06. Conceptual/Philosophical/Value Statements by Leadership

Communicating key values and philosophies to trainees is an important aspect of leadership during a pandemic. Of 10 participating institutions, seven included at least one philosophical statement in their COVID-19 documents. The remaining three institutions focused on relaying facts and logistical protocols without including philosophy statements. With the exception of one document directly from the Division of Hospital Medicine, philosophical statements most often came from residency program leadership including the program director and/or chief residents. For example, UCSF’s residency program leadership listed key priorities, including education, wellbeing, collaboration with other services as part of the pandemic response, and patient care in both inpatient and outpatient settings. Additionally, the theme of gratitude for the residents was evident among these documents, along with statements of optimism and encouragement.

One philosophical aspect to consider is how leaders address residents at high risk for severe COVID-19 illness. Two institutions mentioned this topic very briefly, and one had a clearly delineated protocol for these residents. Notably, as time evolved, one institution changed their policy to begin including residents in the direct care of patients with COVID-19. As surge levels shift, there may be differences in how programs change their exposure risk thresholds for trainees in order to best care for the community.