The impact of COVID-19 on postgraduate training for European Junior Doctors

Authors: Dr Shruti Sharma, Dr Ellen McCourt, Mr Mathias Korner

Context
COVID-19 disrupted and altered everyday life across the globe; healthcare systems had to change the way they worked. Hospital leaders had to reallocate resources to be able to care for COVID-19 patients and reduce planned activity. Junior doctors, the specialist workforce of the future across Europe, experienced significant disruptions to their postgraduate training (PGT).
Excellent PGT is indivisible from excellent healthcare. It is essential that the COVID-19 pandemic does not create a deficit in PGT for coming generations of doctors; a sustainable, predictable medical workforce is essential for high quality healthcare and should be a priority for healthcare leaders.
Methods
The European Junior Doctors Association represents 300,000 junior doctors across Europe. At the beginning of the pandemic junior doctors reported disruptions to post-graduate training. EJD surveyed its member organisations between 2020 and 2022 to establish the impact of the pandemic on training, the impact as the pandemic evolved and progressed, and to identify recurrent themes and mitigating factors that protected postgraduate training.
Results
Sixteen European nations were represented in the EJD survey. 88% reported at the onset of the pandemic that COVID-19 had a negative impact on PGT, although after a year only 6 delegations reported that training in its entirety was postponed. 87% of nations reported that junior doctors had been redeployed from their usual place of work to care for COVID patients; 50% of delegations reported working beyond their rostered hours and beyond EWTD. Delegations reported delays to allocation of specialism, postponement of exit exams, and cancelling of mandatory courses or being converted to online courses.
Discussion
The level of disruption to PGT caused by the response to the COVID-19 pandemic varied across European nations, and where disruption occurred the response by healthcare leaders and managers, educators and employers was inconsistent. Although a number of European nations have examples of focused individualised solutions to missed training, this was by no mean universal and, despite multiple waves of the pandemic, some junior doctors still had no access to services to address lost training and were keen for these best practices to be shared and replicated across Europe. The increased use of digital and online meetings, courses and classes have proved somewhat effective, but will not in its entirety be able to replace physical events in terms of the learning experience. Whilst Europe is approaching a return to “normal service”, healthcare leaders and managers will have an ongoing challenge and responsibility to facilitate postgraduate medical training that mitigates for the impact of the pandemic.