scholarly journals Dana-Farber Cancer Institute/Mass General Brigham Fellowship Response to the COVID-19 Pandemic

2021 ◽  
pp. OP.20.00894
Author(s):  
Robert M. Stern ◽  
M. Dror Michaelson ◽  
Erica L. Mayer ◽  
Aric D. Parnes ◽  
Annemarie E. Fogerty ◽  
...  
Keyword(s):  
Medical Education ◽  
Training Programs ◽  
Well Being ◽  
The United States ◽  
First Year ◽  
Fellowship Program ◽  
Dana Farber Cancer Institute ◽  
Fellowship Programs ◽  
Direct Feedback ◽  
Research Structure

The coronavirus disease (COVID)-19 pandemic has affected graduate medical education training programs, including hematology-oncology fellowship programs, both across the United States and abroad. Within the Dana-Farber Cancer Institute/Mass General Brigham hematology-oncology fellowship program, fellowship leadership had to quickly reorganize the program's clinical, educational, and research structure to minimize the risk of COVID-19 spread to our patients and staff, allow fellows to assist in the care of patients with COVID-19, maintain formal didactics despite physical distancing, and ensure the mental and physical well-being of fellows. Following the first wave of patients with COVID-19, we anonymously surveyed the Dana-Farber Cancer Institute/Mass General Brigham first-year fellows to explore their perceptions regarding what the program did well and what could have been improved in the COVID-19 response. In this article, we present the feedback from our fellows and the lessons we learned as a program from this feedback. To our knowledge, this represents the first effort in the hematology-oncology literature to directly assess a hematology-oncology program's overall response to COVID-19 through direct feedback from fellows.

scholarly journals Fellowship program directors and trainees across the United States find parental leave policies to be inconsistent, inaccessible, and inadequate

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260057
Author(s):  
Daniel Sabido Jamorabo ◽  
Amrin Khander ◽  
Vasilios Koulouris ◽  
Jeremy Eli Feith ◽  
William Matthew Briggs ◽  
...  
Keyword(s):  
United States ◽  
Parental Leave ◽  
Well Being ◽  
Program Directors ◽  
The United States ◽  
Time Constraints ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Fellowship Program ◽  
Fellowship Programs

Introduction Determine the consistency, accessibility, and adequacy of parental leave policies for adult and pediatric medicine fellowship programs. Methods We administered a 40-question survey to fellowship program directors (PDs) and trainees in adult and pediatric cardiology, hematology/oncology, gastroenterology, and pulmonology/critical care fellowship programs in the United States. We used Chi-square tests to compare proportions for categorical variables and t-tests to compare means for continuous variables. Results A total of 190 PDs from 500 programs (38.0%) and 236 trainees from 142 programs (28.4%) responded. Most respondents did not believe that parental leave policies were accessible publicly (322/426; 75.6%), on password-protected intranet (343/426; 80.5%), or upon request (240/426; 56.3%). The PDs and trainees broadly felt that parental leave for fellows should be 5–10 weeks (156/426; 36.6%) or 11–15 weeks (165/426; 38.7%). A majority of PDs felt that there was no increased burden upon other fellows (122/190; 64.2%) or change in overall well-being (110/190; 57.9%). When asked about the biggest barrier to parental leave support, most PDs noted time constrains of fellowship (101/190; 53.1%) and the limited number of fellows (43/190; 22.6%). Trainees similarly selected the time constraints of training (88/236; 37.3%), but nearly one-fifth chose the culture in medicine (44/236; 18.6%). There were no statistically significant differences in answers based on the respondents’ sex, specialty, or subspecialty. Discussion Parental leave policies are broadly in place, but did not feel these were readily accessible, standardized, or of optimum length. PDs and trainees noted several barriers that undermine support for better parental leave policies, including time constraints of fellowship, the limited number of fellows for coverage, and workplace culture. Standardization of parental leave policies is advisable to allow trainees to pursue fellowship training and care for their newborns without undermining their educational experiences.

scholarly journals Impact of COVID-19 on an Academic Pain Fellowship Program

2020 ◽  
Vol 4S;23 (8;4S) ◽  
pp. S433-S437
Author(s):  
Anand Prem
Keyword(s):  
United States ◽  
Medical Education ◽  
Training Programs ◽  
Free Fall ◽  
The United States ◽  
Fellowship Training ◽  
Academic Programs ◽  
Pain Clinic ◽  
Fellowship Program ◽  
Clinic Medical

