ABSTRACT
Background: The COVID-19 pandemic has had a wide-reaching impact. Graduate medical education of orthopedic surgeons was not spared from the jarring changes. Purpose: We sought to survey fellowship program directors in the field of orthopedic surgery about how the COVID-19 pandemic affected the education of the 2019 to 2020 and 2020 to 2021 fellowship classes and the future of their programs. Methods: In October 2020, an 18-item survey was distributed by an official of the American Academy of Orthopedic Surgeons (AAOS) to the specialty societies that govern fellowship training. Each specialty society then distributed the survey to its respective program directors. A reminder email was sent during the enrollment period. Each respondent was able to complete the survey once. Survey questions were grouped into 3 sections: general information about the fellowship training programs, the impact of COVID-19 on the 2019 to 2020 fellowship class, and the future impact of COVID-19 on the fellowship training programs. Results: Of the 564 accredited orthopedic surgery fellowship programs in the United States, 190 directors responded. Of these, 73.59% reported COVID-19 had a negative impact on the 2019 to 2020 fellowship class. A normal distribution of responses was found regarding didactic and academic learning, research, and mentorship opportunities. A majority of respondents said they believe that there will be no negative impact on patient care the fellows provide in the years to come. Conclusion: Orthopedic surgery fellowship program directors acknowledged that while there were negative effects to training in the pandemic, they did not think these would negatively affect patient care provided by 2019 to 2020 fellows in the short and medium term. They also reported positive outcomes from the experience of the pandemic, including new ways to educate fellows.
ABSTRACT
BACKGROUND: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. PURPOSE/HYPOTHESIS: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. STUDY DESIGN: Cross-sectional study. METHODS: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. RESULTS: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were "redeployed" to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). CONCLUSION: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows' exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.