How COVID-19 Reshaped Psychiatric Training for a Generation of Doctors

When the COVID-19 pandemic swept through hospitals in early 2020, it did more than overwhelm intensive care units and supply chains; it upended the way an entire generation of doctors was trained. For psychiatry residents and fellows, the disruption was particularly complex. Their specialty depends on longitudinal therapeutic relationships, nuanced face-to-face observation, and supervised psychotherapy—forms of learning that seemed, at first glance, impossible to translate to a locked-down, screen-mediated world. Yet a new scoping review published in Academic Psychiatry suggests that the crisis did not simply damage postgraduate psychiatric education. It also acted as an unexpected catalyst, accelerating innovations in virtual teaching, telepsychiatry, assessment, and trainee well-being that may permanently reshape how psychiatrists are trained.

The review, led by Polina Perlman, a child and adolescent psychiatrist at the University of Toronto’s Temerty Faculty of Medicine, together with health sciences librarian Jessie Cunningham and senior author Mark D. Hanson, set out to map the full landscape of pandemic-era educational change in postgraduate psychiatry. The team followed Arksey and O’Malley’s five-phase scoping review framework and reported their findings according to the PRISMA extension for scoping reviews. Two comprehensive searches, conducted in May 2022 and May 2023 across MEDLINE, Embase, APA PsycINFO, Web of Science, and the World Health Organization’s COVID-19 database, identified 775 records. After deduplication, title and abstract screening, full-text review, and manual citation searching, 19 studies met the team’s strict eligibility criteria: each had to describe an educational development—including teaching, assessment, or structured well-being programs—that was actually implemented in response to the pandemic and involved residents, fellows, or physicians.

The deliberate exclusion of commentaries, editorials, needs assessments, and opinion pieces distinguishes this review from earlier broad syntheses of pandemic-era medical education. Perlman and colleagues wanted evidence of deployed change, not calls for change. The final corpus, comprising studies published between 2020 and 2023, was dominated by research from the United States, with additional contributions from Sweden, Ireland, the United Kingdom, New Zealand, Singapore, and Thailand. Most studies relied on descriptive, survey-based, or qualitative designs, and the team classified each curricular change as either reactive—introduced in direct response to pandemic conditions—or premeditated, meaning planned or accelerated by the crisis but conceived independently of it.

The dominant theme was unmistakable: fifteen of the nineteen included studies described transitions to virtual or hybrid didactics and clinical encounters. Programs converted lectures, seminars, case conferences, and even psychotherapy supervision to videoconferencing platforms within days or weeks. Remarkably, these hasty adaptations were generally reported as feasible, and in several studies both trainees and faculty expressed a preference for retaining hybrid formats even after the emergency subsided. National survey data cited in the review indicate that many psychiatry residency programs have indeed kept hybrid elements in place. A virtual clinical skills examination developed for general psychiatry was reported as both feasible and acceptable, suggesting that some core competency assessments can be delivered remotely without sacrificing rigor.

Beyond format, the pandemic also changed what was taught. Several programs expanded content on disaster psychiatry, telehealth ethics, and resilience, reflecting the reality that psychiatrists were being asked to support patients, colleagues, and health systems through an unprecedented collective trauma. Telepsychiatry training expanded substantially, with programs integrating focused seminars on remote therapeutic engagement, supervised virtual clinics, and remote case discussions. One notable example of premeditated change was the American Association for Geriatric Psychiatry’s comprehensive online geriatric psychiatry curriculum, a resource conceived before the pandemic but rapidly accelerated by it, which the review’s authors suggest could serve as a model for embedding specialty-specific online modules as core content for all general psychiatry residents, regardless of local service availability.

The review also documented a striking acceleration of well-being curricula. Four studies described structured interventions tailored to the specific stressors of the pandemic era, including redeployment anxiety, social isolation, and pervasive uncertainty. These ranged from structured peer support systems and virtual Balint groups—reflective discussion forums long used in medical training—to a mindfulness-based cognitive therapy-informed well-being program for psychiatry trainees in New Zealand. The authors note that psychiatry has historically been sparsely represented in the broader wellness-curriculum literature, making the appearance of four psychiatry-specific well-being programs in this small corpus particularly notable. They interpret this as a possible cultural shift toward normalizing ongoing emotional support and reflective practice within psychiatric education, rather than treating wellness as an occasional, stigmatized add-on.