Background: While the COVID-19 pandemic still rages on in the United States, leaving in its wake hundreds of thousands of infected patients, families shattered by the untimely death of their loved ones, an economy in free fall that hit all-time highs barely a few months ago, and a fearful citizenry unsure of what the future holds, the effect it has had on residency and fellowship training programs across the country may appear inconsequential to the general populace. However, if you are a graduating trainee confronted with this unusual set of circumstances, fear of the virus is not the only thing that is foremost in your mind. Methods: Literature review. Results: We discuss the unique challenges our pain fellowship program continues to deal with during this pandemic and particularly its impact on our fellows. It is entirely likely these concerns are mirrored in academic programs all over the United States. Limitations: A narrative review with paucity of literature. Key words: COVID-19, pain fellowship, interventional pain, graduating trainees, pain clinic, medical education during a pandemic

scholarly journals Graduate Medical Education on the Frontlines during the COVID-19 Pandemic in New York City- A Response to Promote Well-being

2021 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Health Program ◽  
Mental Health Program ◽  
Well Being ◽  
The United States ◽  
Personal Factors ◽  
Graduate Medical

Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.

scholarly journals A cross-sectional study of factors determining empathy levels among undergraduate medical students of a medical college in Northern Telangana

2021 ◽  
Vol 8 (3) ◽  
pp. 49-55
Author(s):  
Shiv Kumar R ◽  
Puli SK ◽  
P. Kishan ◽  
Sanjay ND ◽  
Pusukuri Sphurthi ◽  
...  
Keyword(s):  
Medical Education ◽  
Well Being ◽  
Cross Sectional Study ◽  
First Year ◽  
Sectional Study ◽  
Global Functioning ◽  
Cross Sectional ◽  
Clinical Rotations ◽  
Medical College ◽  
Second Year

Background: The development of an ideal doctor-patient relationship requires empathy. Empathetic conversation aids in the formation of an open and trusting equation between doctor and patient. Furthermore, this leads to accurate diagnoses and more compliance to the advised treatment. In this manner, empathy helps in overall recovery of the patient and improves global functioning and generalised well-being. This study aims to make note of the fluctuation in empathy levels during medical education. Studies done in various countries have found factors such as curriculum, clinical rotations timing and gender to progressively influences empathy levels in students throughout their medical training. The recent trend of violence against healthcare professionals in India calls for an urgent action into the gap between doctors and patients communication. Empathy towards patients and attendants will reduce such untoward events. In this current context, we should improve empathy levels among the training doctors. As a first step, we should assess various factors affecting empathy among health care professionals. Method: This cross sectional study was done among undergraduates of a rural medical college in Northern Telangana during the time period of October to December 2019. Their empathy levels were assessed using Jefferson’s Scale for Empathy- Student version (JSE-S). Result: Of the 470 students surveyed, 227 were males and 243 females. Female students were having higher empathy among first year and second years (p<0.001). Empathy levels seem to decline from first year to second year following which the mean empathy remains similar throughout the remaining years in students of both sexes. There is no significant relation between mean empathy scores and choice of future speciality (p>0.05). Conclusion: Female undergraduate students are found to be more empathetic than their male counterparts. A fall in empathy scores from the first to second year of MBBS is seen, which is when students enter their clinical rotations. Targeted intervention at this time may go a long way in the creation of a new generation of more empathetic physicians. Hence, there is a need for evaluation of teaching and learning techniques in medical education. Further, there is a call for more research into the determinants of decline in empathy amongst medical professionals.

scholarly journals Elite Youth Sports—The Year That Was 2017

2018 ◽  
Vol 30 (1) ◽  
pp. 25-27
Author(s):  
Craig A. Williams
Keyword(s):  
Youth Development ◽  
Training Programs ◽  
Youth Sports ◽  
Well Being ◽  
The United States ◽  
Participation Rates ◽  
Young Athletes ◽  
Youth Athletes ◽  
Financial Costs ◽  
Health And Well Being

