Of all the unsung heroes of this plague-time, perhaps those who have endured the most are resident physicians. After graduation from medical school, resident doctors spend three to seven years in intensive specialty training before they can practice independently. Residency is a vestige of apprenticeships from a bleaker past. It is chapter in life when one’s time and energy are mostly spent in hospitals or clinics, when 80-hour workweeks are common, when self-care dwindles, when exhaustion and stress stalk even the strongest and brightest. This is true during the best of times. As we descend through the worst public health crisis in a century, residency demands have sharpened while normal supports systems fail.
Most residents are young, often in their mid to late 20s, having spent years ensconced in libraries, research labs, and classrooms learning pathophysiology and pharmacology. Upon graduation from medical school, they are now drafted to the front lines of a generational pandemic, working long hours, often in cities where they are strangers (the process of “matching” into a residency program is one where residents are not in full control of their destiny or geography). They do so while putting their own health in jeopardy. The resident’s experience of the COVID-19 pandemic has been unlike any other, because on average, residents spend almost twice as much time at work as other providers. Residents are allowed to work 80 hours a week on balance, which means it’s fine to log 90 hours in the ICU if the following week is a mere 70.
In short, residents are young, isolated, and working more than anyone else. Salaries can shake out to less than $20 an hour, depending on a monthly schedule. Residents manage this while fighting tooth and nail for the most vulnerable lives in emergency departments, intensive care units, hospital wards, operating rooms, and clinics. Without their labor and expertise, many hospital systems could not function.
We have suffered through the deadliest year in our nation’s history, with over 400,000 people perishing from COVID-19. Perversely, many are doing so away from their loved ones, surrounded by masked strangers in hospitals. To prevent the spread of COVID-19, most hospitals are not allowing visitors. This is excruciating for patients and their families. Amidst this tragedy, residents provide a crucial link between their patients and the outside world. Not only are they caregivers, but counselors, who treat the sick and later spending hours on phone, updating concerned families.
Entangled in the heartbreak and loss of millions of Americans, residents do their work heroically. We are humbled by your dedication, your selflessness, your example. We see your sacrifices. Our debt to you is profound. We thank you for the deceased you cared for with dignity and love and for the many thousands of lives saved by your tireless efforts.
John P. Murray is an internal medicine physician.
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