Perhaps the most sobering findings concerned redeployment. In heavily affected regions such as New York City, psychiatry residents were reassigned to general medical services, caring for patients with acute COVID-19 far outside their specialty training. The studies documenting these experiences revealed substantial gaps in preparedness, supervision, and ethical frameworks for reallocating psychiatric trainees to frontline medical roles. The review argues that future national health emergencies should not be managed as ad hoc disruptions to psychiatric training but as scenarios for which programs can prepare in advance—with clearer redeployment frameworks, defined supervision pathways, structured emotional support, and recognition of psychiatry’s distinctive crisis contributions, including staff support, family communication, and management of acute psychological distress. Telepsychiatry and remote response skills, the authors contend, should be considered core elements of emergency preparedness rather than incidental pandemic adaptations.

The review also surfaced stark global inequities. While programs in higher-income settings such as Sweden and the United States often found digital and hybrid models feasible and worth retaining, the study from Thailand highlighted pronounced logistical barriers and considerable trainee dissatisfaction with remote learning. The success of pandemic-era educational adaptations, the authors conclude, depends heavily on local infrastructure and institutional capacity—a discrepancy that calls for international collaboration on resource sharing and digital infrastructure development so that post-pandemic educational gains do not widen existing divides. These findings carry implications for accreditation bodies as well: if virtual assessment, telepsychiatry exposure, and hybrid formats proved educationally valuable, regulators may need to reconsider how core training experiences are defined and whether competencies can be achieved through a broader range of educational formats.

An unexpected observation threaded through the review is the near-absence of postgraduate psychiatry from earlier broad syntheses of COVID-19-related educational change, even though online learning, telehealth, assessment changes, redeployment, and learner support were prominent themes in those reviews. The authors propose several possible explanations—timing gaps between rapid-response reviews and the later emergence of psychiatry-specific scholarship, and the tendency for pandemic-era changes to be implemented at the hospital or mental health team level rather than within psychiatry programs alone, obscuring psychiatry-specific data—while cautioning that these remain hypotheses. Whatever the cause, the finding underscores the value of discipline-specific knowledge synthesis: without focused reviews, innovations in psychiatric education risk remaining under-recognized in wider conversations about medical education reform.

The review is candid about its limitations. Consistent with scoping review methodology, no formal quality assessment of the included studies was performed, and the restriction to English-language, peer-reviewed publications describing implemented developments may have omitted early descriptive accounts, particularly from resource-limited settings. Most of the included studies were descriptive or survey-based, with little controlled evaluation or longitudinal follow-up—a gap the authors identify as the field’s most pressing research need. Looking forward, they outline priorities for post-pandemic psychiatric education: embedding telepsychiatry and hybrid learning as permanent flexible tools, sustaining well-being initiatives, expanding content to include crisis psychiatry and systems-based care, developing clear redeployment policies, addressing global digital inequities, and rethinking accreditation standards. Although artificial intelligence did not feature in the pandemic-era literature they reviewed, the authors note that AI literacy and its ethical implications for clinical reasoning, teaching, and assessment will likely need a place in future curricula. The pandemic, in their assessment, created an unusual opportunity to reconsider not merely the delivery of psychiatric training but its fundamental aims—and the challenge now is to evaluate which emergency innovations genuinely strengthen it, and to keep the ones that do.

Subject of Research: Changes in postgraduate psychiatric education implemented in response to the COVID-19 pandemic

Article Title: Postgraduate Psychiatric Education During the COVID-19 Pandemic: A Scoping Review

Article References: Postgraduate Psychiatric Education During the COVID-19 Pandemic: A Scoping Review. (n.d.). https://doi.org/10.1007/s40596-026-02424-7

Image Credits: AI Generated

DOI: 10.1007/s40596-026-02424-7

Keywords: psychiatry, medical education, COVID-19, scoping review, telepsychiatry, residency training, trainee well-being, virtual learning, redeployment, assessment, graduate medical education, emergency preparedness