Did the COVID-19 Pandemic Negatively Impact CV Fellowship Programs?

Medical education was compromised by the COVID-19 pandemic, and most cardiovascular fellowship program directors feel that cardiology fellows’ clinical training, didactic learning, academic productivity and well-being were negatively impacted, according to results from the 4th Annual Cardiovascular Program Director Survey published May 25 in JACC: Advances.

Michael W. Cullen, MD, FACC, et al., conducted a 43-question survey to capture the perspective of program directors on the impact of the COVID-19 pandemic on: 1) clinical training of cardiology fellows; 2) fellowship educational practices, 3) fellow academic development; and 4) virtual fellowship recruitment. All U.S.-based, Accreditation Council of Graduate Medical Education-accredited general cardiovascular fellowship programs were eligible for the survey. Data were collected from April 21, 2021 to July 6, 2021.

Program size was defined as small (1-10 fellows), medium (11-17) and large (18 or more) and program director age was defined as early career (34-45 years), mid-career (46-55 years) and late career (≥56 years). A total of 139 program directors of 257 eligible programs (54%) completed the survey. Of the responding programs, 58% were university-based. Most of the responding program directors were men (77%) and the median duration as a program director was five years.

Results showed that program directors reported a negative impact on education in the areas of cardiac catheterization (66%), outpatient general cardiology (52%), nuclear imaging (51%) and echocardiography (50%). In addition, 34% of respondents reported ongoing challenges to clinical rotations or clinical exposure related to the COVID-19 pandemic. One-third of program directors reported negative impacts to inpatient education, while 14% reported a positive effect of pandemic-related practice changes on inpatient intensive care.

The authors note that “despite improving attendance, 75% of program directors felt that virtual educational conferences adversely impacted interaction between participants. Only 22% felt they improved fellow education.” Furthermore, most program directors (85%) reported a negative impact of the pandemic on fellow well-being and burnout, and 57% reported a decrease in research productivity among fellows. Regarding the use of virtual recruitment to interview more competitive candidates, most program directors felt that virtual interviews adversely impacted interactions between fellows and candidates (71%) and the ability to convey the culture of their program (60%).

In an accompanying editorial comment, Benjamin H. Freed, MD, FACC; Doreen DeFaria Yeh, MD, FACC; and Melinda B. Davis, MD, FACC, write that “the rapid and significant changes to medicine and education during the COVID-19 pandemic warrant thorough study and reflection. Fellowship administrators, program directors and fellows demonstrated remarkable resilience and adaptability, and training programs maintained high-quality education even in the midst of this unprecedented crisis.” They add that the study authors are commended for thoughtfully examining the acute educational impact of the pandemic. “Although we hope to never face another global pandemic, we recognize that future challenges will inevitably arise, and we are confident our cardiovascular fellowship training programs will continue to pivot, adapt, reflect and learn.”

Clinical Topics: COVID-19 Hub

Keywords: Pandemics, Fellowships and Scholarships, Resilience, Psychological, COVID-19, Surveys and Questionnaires

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