THE IMPACT OF COVID-19 PANDEMIC ON THE CHOICE OF SUB-SPECIALTY TRAINING IN US MEDICAL RESIDENCY PROGRAMS

Abstract

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: The Covid-19 pandemic led to critical shortage of personal protective equipment worldwide & challenged the motto of safety in healthcare occupations. Pulmonary & critical care medicine (PCCM) is one of the specialties that was heavily involved in care of Covid-19 infected patients. It is not yet determined how an active pandemic can shape the minds of Internal Medicine (IM) residents who wished to pursue fellowship training. While some may deem PCCM to be too high a risk and avoid it altogether, others may process it as a calling. The purpose of this survey study was to determine these effects. METHODS: We surveyed the IM residents enrolled in ACGME accredited residency programs in the United States. The survey invitation link was distributed to the preferred contact email listed on the American Medical Association: Residency & Fellowship Database (FREIDA™) using a mass emailing service. Programs were requested to distribute the survey to IM residents to complete voluntarily. Study data were collected & managed using REDCap electronic data capture tools hosted at Case Western Reserve University. A reminder email was sent at 2-week period to the programs that didn't open the initial enrollment email. Data analysis was completed using REDCap & Microsoft Excel. RESULTS: Of the 258 responses, 12 were excluded due to incomplete data or not meeting criteria. A total of 245 responses were used for analysis of which 48.4% self-identified as male & 51.6% as female. Subgroups based on year of training were: PGY1(66, 26.9%), PGY2(94, 38.4%), PGY3(75, 30.6%) & PGY4(10, 4.1%). Majority of residents were in age group 26-35 (226, 92.2%) with geographical distribution into Northeast (55, 22.4%), Midwest (82, 33.5%), South (61, 24.9%) & West (47, 19.2%). Of the respondents, 179/245(73.1%) were residents aspiring for fellowship positions, 30/245(12.2 %) were undecided & 36/245(14.69%) were not interested in pursuing fellowship. The pandemic events of year 2020 altered the decision to pursue fellowship with an average influence factor of 59.08 (SD 23.4) on a linear scale of 0-100. This change affected 10.6% (26/245) of the respondents, swaying 46.1% of these residents against the field of PCCM & 23% for it. CONCLUSIONS: The COVID-19 pandemic affected only a small proportion of residents into altering their decisions to pursue fellowship of their original choice. However, when applicable it mostly deterred residents from applying to a high risk fellowship such as PCCM. This survey study is limited by the relatively small number of respondents, general limitations of voluntary surveys & lack of responses from some geographic locations. CLINICAL IMPLICATIONS: Covid-19 pandemic may have influenced the decision to pursue fellowship training with a potentially deleterious effect on PCCM. This could be due to ongoing concerns for personal safety. Additional studies are needed to determine underlying factors. DISCLOSURES: No relevant relationships by Samantha DiBenedetto, source=Web Response No relevant relationships by Enambir Josan, source=Web Response No relevant relationships by Ziad Shaman, source=Web Response No relevant relationships by vikrant singh, source=Web Response