Lama Muhammad, MD, board certified in neurology and psychiatry, is an assistant professor of psychiatry at the University of California in San Diego. She is also a professional Arabic Magic Realism Writer who focuses on cultural dilemmas and has published 7 books. Dr Muhammad reached out to us and provided the following recommendations for faculty during the coronavirus disease 2019 (COVID-19) pandemic.
In light of the pandemic, we are making an effort to speak with psychiatric providers from diverse professional backgrounds in order to learn more about their response to the current crisis. To share your perspective on the pandemic and the role of psychiatry, please get in touch with us via our submissions page.
Psychiatry faculty members argue cogently about the best way to enhance residents’ wellbeing, yet they often do not refer to wellbeing guidelines in the case of a pandemic. The COVID-19 pandemic is unique to the psychiatric educational field, as most previous epidemics and catastrophic events took place during a time of stigma for mental illness, or when the field of psychiatry itself was underestablished.
Therefore, when one searches the literature, there are no guidelines on how to manage residency programs or how to prepare the psychiatry training environment to assure residents’ wellbeing during pandemics. Nevertheless, some suggestions might be helpful in this time of resource scarcity to enhance our teaching responsibilities.
1. No perfect egg
Email the residents weekly. Thank them for their great job in this precise time. It is not a job for program directors only; every kind word matters. Psychiatric residents might think that they are less needed as they are not at the frontlines in many states. Such a pandemic without a doubt causes a lot of anxiety, depression, and addiction disorders, especially in our already vulnerable populations. These emails do not need to be perfect or time-consuming.
Kindness and empathy are our first language, and as Anna Freud said, “In our dreams, we can have our eggs cooked exactly how we want them, but we can’t eat them.”
2. Socialize creatively
Try to fit in at least 1 different Zoom meeting a month to discuss a movie or book or even to chat about daily life. Social distancing can affect our residents’ wellbeing, and arranging Zoom meetings for interesting activities can help bring the residents together and give them space to vent and share their ideas. Socializing and taking interest in each other’s lives should continue to be our preferred style.
3. Fight racism
Support minorities and fight racist biases. Equality and justice are among the main concepts for fighting epidemics in the right way. This approach can be enhanced by encouraging residents to speak about their feelings and how they are coping with this pandemic, using their wisdom to dissolve cognitive distortions. We can use our literature to enhance the privilege of being different, as Carl Rogers said, “What I am is good enough if I could just be it openly.”
4. Wellbeing texts
Text residents who are immunocompromised or who are taking care of immunocompromised family members. Contact them weekly to ask them how they are doing and offer help. Even with the work from home option, some residents may continue to feel afraid or even bullied if all your texts and emails are about proper documentation. Encourage residents with very neutral nonverbal statements, and always see their points. Support their wellbeing in an illuminating way.
5. Take-home points
Send take-home points biweekly, with the most valuable points that the team learned from seeing complex cases. This practice is encouraged even outside of the pandemic; however it can be priceless during this time, as it can maintain the educational process and prevent residents from falling behind. Jean Piaget was right in saying, “Teaching means creating situations where structures can be discovered.”
6. Telehealth difficulties
Provide one-on-one Zoom meetings to residents who are struggling with telehealth, which can be difficult because it may slightly affect the mental status exams that we rely on significantly in making our diagnoses. Furthermore, patients’ ability to get labs and imaging could be diminished due to social distancing and transportation difficulties. Offering one-on-one meetings to the residents when they want to discuss complex cases is vital in encouraging the best care for our patients, as well as supporting the residents. Try not to underestimate your ability to help.
Residency training responsibilities are one of the lofty duties we agreed to fulfill. Having our residents’ wellbeing and training as our priorities during the COVID-19 pandemic can not only enhance our patients’ best psychiatric care but also support our excellent training mission, recruitment efforts, and wellbeing.