Above all, residents and fellows want protection with adequate PPE and they want equal ability to get tested for coronavirus if they suspect exposure. The concept of unionizing was brought up with several of the residents I have spoken to, but to date, very few residency programs have successful unionized, likely due to fear of retribution and the intensely vulnerable position that trainees are placed in as soon as they finish medical school. One resident was in her third trimester of pregnancy but chose to continue working because she was afraid to speak up or remove herself from clinical duty and place another co-residents in the line of fire. In the end, most trainees cannot walk away from their programs without causing significant damage to their career, even if they are literally putting their lives at risk by staying. In many programs, residents and fellows have no control over the amount of personal risk they take on during the COVID-19 pandemic, and they are in a poor position to speak up about it. The culture of residency and fellowship programs also makes it difficult to remove oneself from the work pool without causing more work or hardship for colleagues, since everyone is, at baseline, stretched so thin. Unfortunately, the way the residency and fellowship training systems operate is archaic and restricts many liberties in exchange for reliable medical training. However, the key term here is lack of control. But residents and fellows have yet to be afforded any additional benefits, even as many retail companies like Walmart and Target have begun to increase hourly wages for hazard pay.Д¬ertainly many, if not all, residents and fellows in the United States want to serve patients where they are needed most and to be part of the force that is fighting against the coronavirus. In the same vein, some residents have lobbied for hazard pay, which is defined by the Department of Labor as receiving additional pay for performing hazardous duty or work that involves physical hardship. During the coronavirus pandemic, some attending hospitalists- who in some cases already get paid an order of magnitude more than their residents or fellows- have succeeded in negotiating for time-and-a-half payment for extra hours or for taking high-risk shifts. When it comes to pay, residents and fellows are compensated with a modest fixed salary that is predetermined based on geographic location of their residency program and the years spent in residency. However, some trainees have said that there have been situations in which attendings were able to get tested for COVID-19 while trainees remained unable to gain access to tests. Testing for COVID-19 is highly regulated from institution to institution. Trainees have expressed frustration that they have not been included in many of the recent scheduling decisions and have been put at risk unequally compared to their senior counterparts.В Some residents explained that some of their attending physicians had received preferential choice to cover non-COVID services, leaving residents and fellows more exposed. Many surgical residents and fellows have been pulled from operating rooms and deployed to the frontlines of the coronavirus fight, where they not only risk their health, but also educational and training opportunities.ДЄdditionally, numerous residents and fellows have reported sacrificing vacation and elective rotation time.

In many hospitals, residentsвЂ™ schedules and workflow have changed since the coronavirus outbreak started, to avoid healthy patients being exposed while also diverting supplies and workforce to higher-risk units, such as Emergency Departments and Intensive Care Units. Reusing masks and respirators is commonplace, and many have explored unique ways to sterilize used equipment or innovative methods to create novel ones on the fly. Like all healthcare workers, trainees have been grappling with a widespread, dangerous personal protective equipment (PPE) shortage.

Unfortunately, many of the same themes emerged throughout each of those conversations. IвЂ™m a resident, and I interviewed multiple other residents and fellows from around the country for perspectives about working on the frontlines of the COVID-19 crisis.

Doctors in training step 2 videos