Introduction
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus type 2 virus. In March 2020, the World Health Organization (WHO) declared the COVID-19 as a global pandemic. Due to the prevalence of COVID-19 and participation in online classrooms for a long time led to a lot of fear and stress in students. Many studies have shown that the COVID-19 pandemic has led to many mental disorders such as anxiety, depression, and sleep problems in many hospital staff and medical students. Although medical students are not at the frontline of battle against COVID-19, due to presence in medical centers are at risk of infection with COVID-19. Therefore, it can lead to a decreased health-related quality of life (QoL) in medical students compared to other students. This study aims to assess the professional QoL of medical interns in Rasht, Iran.
Methods
This cross-sectional study was conducted on 152 medical interns working in hospitals affiliated to Guilan University of Medical Sciences in 2020 who were selected using a convenience sampling method and the sample size was determined using Krejcie & Morgan’s table. A demographic form and the professional quality of life scale (ProQOL) were used to collect data. The ProQOL was designed by Stamm in 2010. This questionnaire has 30 items and three subscales of compassion satisfaction, burnout, and secondary traumatic stress (10 items for each subscale). The item are rated on a five-point Likert scale from 1=Never to 5= Almost always. The total score ranges 10-50. Scores are categorized as low (≤22), moderate (23-41), and high (≥42). Higher scores indicate greater compassion satisfaction, secondary traumatic stress, and burnout. Descriptive statistics (No., Mean±SD) and Shapiro-Wilk, Mann-Whitney U, Kruskal-Wallis, and Spearman correlation tests were used for data analysis. All statistical analyzes were performed in SPSS software, version 24 statistical.
Results
A total of 152 medical students participated in this study. Most of them (58.3%) were female and single (80.5%) and 24.5% had underlying diseases. The mean score of compassion satisfaction was 38.4±8.3, the mean score of job burnout was 30.9±5.4, and the mean score of secondary traumatic stress was 25.3±7.5. The compassion satisfaction score had a significant relationship with marital status, history of underlying disease, being resident of the city, and work shift duration. Burnout and secondary traumatic stress had significant relationship with the sociodemographic variables (Table 1).


Discussion
In this study, the professional QoL of medical interns in Rasht, Iran was investigated based on three subscales: compassion satisfaction, job burnout, and secondary traumatic stress. The reported compassion satisfaction score in our study was higher than in other studies. This difference can be due to the difference in professional laws and workload in different countries. The score of compassion satisfaction was significantly higher in married students compared to single students and in resident students compared to non-resident students. A study at the University of California found that the increased secondary traumatic stress reduced self-care in nurses. This can reduce their QoL, and increase the risk of infection in them and in their families. Our study showed a significant relationship between compassion satisfaction and duration of work shift in interns. Those with 12-hour emergency shifts had higher scores. A study in US also showed that compassion satisfaction was higher in the emergency department, while the burnout and secondary traumatic stress were higher in the internal and surgical departments. 
One of the limitations of our study is that the study was conducted on medical students in Rasht city; therefore, the results cannot be generalized to all medical students in Iran. It is recommended to conduct similar studies in other cities of Iran.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the research ethics committee of Guilan University of Medical Sciences (Code: IR.GUMS.REC.1399.418).

Funding
The present study was part of the doctoral thesis of Ava Sadaat Hoseini in the professional field of general medicine of the Faculty of Medicine of Guilan University of Medical Sciences, which was supported by the research deputy of the Guilan University of Medical Sciences and did not receive any funding from non-profit institutions.

Authors' contributions
All authors contributed equally in preparing all parts of the research.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors would like to thank the Clinical Research Development Unit of Poursina Hospital in Rasht city and all participants for their cooperation.
 

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