COVID-19 pandemic in São Paulo: a quantitative study on clinical practice and mental health among medical residency specialties

ABSTRACT BACKGROUND: 2020 was a challenging year for all healthcare professionals worldwide. In Sao Paulo, Brazil, the virus SARS-CoV-2 took 47,222 lives up to December 29, 2020. The front line of medical professionals in Sao Paulo was composed of many residents, who were transferred from their rotations to cover the needs of the pandemic. OBJECTIVE: To identify medical residents' mental health and clinical issues, regarding symptoms of burnout, depression and anxiety during the pandemic, and to compare them among specialties. DESIGN AND SETTING: Quantitative study using a convenience sample of medical resident volunteers who responded to an anonymous online survey that was available during April 2020. METHODS: This investigation collected sociodemographic information and used the Oldenburg Burnout Inventory (OLBI) to measure burnout, the Patient Health Questionnaire (PHQ-9) to measure depression and the General Anxiety Disorder (GAD-7) scale to measure anxiety symptoms. This study also developed a COVID-19 Impact Questionnaire (CIQ-19) to assess the residents' beliefs and clinical practices relating to COVID-19 patients. RESULTS: The sample comprised 1,392 medical residents in Sao Paulo, Brazil. Clinical specialty physicians showed the highest rates of anxiety symptoms (52.6%) and burnout (51.2%), among the specialties. CONCLUSION: Clinical specialty residents are at higher risk of anxiety, depression and burnout. The symptoms of anxiety and depression have worsened during the COVID-19 pandemic. There is a general need for mental health support interventions for medical resident physicians, which requires reinforcement during this worldwide crisis.