key: cord-0864138-x4v2828q authors: Mehrzad, Raman; Akiki, Ronald; Crozier, Joseph; Schmidt, Scott title: Mental Health Outcomes in Plastic Surgery Residents during the COVID-19 Pandemic date: 2021-07-09 journal: Plast Reconstr Surg DOI: 10.1097/prs.0000000000008118 sha: 3657b81dd1bf03a3458c9339d778549c513c3022 doc_id: 864138 cord_uid: x4v2828q nan T he field of plastic surgery was inevitably affected by the severe acute respiratory syndrome coronavirus 2. Residents in plastic surgery programs, although originally not on the frontline, had significant changes to their schedules and were deployed to other medical services in the hospital to help with the surge of the coronavirus disease of 2019 (COVID-19) patients. In the setting of the COVID-19 pandemic, plastic surgery residents are at higher risk of psychological distress and other mental health symptoms. 1 To evaluate this, an American Council of Academic Plastic Surgeons-approved survey was distributed to plastic surgery residents in the United States. The nineitem Patient Health Questionnaire and the seven-item Generalized Anxiety Disorder scale were used to assess the severity of symptoms of depression and anxiety. A C oronavirus disease of 2019 (COVID-19) has spread rapidly throughout the world, and the impact on global and national health care, including plastic surgery, has been dramatic and unpredictable. Plastic surgery departments and divisions went into limbo after the American College of Surgeons, American Society of Plastic Surgeons, and The Aesthetic Society, advised that elective and nonessential cases be canceled. 1 All large plastic surgery meetings were canceled. Aspiring plastic surgeon trainees are among those affected by the pandemic; the Association of American Medical Colleges called for a halt in all clinical rotations of at least 4 weeks' duration in the 2020/2021 application cycle, a critical time for fourth-year medical students applying to integrated plastic surgery programs. 2 Medical students typically dedicate April to September rotating as subinterns on the plastic surgery service at their home institution and at several "away institutions" throughout the United States. Away rotations play a significant role in the plastic and reconstructive surgery match process; 67 percent of successful applicants in a given year participated in a rotation at the institution they matched into. 3 Students also attend national meetings for the opportunity to present their research, meet renowned faculty members across the country, and receive feedback on their application and performance. Often faculty, residents, and students at such events become lifelong colleagues and mentors. 4,5 These opportunities are now no longer available for students applying in the current COVID-19 pandemic. Plastic surgery residency applicants applying in the 2020/2021 cycle era are facing the daunting unknown with more limited opportunities for meeting influential individuals in the field. Students at institutions that do not have a plastic surgery home program may be affected the most. Consequently, mentorship of future trainees is arguably more important than ever, as it provides prospective applicants with a unique opportunity to connect students with faculty across the country to discuss research and personal career development and to expand one's network of mentors and colleagues. In 2015, the Plastic Surgery Research Council established a formal mentorship program with the goal of facilitating relationships between trainees and senior figures and of fostering unique guidance regarding career development. Medical student members and plastic surgery applicants can be paired with mentors across the nation from diverse backgrounds, and mentors can provide invaluable advice electronically regarding research endeavors and residency applications. With the current restrictions imposed by the evolving COVID-19 pandemic, electronic mentee-mentor interactions may be the only chance that prospective plastic surgery residents have to appreciate and converse with faculty and residents from different institutions, We thus want to emphasize the value of mentorship relationships and formal mentorship programs such as that offered by the Plastic Surgery Research Council. It is critically important to connect medical students/ trainees with faculty members to help them learn the Reviewing the mental health outcomes from a structural point of view, residents who had increased physical activity and more emphasis on wellness activities were found to have less severe symptoms of anxiety and depression. Wellness activities have been proven to reduce anxiety, reduce depression, and improve productivity, morale, and overall performance among residents, as well as help to decrease the risks of burnout. [3] [4] [5] However, these activities must be well implemented and encouraged to avoid conveying feelings of weakness and stigma. Our findings corroborate the importance of established wellness programs and trust between faculty and residents in academic programs, as well as identifying residents at risk for burnout, as these effects can have longstanding sequelae and consequently remain, even when the COVID-19 pandemic is over or under control. The Match: National Resident Matching Program International medical graduates in the US plastic surgery residency: Characteristics of successful applicants Matching into integrated plastic surgery: The value of research fellowships Matching into integrated plastic surgery: The value of research fellowships (Letter) Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019 Physician suicide: A call to action Well-being in graduate medical education: A call for action Well-being in residency: A systematic review Resident physician wellness curriculum: A study of efficacy and satisfaction The authors have no potential conflicts of interest to disclose.