Internal Medicine Resident Work Absence During the COVID-19 Pandemic at a Large Academic Medical Center in New York City

• DOI: 10.4300/jgme-d-20-00657.1
• Publication Date: 2020-10-20T18:40:35Z
• Authors: Ross Merkin; Ariel Kruger; Gaurav Bhardwaj; Grace R. Kajita; Lauren Shapiro; Benjamin T. Galen
• Keywords: Academic Medical Centers; Infectious Disease Transmission, Patient-to-Professional; SARS-CoV-2; Personnel Staffing and Scheduling; COVID-19; Internship and Residency; 3. Good health; 03 medical and health sciences; COVID-19 Testing; 0302 clinical medicine; Occupational Exposure; Internal Medicine; Humans; New York City; Sick Leave; Retrospective Studies

ABSTRACT

Background Montefiore Medical Center (MMC) is a large tertiary care center in the Bronx, New York City, with 245 internal medicine residents. Beginning on February 29, 2020, residents became ill with COVID-19-like illness (CLI), which required absence from work. There was initially a shortage of personal protective equipment and delays in SARS-CoV-2 testing, which gradually improved during March and April 2020.

Objective We evaluated the relationship between CLI-related work absence rates of internal medicine residents and MMC's COVID-19 hospital census over time.

Methods Data on resident work absence between February 29 and May 22 were reviewed along with MMC's COVID-19 hospital census data. To determine the effect of patient exposure on resident CLI incidence, we compared the mean incidence of CLI per patient exposure days (PED = daily hospital census × days pre- or post-peak) before and after peak COVID-19 hospital census.

Results Forty-two percent (103 of 245) of internal medicine residents were absent from work, resulting in 875 missed workdays. At the peak of resident work absence, 16% (38 of 245) were out sick. Residents were absent for a median of 7 days (IQR 6–9.5 days). Mean resident CLI incidence per PED (CLI/PED) was 13.9-fold lower post-peak compared to pre-peak (P = .003).

Conclusions At the beginning of the COVID-19 pandemic in New York City, a large portion of internal medicine residents at this single center became ill. However, the incidence of CLI decreased over time, despite ongoing exposure to patients with COVID-19.