In 2017, considerable attention has been paid by researchers on early sports specialization for youth athletes. Issues related to injury, burnout, and talent development to name a few have been debated, particularly when contrasted against other opposing youth development approaches, such as a multisport approach. The increasing professionalization of young athletes, a particular concern of this author, is coupled with the ensuing physical and mental pressures on these youngsters, as highlighted by the 2 highlighted publications in this commentary. Moreover, the financial costs to parents to support talented youngsters lead me to conclude that we must not treat them as “mini-adult athletes.” Trying to predict too far into the sporting future of a 9- or 10-year athlete can lead us to forgetting that they are just a 9 year, who typically wants to play, have fun, and be with their friends. Embarking on concentrated training programs, endless travel for tournaments, and an overemphasis on winning can be detrimental to participation rates as shown by recent data in the United States. Therefore, the challenge for researchers in elite youth sports is to ensure that practices we pursue with our young charges promote their health and well-being and that sports is for the benefit of the athlete and not the other way around.

scholarly journals 2534. Development of an Infectious Diseases Fellowship Well-Being Program

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S881-S881
Author(s):  
Jehan Budak ◽  
Cristina Brickman ◽  
Emily Abdoler ◽  
Erika Wallender ◽  
Jennifer S Mulliken ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Well Being ◽  
Fellowship Training ◽  
Teaching Hospitals ◽  
First Year ◽  
Fellowship Program ◽  
Protected Time ◽  
Faculty Committee ◽  
External Program ◽  
The Impact

Abstract Background Burnout in graduate medical education is common and reported in ~70% of Internal Medicine (IM) residents. Most studies have described interventions focused on residency training, but fellowship training suffers from similar challenges and likely similar levels of burnout. After conducting a needs assessment amongst fellows within our Infectious Diseases (ID) fellowship program, we developed a wellness program to address these issues. Methods In Spring 2018, we reviewed the existing literature and consulted with local experts on trainee well-being. Based on our findings, we designed a multi-tiered approach to enhance wellness amongst fellows. An ID Fellowship Well-Being Committee (WBC) was created in September 2018 to lead the intervention. The WBC includes an even mix of fellows and faculty at multiple levels at all three main teaching hospitals associated with the program. Meetings occur every other month, and co-chairs (one faculty and one fellow) report back to the program director quarterly. Topic areas and interventions are described in Table 1. Fellows were sent a qualitative survey to evaluate the impact of the well-being interventions to date. Results Four of 5 first year fellows responded to the survey, and all felt the retreat should be repeated yearly. Themes identified from the survey included benefits of having protected time together, convening in a low pressure and informal setting to provide feedback, and spending quality time in a non-clinical setting with co-fellows. Fellows cited the wellness retreat as a strength at our annual fellowship external program review. Conclusion Burnout is likely high among IM sub-specialty fellows, and interventions are needed to support the well-being of those trainees. We describe a roadmap for the development of a well-being program at a relatively large, academic ID fellowship program led by a mixed fellow and faculty committee. We will continue to monitor data on fellow burnout and make programmatic changes based on feedback. We are hopeful that our work will empower other programs to engage in developing their own well-being programs. Disclosures All authors: No reported disclosures.

Academic impact and rankings of neuroendovascular fellowship programs across the United States

2017 ◽  
Vol 127 (5) ◽  
pp. 1181-1189 ◽  
Author(s):  
Ashish Sonig ◽  
Hussain Shallwani ◽  
Bennett R. Levy ◽  
Hakeem J. Shakir ◽  
Adnan H. Siddiqui
Keyword(s):  
The United States ◽  
Fellowship Program ◽  
Academic Impact ◽  
High Productivity ◽  
Thomson Reuters ◽  
Significant Difference ◽  
Fellowship Programs ◽  
Positive Correlations ◽  
Comprehensive Stroke Center ◽  
Stroke Center

