COVID-19-Related Disruptions Are an Opportunity for Reflection on the Role of Research Training in Psychiatric Residency Programs

Round 1

Reviewer 1 Report

This paper discusses that the importance of research training in psychiatric residency program and impact of COVID-19 on postgraduate training.

In my opinion, revisions are needed for some points.

1) In the section of a case-related to postgraduate psychiatry training, there is a description that psychiatry resident had hard time with research during COVID-19, but the description is not specific enough. It would be better to specify the difficulties for resident, supervisors, and program faculty, as well as the points they devised. Tables and figures may make it easier to understand.

2) L124-126: "Short-term considerations in this scenario were practical: What accommodations were possible and appropriate in evaluating the student’s fulfillment of research requirements?" More detailed descriptions would be needed for the reader.

Author Response

Thank you for your feedback, which has helped strengthen the paper.  We have detailed our responses to your suggestions below:

1) We have provided more detail and examples of difficulties faced by the resident, supervisor, and program.  We did not place this in a table because of concerns about space limitations for a commentary and thought the flow of information in the text was accessible.  However, we would provide tables if others feel strongly that they are needed.

2) We have expanded this section (now L143-L141) to more detailed coverage of the accommodations considered and provided for evaluation of the research project.

Reviewer 2 Report

Given the COVID-19 has been widely imposing undergraduate and graduate medical educations in multifaceted ways, such challenges are imaginable and describable for readers based on both scientific and anecdotal evidences. It is no doubt that research is one of the key elements in clinical science and medical education in the era of evidence-based medicine. However, what specific constraints that trainees and educators in a resource-limited small island developing state have experienced compared to other trainees in other nations as almost all residency programs were forced to reflect, accommodate, and modify their schemes and structures of resident training during the pandemic. 
In a case study, It is unclear what refers to "the student." Does the resident same as the student? The 3/4 of the paper describes about the general importance of research training in residency programs. In what context and relevant unforeseen experiences in the training in a small island developing state had to address and drew conclusion of the importance and need for ensuring the high quality residency and research training? 

Author Response

Thank your for your helpful suggestions, which we have incorporated into our revision. We have provided more detailed coverage of both constraints and accommodations in our setting and tied some of this more directly to implications for LMICs and SIDS. Further, we have edited the case study to make clear throughout that the text refers to a resident.

Reviewer 3 Report

This commentary describes how research training has been more severely affected than clinical training due to the multifaced challenges under the COVID-19 pandemic, then discusses what innovations have been made in conducting and evaluating research activities using a case-study, and suggests ways to address challenges in future psychiatric research training.

The topic of a manuscript is really important. It is almost well structured and the argument is clear, however, I have some comments which may help improving the manuscript.

Minor comments

The three paragraphs after line 129 (See "Importance of research literacy training during psychiatry residency programs") only introduce the role and importance of research activities in current post-graduate training in psychiatry. Therefore, it is not clear how they relate to the challenges and innovations revealed through the case.

Thus, would it be possible to supplement the following points?

C1(line 126-127):

The article refers to implication of this case on the importance of research training and its relationship to development of clinical competencies. Could you describe the specific points in this case that show the importance of research training and its relationship to development of clinical competencies?

Alternatively, please describe in detail what capabilities the resident improved with devised research activities and evaluation methods in this constrained environment.

C2(line 161-163)

Several issues in current psychiatric training are presented, and you concluded that longitudinal integration and flexibility of research requirements are needed in future psychiatric residency.

Please give specific examples of how you would apply what you devised under the COVID-19 pandemic to these issues.

Author Response

Thanks very much for your comments to help us improve the manuscript. We have incorporated your suggestions in our revision.

C1: We have provided more detail on the capabilities emphasized for the resident and evaluated in the modified assessment.

C2: We have provided more specifics and emphasized the context of LMICs and SIDS. 

Round 2

Reviewer 1 Report

Appropriate corrections have been made to the comments.

Reviewer 2 Report

Much improved and clear statements compared to a prior version.