Impact of COVID-19 on Emergency Medicine Residency Programs

A Cross-Sectional Study in New York State

Muhammad Waseem, MD, MS; Nidhi Garg, MD; Bernard P. Chang, MD, PhD; Juan Acosta, DO, MS; John DeAngelis, MD, RDMS; Mary E. McLean, MD; Laura D. Melville, MD, MS; Timothy Pistor, BS; Kaushal H. Shah, MD; JoAnne Tarantelli, BS; Susan M. Wojcik, PhD, ATC; James Gerard Ryan, MD

Disclosures

Western J Emerg Med. 2022;23(2):246-250. 

In This Article

Abstract and Introduction

Abstract

Introduction: The 2019 novel coronavirus pandemic has caused significant disruptions in the clinical operations of hospitals as well as clinical education, training, and research at academic centers. New York State was among the first and largest epicenters of the pandemic, resulting in significant disruptions across its 29 emergency medicine (EM) residency programs. We conducted a cross-sectional observational study of EM residency programs in New York State to assess the impact of the pandemic on resident education and training programs.

Methods: We surveyed a cross-sectional sample of residency programs throughout New York State in June 2020, in the timeframe immediately after the state's first "wave" of the pandemic. The survey was distributed to program leadership and elicited information on pandemic-prompted curricular modifications and other educational changes. The survey covered topics related to disruptions in medical education and sought details on solutions to educational issues encountered by programs.

Results: Of the 29 accredited EM residency programs in New York State, leadership from 22 (76%) responded. Of these participating programs, 11 (50%) experienced high pandemic impact on clinical services, 21 (95%) canceled their own trainees' off-service rotations, 22 (100%) canceled or postponed visiting medical student rotations, 22 (100%) adopted virtual conference formats (most within the first week of the pandemic wave), and 11 (50%) stopped all prospective research (excluding COVID-19 research), while most programs continued retrospective research.

Conclusion: This study highlights the profound educational impact of the pandemic on residency programs in one of the hardest- and earliest-hit regions in the United States. Specifically, it highlights the ubiquity of virtual conferencing, the significant impact on research, and the concerns about canceled rotations and missed training opportunities for residents, as well as prehospital and non-physician practitioner trainees. This data should be used to prompt discussion regarding the necessity of alternate educational modalities for pandemic times and the sequelae of implementing these plans.

Introduction

The 2019 novel coronavirus (COVID-19) pandemic has upended broad swaths of the medical and educational world. The World Health Organization declared COVID-19 a global pandemic on March 11, 2020,[1] and on March 18, 2020, Governor Andrew Cuomo of New York State (NYS) declared a state of emergency. The disruptive effects of the pandemic influenced individuals' lives broadly across the healthcare system. The state of New York was one of the earliest COVID-19 epicenters across the nation. It is also home to the largest number of emergency medicine (EM) residencies in the country, most of which are located within the New York City epidemic area. As the pandemic crisis evolved, the Accreditation Council for Graduate Medical Education (ACGME) monitored the needs of the graduate medical education community and provided appropriate guidance for residency training programs by declaring pandemic status for affected institutions.

These guidelines increased flexibility, allowing sponsoring programs to increase availability of physicians in clinical care settings. However, programs are required to maintain adequate resident supervision, continue meeting work hours limits, and provide alternative educational resources. Both anecdotally and through personal experiences, we learned that the pandemic resulted in canceled core rotations, conferences, other educational sessions, and research activities for EM residents in NYS. Through this study, we endeavored to document and analyze the pandemic's disruptions on clinical training, didactic educational experiences, research programs, and wellness activities at NYS EM residency programs.

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