OBJECTIVEPublication has become a major criterion of success in the competitive academic environment of neurosurgery. This is the first study that has used departmental h index–and e index–based matrices to assess the academic output of neuroendovascular, neurointerventional, and interventional radiology fellowship programs across the continental US.METHODSFellowship program listings were identified from academic and organization websites. Details for 37 programs were available. Bibliometric data for these programs were gathered from the Thomson Reuters Web of Science database. Citations for each publication from the fellowship's parent department were screened, and the h and e indices were calculated from non–open-surgical, central nervous system vascular publications. Variables including “high-productivity” centers, fellowship–comprehensive stroke center affiliation, fellowship accreditation status, neuroendovascular h index, e index (h index supplement), h10 index (publications during the last 10 years), and departmental faculty-based h indices were created and analyzed.RESULTSA positive correlation was seen between the neuroendovascular fellowship h index and corresponding h10 index (R = 0.885; p < 0.0001). The mean, median, and highest faculty-based h indices exhibited positive correlations with the neuroendovascular fellowship h index (R = 0.662, p < 0.0001; R = 0.617, p < 0.0001; and R = 0.649, p < 0.0001, respectively). There was no significant difference (p = 0.824) in the median values for the fellowship h index based on comprehensive stroke center affiliation (30 of 37 programs had such affiliations) or accreditation (18 of 37 programs had accreditation) (p = 0.223). Based on the quartile analysis of the fellowship h index, 10 of 37 departments had an neuroendovascular h index of ≥ 54 (“high-productivity” centers); these centers had significantly more faculty (p = 0.013) and a significantly higher mean faculty h index (p = 0.0001).CONCLUSIONSThe departmental h index and analysis of its publication topics can be used to calculate the h index of an associated subspecialty. The analysis was focused on the neuroendovascular specialty, and this methodology can be extended to other neurosurgical subspecialties. Individual faculty research interest is directly reflected in the research productivity of a department. High-productivity centers had significantly more faculty with significantly higher individual h indices. The current systems for neuroendovascular fellowship program accreditation do not have a meaningful impact on academic productivity.

scholarly journals 2541. Impact of a Combined Infectious Disease-Critical Care Medicine (ID-CCM) Track on Fellowship Recruitment

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S883-S883
Author(s):  
Nitin Bhanot ◽  
Zaw Min ◽  
Matthew Moffa ◽  
Thomas L Walsh ◽  
James D Como
Keyword(s):  
Infectious Disease ◽  
Medical Education ◽  
Critical Care ◽  
Critical Care Medicine ◽  
Collaborative Effort ◽  
Fellowship Program ◽  
Fully Integrated ◽  
Increasing Trend ◽  
Fellowship Programs ◽  
Allegheny General Hospital

Abstract Background There has been a declining national trend in recent years of resident applications to Infectious Disease (ID) fellowship programs. This dearth of interested and available applicants has resulted in many programs failing to fill some or all of their fellowship slots. Our ID fellowship program, founded in 2013 at Allegheny General Hospital, had met with similar difficulty. Methods To increase the recruitment pool of candidates and combat the challenge to fill our positions, we incorporated a combined 3 year ID-Critical Care Medicine (CCM) track in 2016, initially with one of our two annual fellowship slots allotted to this track. This entailed a collaborative effort between the ID and CCM divisions, an internal application completion outlining the need and rationale for this combined program, and finally, approval from the institutional as well as the Accreditation Council for Graduate Medical Education (ACGME). Results The number of applicants interviewed from 2013 to 2016 for ID (pre-inception of the ID-CCM track), as well as those for ID, ID-CCM, or those interviewing for both tracks following 2016, were counted. We noted a consistent increasing trend in the numbers interviewed for both the ID (4, 8, and 12 total applicants) and ID-CCM (4, 10, and 12 total applicants) tracks over the three since the inception of our combined fellowship program; 3 additional applicants in years 2017 and 2018, and 5 in 2019, expressed interest in either ID or ID-CCM (Graph 1). This favorably amounted to filling our training positions. Conclusion Implementation of a combined ID-CCM fellowship program proved to be a viable strategy to increase the number of applicants at our institution. Given the success of having one dually-accredited slot, we have expanded the combined-track to both positions. As the first fully-integrated ID-CCM fellowship program in the country, we may be pioneering this novel training pathway for future physicians. Disclosures All authors: No reported disclosures.

