584 - Impact of the COVID-19 Pandemic on the Training and Wellness of Pediatric Subspecialty Fellows

Poster Number: 584
Publication Number: 584.117

Monique M. Naifeh, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Erika Abramson, Weill Cornell Medicine, New York, NY, United States; Michelle Stevenson, University of Louisville School of Medicine, Louisville, KY, United States; Pnina Weiss, Yale School of Medicine, New Haven, CT, United States; Jennifer G. Duncan, Washington University School of Medicine, St. Louis, MO, United States; Jennifer A. Rama, Texas Children's Hospital/Baylor College of Medicine, Houston, TX, United States; Christopher E. Aston, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Su-Ting T. Li, University of California, Davis, School of Medicine, Sacramento, CA, United States

Background: The COVID-19 pandemic has disrupted pediatric clinical care and training.

Objective: Examine impact of COVID-19 pandemic on education and wellness of pediatric subspecialty fellows.

Design/Methods: We conducted a national survey of pediatric fellowship program directors (FPDs) via the APPD Subspecialty Pediatric Investigator Network starting in March of 2021. Data analysis included descriptive statistics, Х2 and Wilcox rank sum tests.

Results: Response rate was 34% (300/891). FPDs reported decreased in-person clinical care and increased participation in telemedicine (Figure 1). Most FPDs reported the COVID-19 pandemic negatively affected clinical education in outpatient (69%) and inpatient (54%) areas, overall fellow wellbeing (55%), procedural competence (46%), fellowship program morale (42%), and fellow preparation for more senior roles (34%) (Figure 2). 33% of FPDs reported their fellows cared for patients who were older than usual and 15% reported redeployment of fellows, primarily within the hospital network to care for adults. 70% of FPDs reported that at least some of their fellows missed work due to the COVID-19 pandemic, though less than 1% reported fellows missed work due to COVID-19 illness. Most (81%) FPDs reported being concerned that fellows missed key educational experiences due to the COVID-19 pandemic, though only 12% of FPDs reported their graduating fellows would use the American Board of Pediatrics waiver for reduced clinical time. In addition, while most FPDs reported at least some of their fellows had major disruptions to their primary scholarly activity (63%) and ability to present their scholarly work (62%), only 5% of reported their graduating fellows failed to complete their required scholarly work product. 36% of FPDs reported fellows’ ability to find a job was negatively impacted. Finally, fellowship program funding was decreased for 20% of programs.Conclusion(s): The COVID-19 pandemic has affected nearly all facets of pediatric subspecialty training. As the pandemic evolves, programs must carefully consider how to ensure clinical competence and preserve fellow wellbeing. Focusing on prioritizing continued in person clinical care of patients and maintaining adequate infrastructure to support frequent assessments of competence, fellow scholarly projects, and help with networking and the job search will likely be necessary going forward.
Figure 1: Effect of COVID-19 Pandemic on Volume of Patients Cared for In-Person and via Telemedicine Across Different Healthcare Settings by Region*To create the left half of this figure, answer choices were on a 5- point Likert-type scale ranging from very decreased to very increased. Each answer choice was assigned a value: -2 Very decreased, -1 decreased, 0 unchanged, 1 increased, 2 very increased. Programs were sorted by region and the mean score for programs in that region is presented.
Figure 2: Impact of COVID-19 on Fellow Education and Wellness