The Impact of the COVID-19 Pandemic on Postgraduate Studies
The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted various aspects of life, and postgraduate medical education, training, and research have been significantly affected across specialties. The pandemic has presented unprecedented challenges, compelling institutions to seek innovative solutions to continue teaching and training postgraduate trainees while maintaining physical distance. This article explores the multifaceted impact of COVID-19 on postgraduate studies, encompassing challenges faced by students, adaptations in teaching methodologies, and the resulting stress and anxiety among students.
Disruption of Thesis Work and Research Activities
The COVID-19 pandemic has significantly hampered postgraduate research projects across all clinical disciplines. Many thesis are planned on electively admitted patients and often require the support of diagnostic laboratory and imaging services. Social distancing norms to curb COVID-19 transmission and conversion of many institutes to dedicated COVID centers has resulted in suspension of elective hospital services, reduced the availability of participants, and has affected most of the thesis-related research activities. A survey revealed that 75.9% of cases experienced hindrance in thesis conduct. The responsibility of thesis submission itself was responsible for majority of the pessimism and distress amongst the students as there was no correlation with their sample size or level of completion of thesis. A significant number of residents, 84.6% among those not allotted a thesis, reported a delay in thesis topic allotment. The major concerns regarding the thesis included fear of extension (42.7%), risk of infection (35.8%), and inability to publish the thesis (35.1%).
Mental Health and Well-being
The pandemic has resulted in increased workload and emotional stress related to both academics and the risk of contracting infection to self and family members, significantly impacting resident doctors. Working in isolation, loss of social support, changes in working methods, stressful working conditions, and hectic working hours in COVID areas have added to the woes of postgraduates, who are already concerned about their academics and thesis. Many residents (26%) were unable to sleep properly, and 22.1% were unable to concentrate on academics. A significant majority (88.8%) admitted that the inability to conduct the thesis and the break in academics caused a significant amount of mental stress. Fear of extension of the course (53%) and getting infected with COVID-19 (46.6%) were the most cited reasons for significant stress in most of the residents. The reduced footfall of patients in teaching hospitals due to the pandemic has also hampered the ongoing postgraduate research projects across all clinical disciplines.
Adaptations in Teaching Methodologies
During the initial phase of the COVID pandemic, the teaching activities were stopped because of lockdown, which affected academics severely in the majority of the students (88.3%). Nonetheless, the majority had continued academics in some form via virtual online digital platforms like Zoom, GoTo meet, etc. These platforms may enhance student participation by providing flexible scheduling and allow the convenience of attending irrespective of the place and time. The Accreditation Council for Graduate Medical Education (ACGME) had also advocated the use of tele-platforms for continuing educational activities during the present pandemic. The classes had resumed through online platforms for most (75.4%) residents.
However, these platforms have limitations like lack of familiarity and knowledge of their usage, accessibility problem, connectivity issues, poor voice clarity, background noise and cybersecurity concerns. They cannot fully replace traditional classroom teaching, which provides real-time instant feedback, interaction and involvement of the students, collaborative learning, critical thinking, and ensures sincerity in class. Despite the challenges, online platforms have provided a means to continue education during the pandemic.
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Skill-Based Training and Clinical Experience
The postgraduates are our next-generation health professionals and are expected to handle cases independently post training. They are expected to be trained in a wide variety of locations to gain clinical experience and develop a wide variety of skills. Reduction in the number of elective services (both outpatient and inpatient) had affected the usual rotation schedules of PGs and reduced the probability of gaining experience in the clinical bedside teaching in all fields in their limited tenure. Many PGs (64.5%) believed that the learning of essential skills was being hampered. Similarly, case load and variety has got severely affected and has led to major hindrance to the conduct of research work.
Psychological Impact and Well-being
The COVID-19 pandemic has had a severe negative impact on the psychological state of residents. Majority of the residents (73%) in our survey expressed to be having severe negative impact of the pandemic on their life in form of sleep disturbances, inability to concentrate on the academics and had memory issues leading to constant irritation and feeling of doom. This may be due to fear of contracting COVID-19 (45.7%) during direct involvement in care of COVID-19 patients, simultaneous pressure to keep pace with their studies and continue thesis work. In addition, longer working hours in personal protective gear, staying away from home due to restriction in travel, fear of carrying infection to the parents and lack of social life due to decrease in group meetings and classes may have been responsible for severe impact on the psychological state of the residents.
Furthermore, the PGs working in COVID-19 care areas were quarantined or isolated (in case of contracting the disease) as decided by institutional policy. The restrictions during quarantine period could be an additional reason responsible for disruption of the PG academic and thesis-related activities.
Strategies to Mitigate the Impact
Given the unprecedented challenges posed by the COVID-19 pandemic, several strategies have been proposed to mitigate its impact on postgraduate studies. These include:
- Increased reliance on telemedicine, simulation, and interactive web-based educational programs, including tele mentoring: These innovative strategies can help ensure quality academics and research work for trainees.
- Regularly scheduled offline classes along with online classes with social distancing in batches: This hybrid approach can provide a balance between online and traditional learning methods.
- Relaxations in thesis submission deadlines: Providing flexibility in deadlines can alleviate some of the stress and anxiety associated with thesis completion.
- Reduction in sample size and change in topic: Adjusting thesis requirements can make it easier for students to complete their research during the pandemic.
Global Perspectives and Solutions
A national lockdown was imposed in March 2020 which had profound effects for students across the UK higher education sector. Understanding how the pandemic has affected postgraduate research (PGR) students, relating to their mental wellbeing, social lives, and study experiences is very timely. Student-led policy suggestions at both national and institutional levels are provided drawing on the lived experiences and voice of PGR students. The findings demonstrate the need for generalised and specific support combining financial assistance, mental health and pastoral support, communication, and academic study support.
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The Indian Postgraduate Medical Education Context
In India, the postgraduate residents form an indispensable part of the medical fraternity and are the pillars of strength of any teaching medical institute. These students were the first line recipients of the effects of the pandemic both in terms of clinical care and in deceleration of their medical education. The World Health Organization defines the social role of a medical college as âthe obligation to direct their (students') education, research and service activities towards addressing the priority of the health concerns of the community, region and nation that they serve.â During the deadly pandemic, the service of the community suffering from this new illness, thus became the prime duty of postgraduate medical residents world over.
Postgraduate residency programmes in India are essentially based on specialty based curriculums which include clinical postings, hands on and bed side training, academic lectures, presentations and dissertation work. A variety of clinical exposure during the tenure of postgraduate training is essential for both research and learning experiences. With the advent of the pandemic, many web based educational options found their way into the mainstream medical education system. The lesser prevalent webinars replaced onsite seminars and conferences, on site clinical teaching was replaced by online presentations through various platforms.
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