The COVID-19 global pandemic has impacted every sphere of life including lab medicine residency programs. Our program here at Ram Manohar Lohia Hospital in New Delhi, India is no exception. However, we’ve implemented some strategies to mitigate the challenges posed to our residents and our training program that might benefit other programs.

Laboratory medicine is an essential healthcare service for day-to-day diagnostics, and we had to meet the ever-rising demand for SARS-CoV-2 diagnostic testing. With post graduate residents and senior residents across institutions called into patient care, resident training has been disrupted significantly. Our immediate response has been to shift to online, elearning. Although our trainees have been extremely positive about this change, a huge component of laboratory medicine is practical laboratory work. We’ve had to improvise resident and staff shifts to enable team segregation and encourage social distancing in our laboratory. We also made separate teams of residents and posted only one resident at a time in any particular section of the laboratory.

Some of the residents have been deployed to the COVID-19 wards and intensive care units for patient care. Approximately 25% of residents from each department have been assigned to ward duties on rotation. The residents are on duty for 14 days followed by 14 days of quarantine. These residents miss the online learning sessions due to their patient care commitments. Hence, we record and archive each session so that residents unable to attend a session live can access it later. Since our lab conducts COVID-19 molecular and serology testing and our molecular lab operates 24/7 for COVID-19 testing, many residents are posted round the clock to collect samples in our screening center and flu clinics. Additionally, one resident is posted at all times in routine clinical and hematology sections.

We conduct regular sessions online for clinical case discussions, journal clubs, grand rounds, and faculty lectures usually with video conferencing platforms like Zoom, Webex, and Loopup. We also evaluate residents from time to time by online viva-voce. We’ve asked them to prepare e-portfolios for both formative and summative evaluations. Trainees’ curriculum involves completing research work; however, due to the outbreak most of our research laboratories have been shut down completely. During this period, we’ve encouraged mentees and mentors to conduct literature reviews of the already performed work. Some trainees who have completed their laboratory work have been writing their dissertations and have published their work. We continually train our residents on updated COVID-19 bio-safety guidelines, ventilator management, and basic and advanced life support.

The laboratory medicine department is also responsible for undergraduate teaching of MBBS students. Due to lockdowns being implemented in several countries many undergraduate students had to return to their hometowns. Our institution adopted an online pedagogy using Google classroom and Zoom. Residents and faculty conduct didactic lectures and evaluate the assignments on a regular basis to continue the undergraduate teaching.

Living and working in the time of COVID-19 has been stressful for everyone, including our residents working long hours and even performing patient care with the attendant concerns about contracting the disease and passing it to friends and family. Therefore, we arranged for food and accommodation for all residents on duty and in quarantine. With our trainees’ personal wellbeing in mind, we encouraged online peer to peer counseling among residents and we assigned a mentor for each team of residents. We also made contingency plans in the scenario of residents getting infected or having personal emergencies, and we designed a protocol for de-isolating and returning to work after illness.

As laboratorians we have faced this pandemic with grit and determination. Although the residency program had to go through major changes, we prioritized education and took all measures to uphold our commitment to educating bright young minds during these trying times.

 

Saswati Das, MD, is a specialist biochemist at Ram Manohar Lohia Hospital in New Delhi, India. +Email: drsaswatidas@gmail.com