Palliative radiotherapy education in hospice and palliative medicine fellowship: A national needs assessment.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 87-87
Author(s):  
Emily Jean Martin ◽  
Joshua Adam Jones
Keyword(s):  
Medical Education ◽  
Radiation Oncology ◽  
Palliative Medicine ◽  
Palliative Radiotherapy ◽  
Program Directors ◽  
Fellowship Program ◽  
Electronic Survey ◽  
Fellowship Programs ◽  
Curricular Interventions ◽  
Fractionation Schedules

87 Background: Educational deficiencies among hospice and palliative medicine (HPM) physicians are thought to contribute to sub-optimal utilization of palliative radiotherapy (PRT) for patients with advanced cancer. We conducted a national survey of HPM fellowship program directors and fellows to assess the need for increased PRT education in HPM fellowship. Methods: A 17-item, anonymous, electronic survey was distributed via email in May 2018 to the directors of all US Accreditation Council for Graduate Medical Education-accredited HPM fellowship programs with at least one enrolled fellow. A similar 19-item survey was emailed to the coordinators of these programs for distribution to enrolled fellows. Three reminder emails were sent over a one-month period. Results: Eighty-one (68%) of 120 eligible program directors and 114 (34%) of 338 eligible fellows completed the surveys. Nearly all respondents (98% of program directors and 99% of fellows) agreed that HPM physicians should be familiar with the principles of PRT and 95% of both groups agreed that this topic should be taught in HPM fellowship. Thirty percent of programs, however, lacked any PRT curriculum and 57% of programs provided only 1 or 2 hours of didactic PRT education. The minority of fellows felt confident in their ability to identify radiation oncology emergencies (43%) or to manage symptoms associated with radiotherapy toxicities (42%) and only 56% felt confident in their ability to assess which patients should be referred to radiation oncology for possible PRT. Notably, the majority of fellows reported that if they were more knowledgeable about PRT they would be more likely to consider referral to radiation oncology (78%), to collaborate with the radiation oncologists involved in their patients’ care (76%), and to advocate for shorter fractionation schedules or possible omission of radiation therapy altogether based on a patient’s prognosis or goals of care (78%). Conclusions: HPM fellowship program directors and fellows agree that that there is a need for increased education in PRT in HPM fellowship. Curricular interventions that address this need may result in more appropriate utilization of PRT.

scholarly journals Impact of the COVID-19 Pandemic on Nephrology Fellow Training and Well-Being in the United States: A National Survey

2021 ◽  
pp. ASN.2020111636
Author(s):  
Kurtis A. Pivert ◽  
Suzanne M. Boyle ◽  
Susan M. Halbach ◽  
Lili Chan ◽  
Hitesh H. Shah ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Training Programs ◽  
Well Being ◽  
The United States ◽  
Work Life ◽  
Work Life Balance ◽  
Life Balance ◽  
Preparedness For Practice

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic’s effects on nephrology fellows’ educational experiences, preparedness for practice, and emotional wellbeing are unknown.MethodsWe recruited current adult and pediatric fellows and 2020 graduates of nephrology training programs in the United States to participate in a survey measuring COVID-19’s effects on their training experiences and wellbeing.ResultsOf 1005 nephrology fellows-in-training and recent graduates, 425 participated (response rate 42%). Telehealth was widely adopted (90% for some or all outpatient nephrology consults), as was remote learning (76% of conferences were exclusively online). Most respondents (64%) did not have in-person consults on COVID-19 inpatients; these patients were managed by telehealth visits (27%), by in-person visits with the attending faculty without fellows (29%), or by another approach (9%). A majority of fellows (84%) and graduates (82%) said their training programs successfully sustained their education during the pandemic, and most fellows (86%) and graduates (90%) perceived themselves as prepared for unsupervised practice. Although 42% indicated the pandemic had negatively affected their overall quality of life and 33% reported a poorer work-life balance, only 15% of 412 respondents who completed the Resident Well-Being Index met its distress threshold. Risk for distress was increased among respondents who perceived the pandemic had impaired their knowledge base (odds ratio [OR], 3.04; 95% confidence interval [CI], 2.00 to 4.77) or negatively affected their quality of life (OR, 3.47; 95% CI, 2.29 to 5.46) or work-life balance (OR, 3.16; 95% CI, 2.18 to 4.71).ConclusionsDespite major shifts in education modalities and patient care protocols precipitated by the COVID-19 pandemic, participants perceived their education and preparation for practice to be minimally affected.

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