Five unique surveys were distributed electronically through the Qualtrics platform (Provo, Utah) in May 2020. Given the sensitive nature of discussion, participation was voluntary, anonymous, and participants could choose to skip select survey questions. Prior to enrollment, graduates were informed that the decision to enroll would not affect their residency training, employment, or academic status. Survey tools were piloted among study investigators prior to dissemination.

Initially, we asked all early graduates to fill out a survey aggregate, composed of a demographics questionnaire, initial experience survey, and three other surveys (Intern Skills, COVID Care, and Burnout Assessment: disseminated May 15, 2020). The Intern Skills survey was an 18-item tool that gauged self-reported confidence or comfort in important skills to hone for the medical internship year, as deemed so by a majority of Internal Medicine program directors [18]. The COVID Care survey contained 13 questions that evaluated the comfort-level of early graduates in managing and monitoring patients with COVID-19 infection. All questions in these surveys were on a 5-point Likert scale. The Burnout Assessment scale was a single-item measure previously developed and validated to evaluate burnout levels [19].

Those who worked as JPs and filled out the initial surveys were invited on May 29, 2020 to complete the Recap survey, which sought to further understand JP experiences. The survey contained up to 27 questions, including open-ended, yes/no, and 5-item Likert scale items. All evaluative surveys are provided in Supplementary file 1.

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