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Abstract
Background The COVID-19 pandemic introduced new challenges to provide care and educate junior doctors (resident physicians). We sought to understand the positive and negative experiences of first-year resident physicians and describe potential ethical issues from their stories.
Method We used narrative inquiry (NI) methodology and applied a semistructured interview guide with questions pertaining to ethical principles and both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio recorded and transcribed. Three members of the research team coded transcripts in duplicate to elicit themes. Discrepancies were resolved through discussion to attain consensus. A composite story with threads was constructed.
Results 11 residents participated across several programmes. Three main themes emerged from the participants’ stories: (1) complexities in navigating intersecting healthcare and medical education systems, (2) balancing public health and the public good versus the individual and (3) fair health systems planning/healthcare delivery. Within these themes, participants’ journeys through the first wave were elicited through the threads of (1) engage us, (2) because we see the need for the duty to treat and (3) we are all in this together.
Discussion Cases of the ethical issues that took place during the COVID-19 pandemic may serve as a foundation on which ethics teaching and future pandemic planning can take place. Principles of clinical ethics and their limitations, when applied to public health issues, could help in contrasting clinical ethics with public health ethics.
Conclusion Efforts to understand how resident physicians can navigate public health emergencies along with the ethical issues that arise could benefit both residency education and healthcare systems.
- COVID-19
- Quality of Health Care
- Clinical Competence
- Education
- Ethics
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Footnotes
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Contributors AK is responsible for the overall content as guarantor and accepts full responsibility for the finished work and/or the conduct of the study, had access to the data and controlled the decision to publish. AK designed the study, collected data, analysed data and wrote the manuscript. SP helped to design the study, analyse the data and reviewed/co-wrote the manuscript. JL helped to design the study, analyse the data and reviewed/co-wrote the manuscript. RH helped to design the study, reviewed the interview guide, assisted with data collection and reviewed the manuscript. MC helped to design the study, reviewed the interview guide, assisted with data collection and reviewed the manuscript. IM supervised AK, helped to design the study, reviewed the interview guide, helped to analyse the data and co-wrote and reviewed the manuscript.
Funding This study was funded by University of Calgary, Faculty of Graduate Studies (Not Applicable).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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