation in May ,” he said . “ I was nervous to get back into the clinical setting . Not only was I apprehensive about the grind of a pediatric residency , but I was concerned about my own personal health . Was I putting my family , friends , and myself at risk due to the frequent exposure to COVID-19 ? Grabbing a mask before leaving the apartment to walk over to the hospital became part of my daily routine as did other tasks like eating lunch alone in a secluded area . There were times during my clinical rotations when I forgot about the ongoing pandemic due to the usual whirlwind of residency . However , I was reminded of the rampant virus when the only social outings allowed with my co-residents occurred virtually . Our pediatrics team experienced an extremely challenging season in the winter of 2022-2023 when we cared for a deluge of pediatrics patients infected with COVID-19 , RSV , and / or influenza . As my final year of residency rolled around , personal protection equipment restrictions were eventually removed , and my inpatient and ambulatory clinical experiences returned to what I remember before I began residency . Finally , I was able to see my patients ’ smiles as masks no longer hid the lower part of their faces , and the children were then able to see me smiling back at them — a reassuring visual pleasantry that we had missed for three years .”
To align with the theme of these reflections , this journal issue includes three more pandemic-related scientific articles . Dimachkie and colleagues discuss the pre-vaccine COVID-19 antibody positivity rate in healthcare workers in WV in the late spring of 2020 . 2 Welch et al . describe Charleston Area Medical Center ’ s experience with the use of antithrombotic therapy in patients infected with COVID-19 , 3 while Tripathi and co-authors highlight the history of an adult patient with COVID encephalitis myoclonus and provide a discussion of their literature review on the topic . 4
REFERENCES
1 . Centers for Disease Control and Prevention . Quarterly Provisional Death Rates for COVID-19 . Available at : https :// www . cdc . gov / nchs / pressroom / sosmap / covid19 _ mortality / Provisional _ COVD19 . htm . Accessed on November 27 , 2023 .
2 . Dimachkie Z , DeCicco D , Lerfald N , Sarwari A , Khakoo R , Juskowich J . Pre-vaccine COVID-19 antibody positivity in healthcare workers in West Virginia . WVMJ . 2024 ; 120 ( 1 ): 14-19 .
3 . Welch CA , Dinesan S , Kali MA , Jubelirer S , Davis E . Adherence to Antithrombotic Therapy Guidelines in COVID-19 Patients at a Major Medical Center in West Virginia . WVMJ . 2024 ; 120 ( 1 ): 20-23 .
4 . Tripathi R , Munir B , Smith M . COVID-19 encephalitis associated myoclonus : a case report and literature review . WVMJ . 2024 ; 120 ( 1 ): 24-26 .
6 • www . wvsma . org