The Toll of the COVID-19 Pandemic on Women Medical Students

By Deborah Rupert, MS, MA

The impact of the COVID-19 pandemic on women physicians has sparked ongoing discussions about gender-disproportionate personal burdens (Soares, et al, 2021) and professional consequences on academic publication rates (“productivity”) (Andersen, et al, 2020; Ipe, et al, 2021; Krukowski, et al, 2021), compensation (Woodhams, et al, 2020) and promotional track advancement (Narayana, et al, 2020).

However, less discourse has focused on the pandemic’s toll on women trainees in their medical school years. Instead, literature investigating the pandemic’s impact at the undergraduate medical education (UME) level has largely pooled medical students and discussed adaptive curriculum (Lin, et al, 2021; Sani, et al, 2020; Compton, et al, 2020; Miller, et al, 2020). This has resulted in knowledge gaps, outlined herein, as to the unique challenges faced by the next generation of women in medicine.

First and foremost, we must acknowledge and appreciate that the pandemic has cast intersectional feminism in medicine into the spotlight. As the economic (AAMC, 2018) and racial diversity (Lett, et al, 2019) of UME matriculants has increased in recent years, we must consider the population of trainees whose home lives, families and communities were hit hardest by the pandemic, including Black and Latinx students as well as those living in poverty (Abraham, et al, 2021). Racially diverse UME students were faced with balancing the demands of their medical education, racial unrest and a global pandemic; this has contributed to the significant mental and emotional burdens carried by historically underrepresented minority (URM) trainees (Salahou, et al, 2021; Stowers, et al, 2021). These issues are compounded by the disproportionate caretaker and mental health challenges of women trainees; women URM at the UME level are more likely to have become caretakers due to the pandemic and face mental health issues in the face of dire consequences to their families and communities (Robinson, et al, 2021). Moreover, it is likely, though poorly documented, that women trainees and/or their families have disproportionately faced financial struggles resulting in housing or food insecurities, because of the pandemic. These are highly complex, often hidden and under-investigated issues that likely increased for URM, women and URM-women trainees over the past year and a half.

Likewise, while the pandemic has worsened the mental health of UME students as a group (Meo, et al, 2020; Gupta, et al, 2021; Harries, et al, 2021), several lines of evidence support the conclusion that women trainees collectively experienced greater pandemic-exacerbated mental stress and illness than their male colleagues (Abdulghani, et al, 2020; Alsoufi, et al, 2020). This exacerbation of mental health issues is intimately linked to disproportionate, gender-biased emotional and mental loads as women are more likely to face caretaker burdens. According to the 2020 AAMC Questionnaires, 3.1 percent of entering and 7.3 percent of graduating UME students respectively have a non-spouse dependent. Given that since 2019 the majority of medical school matriculants in the United States are women (Durfey, et al, 2021; Glauser, 2019; Taylor, 2013), it is likely that the majority of medical-student parents are women. However, the gender breakdown of parenthood among UME trainees is not well documented. (The exact gender breakdown of the student-parent population, however, is not reported by the AAMC in their annual Graduation or Matriculating questionaries.) How the training of student-physician parents, specifically mothers, was impacted during the pandemic has been the focus of sparse investigative work (Murphy, 2020). Likewise, the percentage of UME women who became parents during the pandemic specifically has not been determined. Further, bridging curricular adaptations for this population over the past year and a half has the potential to drive more long-term, institutional reforms (Arowoshola, 2020; Lin, et al, 2021).

Finally, it bears mentioning that in addition to their own experiences, women UME students have witnessed the pandemic’s well-documented consequences on the career trajectories of early-, mid- and late-career women mentors. What does it mean to watch those we respect so much struggle to find institutional and personal support while fighting on the front lines of a public health crisis? The advocacy efforts by women in medicine, on their own behalf as well as their peers’, often have important downstream ripple effects that reach far beyond the walls of any individual institution. Like women physicians, women medical students are just beginning to parse out what recovery in the wake of the pandemic’s gender-driven consequences will look like, both professionally and personally. Therefore, as the community of women in medicine begins to fight for solutions-focused initiatives (Narayana, et al, 2020), we must urge a sense of unity across levels of training.

References

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