Table 1 Illustrative Quotes of the Six Main Themes

Infection Fears

7

“Additionally, COVID-19 has been very scary for me as a medical student in terms of contracting the illness while treating patients. I am constantly afraid of being exposed to the virus and transmitting the virus to my family and friends unknowingly. There have been exposures to COVID-19 in my medical student class, and as someone who prior to COVID-19, visited family members every other week, I am now thinking twice about going home regularly.” (C2 R14)

Negative feelings of impact on education and exams

28

“The COVID-19 pandemic shutdown began about one week before I was scheduled to be taking my Step 1 board licensure exam, which was cancelled at the time. Since then, my exam was continuously delayed and rescheduled on a short-term basis over the next 4 months, leading to an incredibly stressful extended study period for my boards…Once our medical training restarted, I was actually studying for my Step 1 licensure until halfway through my rotation, which definitively affected and decreased the amount of time I could spend preparing for my day of working with my attending or residents.” (C1 R15)

“Our clinical time in our first two rotations has been cut by about 50–75%, with the excuse that “online” coursework is making up for the rest of the training time we would have had. Online coursework is not helpful in acquiring the skills we need to become a physician, and it is more evident than ever that medical education cares more about generating income than training good physicians and doing right by their students.” (C2 R25)

Loss of skill development

35

“On a more specific level to my medical training, I feel like COVID-19 has directly limited the amount of clinical time and exposure I’ve received. At this point, having completed four weeks of clinicals, I feel like I have had the amount of clinical exposure that in pre-COVID-19 times would equal ~ 1–1 and a half weeks. I feel myself growing more accustomed, adept, and less anxious with patients, but ultimately, I feel like my potential is being limited a ton. Ultimately, I really want to just see more and have more time in the clinic. I feel frustrated because I feel like a lot of my preceptors share the same opinion - they feel like I am improving, but at this point, the secret ingredient to becoming a better 3rd year student is simply just getting in the clinic more.” (C1 R14)

“I believe that COVID-19 has negatively impacted my medical training. This is primarily due to the decreased number of patient’s being admitted to hospitals or seen in an office at any point in time…The quality of cases I have seen has also decreased due to the inability to see anyone who is COVID-19 positive, even if they are asymptomatic and are in the hospital for something completely unrelated. In all there is a decreased amount of quality teaching time due to the lack of clinical time received in order to accommodate the increased number of students.” (C2 R16)

Adaptability

21

“I am learning to appreciate that a good medical training is not simply knowing the right information and the most up to date algorithms for patient care, but to be able to adapt and problem solve. I have been able to see physicians adapt quickly and efficiently with the sweeping remote nature of the pandemic, which has highlighted the importance of that adaptable and problem-solving spirit for physicians.” (C1 R23)

“I have also learned that a huge part of being a good provider is about adaptability. It is true that we can’t see patients in person as much, but this doesn’t mean that we can’t advocate for them. I have advocated for patients simply over the phone and built relationships through phone calls. It takes extra work and leaving your comfort zone, but it is very much possible.” (C1 R12)

“Medical training during the time of COVID-19 is a lesson in flexibility. In fact, I would argue that the entirety of 2020 has been a lesson in flexibility. The past 6 months have been unimaginable and unpredictable, and as such, we’ve had to pivot in our daily lives and make major adjustments to education delivery.” (C2 R26)

Perspective change and finding meaning

45

“The very sudden uptick in illness and suffering this country has faced, and the way in which the medical professions have stood up to meet it, has strengthened my resolve to be a physician.” (C1 R26)

“With all this said, despite having a much lower quality education as a result, I do value the little bit of education I have received so much more. I try my best to draw every ounce of meaning and learning from each minute talking to a patient or provider. I try to always think of good questions and think deeply about the cases because I know that the number of encounters will be limited.” (C2 R20)

Public education and advocacy

11

“I think there also comes a newfound responsibility to try and dispel myths, appease fear and remind people to behave responsibly. I choose to focus on the fact that many have a deepened appreciation for the sacrifice that doctors make to take care of their patients and am honored that I’m able to be a part of such a noble profession. This pandemic has showed me that there is need for change and that doctors can play an important role in advocating for such.” (C1 R18)

“In pandemic scenarios like the one we face today patients are often confused about what to do. Doctors are in the unique position to educate large segments of the population about safety measures and ways to control the spread of disease. I have found that most patients will truly listen and consider what their doctor tells them.” (C2 R7)