Academic Impact on Emergency Medicine Training Programs During COVID-19 Pandemic

ABSTRACT

Background: Rapid spread of the Novel Coronavirus Disease (COVID-19) resulted in a global pandemic. As front-line health care workers, this crisis significantly affected emergency medicine residents and their respective programs. We sought to explore the impact of COVID-19 on the education and training of emergency medicine residents across the United States and Puerto Rico. Methods: A survey was sent out to Accreditation Council for Graduate Medical Education (ACGME) accredited United States and Puerto Rico emergency medicine residency programs (264 programs at the time) via email correspondence to the Program Directors and the Program Coordinators. The survey stratified program type (practice setting, length of training, institution type, moonlighting allowed) and impact of COVID-19 on residents (off-service rotations, weekly conferences, effect on research, and resident wellness initiatives). Comparison was made by United States and Puerto Rico regions divided by Northeast, South, Midwest, and West, as these closely correlated with the differences in areas of COVID-19 spread and saturation. REDCap was used as the platform for data capture. Results: A total of 134 emergency medicine residency programs completed the survey. Northeast (44%), South (26%), Midwest (17%) and West (13%) programs by regions were reviewed. Overall, the majority of programs were in an urban setting (70%), and academic practice comprised 58%, followed by community at 40% (p=NS). The curriculum was a 3-year format for 71% of the programs (p=0.002). Overall half of the programs stated their institution was declared a site of pandemic emergency status by the ACGME, with 70% in Northeast and 39% of the Midwest, followed by the West and South regions (p=0.011). The impact of COVID-19 on off-service rotations for the emergency medicine residencies was not significant;Northeast had a high impact in 34% of the programs, moderate impact for Midwest (35%) and minimal impact in the South (34%) and West (29%) programs. Weekly lectures were switched to virtual format and smaller groups. Of note, clinical research for prospective studies was negatively impacted throughout all the regions (p=0.034), however retrospective studies were not affected. Additionally, 88% of programs reported changes since the start of COVID-19 to assure residents with new initiatives and activities such as improving wellness and reducing burnout and stress. Conclusions: The COVID-19 pandemic impacted the training of emergency medicine residents in various aspects. Northeast programs were more affected compared to the other regions. Weekly didactic sessions largely transitioned to a virtual format and/or small group sessions. Off-service rotations overall were not significantly affected. Retrospective clinical research continued while there was a substantial disruption in prospective research projects. Finally, a positive outcome was the increased awareness to changes in improving resident well-being overall.