COVID-19 Impact on Interventional Pulmonology Training

Or Kalchiem-Dekel; Audra J Schwalk; Niral M Patel; I-Hsin Lin; Jason A Beattie; Bryan C Husta; Mohit Chawla; Ashutosh Sachdeva; Jason A Akulian; Ali I Musani; A Christine Argento; Hans J Lee; John J Mullon; Neeraj R Desai; David W Hsia; Robert P Lee

doi:10.34197/ats-scholar.2020-0126OC

COVID-19 Impact on Interventional Pulmonology Training

ATS Sch. 2021 Apr 13;2(2):236-248. doi: 10.34197/ats-scholar.2020-0126OC. eCollection 2021 Jun.

Authors

Or Kalchiem-Dekel¹, Audra J Schwalk², Niral M Patel^{3

4}, I-Hsin Lin⁵, Jason A Beattie¹, Bryan C Husta¹, Mohit Chawla¹, Ashutosh Sachdeva⁶, Jason A Akulian⁷, Ali I Musani³, A Christine Argento⁸, Hans J Lee⁹, John J Mullon¹⁰, Neeraj R Desai^{11

12}, David W Hsia^{13

14}, Robert P Lee¹

Affiliations

¹ Department of Medicine, Pulmonary Service and.
² Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
³ Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado, Aurora, Colorado.
⁴ Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, Colorado.
⁵ Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
⁶ Division of Pulmonary, Critical Care, and Sleep Medicine, School of Medicine, University of Maryland, Baltimore, Maryland.
⁷ Division of Pulmonary and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
⁸ Division of Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine, Northwestern University Feinberg, Chicago, Illinois.
⁹ Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
¹⁰ Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota.
¹¹ Chicago Chest Center, Elk Grove Village, Illinois, and Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, Illinois.
¹² AMITA Health, Lisle, Illinois.
¹³ Division of Respiratory and Critical Care Physiology and Medicine and.
¹⁴ The Lundquist Institute for Biomedical Innovation, Harbor-UCLA Medical Center, Torrance, California.

Abstract

Background: The impact of the coronavirus disease (COVID-19) pandemic extends beyond the realms of patient care and healthcare resource use to include medical education; however, the repercussions of COVID-19 on the quality of training and trainee perceptions have yet to be explored. Objective: The purpose of this study was to determine the degree of interventional pulmonology (IP) fellows' involvement in the care of COVID-19 and its impact on fellows' clinical education, procedure skills, and postgraduation employment search. Methods: An internet-based survey was validated and distributed among IP fellows in North American fellowship training programs. Results: Of 40 eligible fellows, 38 (95%) completed the survey. A majority of fellows (76%) reported involvement in the care of patients with COVID-19. Fellows training in the Northeast United States reported involvement in the care of a higher number of patients with COVID-19 than in other regions (median, 30 [interquartile range, 20-50] vs. 10 [5-13], respectively; P < 0.01). Fifty-two percent of fellows reported redeployment outside IP during COVID-19, mostly into intensive care units. IP procedure volume decreased by 21% during COVID-19 compared with pre-COVID-19 volume. This decrease was mainly accounted for by a reduction in bronchoscopies. A majority of fellows (82%) reported retainment of outpatient clinics during COVID-19 with the transition from face-to-face to telehealth-predominant format. Continuation of academic and research activities during COVID-19 was reported by 86% and 82% of fellows, respectively. After graduation, all fellows reported having secured employment positions. Conclusion: Although IP fellows were extensively involved in the care of patients with COVID-19, most IP programs retained educational activities through the COVID-19 outbreak. The impact of the decrease in procedure volume on trainee competency would be best addressed individually within each training program. These data may assist in focusing efforts regarding the education of medical trainees during the current and future healthcare crises.

Keywords: COVID-19; interventional pulmonology; survey; training.

Grants and funding

P30 CA008748/CA/NCI NIH HHS/United States