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. 2020 Jul;71(1):6-11.
doi: 10.1097/MPG.0000000000002768.

Impact of COVID-19 on Pediatric Gastroenterology Fellow Training in North America

Daniel Mallon  1 , John F Pohl  2 , Uma P Phatak  3 , Melissa Fernandes  4 , John M Rosen  5 , Sarah S Lusman  6 , Cade M Nylund  7 , Candi S Jump  8 , Aliza B Solomon  9 , Arvind Srinath  10 , Andrew Singer  11 , Rula Harb  12 , Norberto Rodriguez-Baez  13 , Kristin L Whitfield Van Buren  14 , Shifra Koyfman  15 , Riha Bhatt  16 , Dellys M Soler-Rodriguez  17 , Mamata Sivagnanam  18 , Christine K Lee  19 ; NASPGHAN Training Committee COVID-19 Survey Working Group
Affiliations

Impact of COVID-19 on Pediatric Gastroenterology Fellow Training in North America

Daniel Mallon et al. J Pediatr Gastroenterol Nutr. 2020 Jul.

Abstract

Background: The COVID-19 pandemic has drastically changed healthcare systems and training around the world. The Training Committee of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition sought to understand how COVID-19 has affected pediatric gastroenterology fellowship training.

Methods: A 21 question survey was distributed to all 77 pediatric gastroenterology fellowship program directors (PDs) in the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition program director database via email on April 7. Responses collected through April 19, 2020 were analyzed using descriptive statistics.

Results: Fifty-one of 77 (66%) PDs from the United States, Canada, and Mexico responded to the survey. Forty-six of 51 (90%) PDs reported that they were under a "stay-at-home" order for a median of 4 weeks at the time of the survey. Two of the 51 (4%) programs had fellows participating in outpatient telehealth before COVID-19 and 39 of 51 (76%) at the time of the survey. Fellows stopped participating in outpatient clinics in 22 of 51 (43%) programs and endoscopy in 26 of 51 (52%) programs. Changes to inpatient care included reduced fellow staffing, limiting who entered patient rooms, and rounding remotely. Fellows in 3 New York programs were deployed to adult medicine units. Didactics were moved to virtual conferences in 47 of 51 (94%) programs, and fellows used various online resources. Clinical research and, disproportionately, bench research were restricted.

Conclusions: This report provides early information of the impact of COVID-19 on pediatric fellowship training. Rapid adoption of telehealth and reduced clinical and research experiences were important changes. Survey information may spur communication and innovation to help educators adapt.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
How fellows operate telehealth visits with their faculty preceptors. A, Fellow and attending in the same room, doing the telehealth visit from the same computer. B, Fellow and attending on separate computers, attending on video call for the entire visit. C, Fellow conducts the majority of the telehealth visit alone. BEFORE the call is completed, attending joins VIDEO CALL. D, Fellow conducts the majority of the telehealth visit alone. BEFORE the call is completed, fellow calls the attending on the PHONE. E, Fellow conducts the entire telehealth visit alone. AFTER completing the call, fellow calls the attending on the PHONE. F, Not applicable—fellows are not participating in telehealth.
FIGURE 2
FIGURE 2
Changes to inpatient rounds and consults. A, The number of staff and trainees allowed in patient rooms for examinations have been reduced. B, Fellows are not going into patient rooms unless deemed important/necessary. C, Some/all of patient/family conversations with inpatient teams are now done remotely. Examinations are still being performed in person. D, Inpatient consult discussions with the patient/family and consulting teams are done remotely by video or phone call. Examinations are performed in person. E, Fellows are going into most patient rooms with the attending. F, No significant changes (other than personal protective equipment [PPE] requirements).
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