Abstract：
BACKGROUND: The COVID-19 pandemic introduced new challenges to provide care and educate junior doctors (resident physicians). We sought to understand the positive and negative experiences of first-year resident physicians and describe potential ethical issues from their stories.
METHODS: We used narrative inquiry (NI) methodology and applied a semistructured interview guide with questions pertaining to ethical principles and both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio recorded and transcribed. Three members of the research team coded transcripts in duplicate to elicit themes. Discrepancies were resolved through discussion to attain consensus. A composite story with threads was constructed.
RESULTS: 11 residents participated across several programmes. Three main themes emerged from the participants\' stories: (1) complexities in navigating intersecting healthcare and medical education systems, (2) balancing public health and the public good versus the individual and (3) fair health systems planning/healthcare delivery. Within these themes, participants\' journeys through the first wave were elicited through the threads of (1) engage us, (2) because we see the need for the duty to treat and (3) we are all in this together.
CONCLUSIONS: Cases of the ethical issues that took place during the COVID-19 pandemic may serve as a foundation on which ethics teaching and future pandemic planning can take place. Principles of clinical ethics and their limitations, when applied to public health issues, could help in contrasting clinical ethics with public health ethics.
CONCLUSIONS: Efforts to understand how resident physicians can navigate public health emergencies along with the ethical issues that arise could benefit both residency education and healthcare systems.
METHODS: We used narrative inquiry (NI) methodology and applied a semistructured interview guide with questions pertaining to ethical principles and both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio recorded and transcribed. Three members of the research team coded transcripts in duplicate to elicit themes. Discrepancies were resolved through discussion to attain consensus. A composite story with threads was constructed.
RESULTS: 11 residents participated across several programmes. Three main themes emerged from the participants\' stories: (1) complexities in navigating intersecting healthcare and medical education systems, (2) balancing public health and the public good versus the individual and (3) fair health systems planning/healthcare delivery. Within these themes, participants\' journeys through the first wave were elicited through the threads of (1) engage us, (2) because we see the need for the duty to treat and (3) we are all in this together.
CONCLUSIONS: Cases of the ethical issues that took place during the COVID-19 pandemic may serve as a foundation on which ethics teaching and future pandemic planning can take place. Principles of clinical ethics and their limitations, when applied to public health issues, could help in contrasting clinical ethics with public health ethics.
CONCLUSIONS: Efforts to understand how resident physicians can navigate public health emergencies along with the ethical issues that arise could benefit both residency education and healthcare systems.
摘要：
背景：COVID-19大流行为提供护理和教育初级医生（住院医师）带来了新的挑战。我们试图了解第一年住院医师的积极和消极经历，并从他们的故事中描述潜在的道德问题。
方法：我们使用了叙述性调查（NI）方法，并应用了半结构化访谈指南，其中包含与道德原则以及大流行的积极和消极方面有关的问题。取样是有目的的。访谈是录音和转录的。研究小组的三名成员对抄本进行了一式两份的编码，以引出主题。通过讨论解决了分歧，以达成共识。构建了一个带有线程的复合故事。
结果：11名居民参与了多个项目。参与者的故事中出现了三个主要主题：（1）导航交叉医疗保健和医学教育系统的复杂性，（2）平衡公共卫生和公共利益与个人；（3）公平的卫生系统规划/医疗保健提供。在这些主题中,参与者通过第一波的旅程是通过(1)吸引我们的线程引起的，（2）因为我们看到了对待责任的必要性（3）我们都在一起。
结论：在COVID-19大流行期间发生的道德问题案例可能是进行道德教学和未来大流行计划的基础。临床伦理学的原则及其局限性，当应用于公共卫生问题时，可以帮助将临床伦理与公共卫生伦理进行对比。
结论：努力了解住院医师如何驾驭突发公共卫生事件以及出现的伦理问题，可以使住院医师教育和医疗保健系统受益。
方法：我们使用了叙述性调查（NI）方法，并应用了半结构化访谈指南，其中包含与道德原则以及大流行的积极和消极方面有关的问题。取样是有目的的。访谈是录音和转录的。研究小组的三名成员对抄本进行了一式两份的编码，以引出主题。通过讨论解决了分歧，以达成共识。构建了一个带有线程的复合故事。
结果：11名居民参与了多个项目。参与者的故事中出现了三个主要主题：（1）导航交叉医疗保健和医学教育系统的复杂性，（2）平衡公共卫生和公共利益与个人；（3）公平的卫生系统规划/医疗保健提供。在这些主题中,参与者通过第一波的旅程是通过(1)吸引我们的线程引起的，（2）因为我们看到了对待责任的必要性（3）我们都在一起。
结论：在COVID-19大流行期间发生的道德问题案例可能是进行道德教学和未来大流行计划的基础。临床伦理学的原则及其局限性，当应用于公共卫生问题时，可以帮助将临床伦理与公共卫生伦理进行对比。
结论：努力了解住院医师如何驾驭突发公共卫生事件以及出现的伦理问题，可以使住院医师教育和医疗保健系统受益。
