S1241 The COVID-19 Pandemic Effect on Fellow Education in U.S. GI Training Programs (CAFE-GI)

Abstract

INTRODUCTION: The COVID-19 pandemic has changed the educational experience of trainees in Gastroenterology (GI) training programs. Understanding how these changes have affected GI training is important for ensuring clinical competency of our current trainees and for future curricula planning purposes. METHODS: We sent an email invite to complete the anonymous online survey to all program directors (PD) of ACGME-accredited GI fellowship programs. Surveys were completed between May 11th to June 5th, 2020. The study was approved by the institutional review board. RESULTS: 44/205 (21%) PD completed the survey. At the time of the survey, programs were operating within the following ACGME defined stages of GME training: 7 (15.9%) were at stage 1, “business as usual,” 27 (61.4%) were at stage 2, “increased clinical demands,” and 10 (22.7%) were at stage 3, “pandemic emergency status.” Endoscopy Training: All PD reported decreased outpatient procedure volume for trainees with 70.5% reporting a greater than 75% decrease. 93.2% of PD reported decreased inpatient procedure volume with 34.1% reporting a greater than 75% decrease (Figure 1). Inpatient Consults: All PD reported fellows continued to perform inpatient consultations, but 50% of PD reported changing the structure of the consult service. 27.2% of PD reported a more than 50% decrease in the volume of consultations (Table 1). Outpatient Clinics: 90.9% of PD reported trainees continued outpatient clinics, but 81.9% of PD reported trainees saw fewer patients. The form of patient interaction changed in most programs: 75% used telephone visits; 55% used video visits; and only 30% maintained in-person visits (Table 1). Virtual Conferences: 81.8% of PD reported a high attendance rate (>80%) of virtual conferences. Though, 27.3% of PD considered virtual conferences a worse experience, and 70.5% of PD reported difficulty with engaging fellows in virtual conferences (Table 2). Overall Feedback: 72.7% of PD were worried that the pandemic would significantly decrease endoscopy exposure of the fellows, and 59.1% of PD were worried about the decrease in outpatient clinical experiences. CONCLUSION: The COVID-19 pandemic impact on US GI fellowship programs is significant, with large decreases in endoscopy and clinical encounter volume and shifting of clinical interaction away from in-person visits. Virtual conferences are highly attended, but engagement is challenging. Further adjustment of GI training programs is needed to accommodate these changes.Figure 1.: Volume change of endoscopy procedures performed by fellows during the COVID-19 pandemic.Table 1.: Changes to inpatient consult and outpatient clinic training in GI fellowship during the COVID-19 pandemicTable 2.: Response and feedback about virtual conference and lecture during the COVID-19 pandemic