Rates of completely accessible LNG-EC are low in Colorado despite high rates of availability. Behind-the-counter status and proof-of-age requirements are identified as the main sources of access restriction in Colorado.

Background Fellows have been uniquely affected by the widespread changes in educational structure, mandatory limitations in elective procedural volume, and hiring freezes during the COVID-19 global pandemic. Study Design A voluntary and anonymous survey was distributed to all Graduate Medical Education fellows at a tertiary medical center querying perspectives on clinical and didactic training and job placement. Results A total of 47 of 121 fellows (39%) completed the survey. The majority were in a medical (43%) or surgical specialty (34%) followed by critical care (13%) and procedure-based (11%) fellowships. Approximately 59% of surveyed fellows felt their programs were providing a virtual curriculum that would train them just as well as the in-person curriculum. Twenty-eight (60%) fellows were in their final or only year of training. Of the 25 fellows who were seeking employment, 52% have experienced difficulty in finding a job due to hiring freezes and 40% have encountered challenges with job interview cancellations and changes to virtual interview formats. Conclusion Almost half of surveyed fellows reported an educational deterioration due to COVID-19 and graduating fellows seeking employment felt hindered by both the virtual interview format and widespread hiring freeze. Fellows are both unique and vulnerable as they balance the solidification of clinical training with securing employment during these tumultuous and unprecedented times.

Background The COVID-19 pandemic has impacted surgical training nationwide. Our former curricula will likely not return, and training will need to adapt, so we are able to graduate residents of the same caliber as prior to the pandemic. Methods A survey evaluating perceptions of changes made in surgical training was conducted on surgery residents and attendings. Results Disaster medicine training has become more relevant and 85% residents and 75% attendings agreed it should be incorporated into the curriculum. Safety of family was the most significant concern of residents. Virtual curriculum was perceived to be acceptable by 82% residents and only 22% attendings (p < 0.01). Residents (37%) were less concerned than attendings (61%) of falling behind on their overall training (p = 0.04). Both groups agreed operative skills would be adversely affected (56%vs72%; p = 0.37). Conclusions To maintain an effective surgical curriculum, programs will need to implement new educational components to better prepare residents to become surgeons of the future.

testosterone and Male to Female (MTF) patients on estrogen with or without testosterone blockers (ie. spironolactone). Patients with endocrine disorders that would predispose patients to altered metabolic profiles, including CAH and PCOS, were excluded. Previously recorded measurements of testosterone, estradiol, prolactin, and lipids were reviewed, as well as blood pressure, BMI, electrolytes, liver function tests, hemoglobin/ hematocrit, and hemoglobin A1c. Values reviewed were obtained from prior to the beginning of therapy (baseline), at 1-3 months after the initiation of therapy, at 4-6 months, and at 6 months and beyond. Repeated measures ANOVA models were used to evaluate the change in lab values and other metabolic markers over time.Results: A total of 116 adolescents were included in the study, including 72 FTM patients on testosterone and 44 MTF patients on estrogen. Of the 72 subjects on testosterone therapy, hemoglobin and hematocrit significantly increased at each subsequent visit. There was also a significant increase in BMI and lowering of HDL levels found at each visit. There was an increase in blood pressure, total cholesterol and LDL noted at the 3 month visit; however, these were not statistically significant and were noted to plateau after three months. Changes in AST/ALT, BUN/Cr, Estradiol, Prolactin, Triglycerides and HgbA1c were also not found to be statistically significant. Of note, testosterone doses above 50mg weekly were associated with a greater increase in hematocrit, systolic blood pressure and HDL compared to those receiving only 25mg every week.Of the 44 subjects on estrogen therapy, no statistically significant changes were noted to measured metabolic parameters over time. There was also no statistically significant difference in measured metabolic parameters among the different Methods of administration of estradiol (patch, oral or parenteral). There was also no significant change in potassium levels over time among the 38 subjects on concurrent spironolactone therapy.Conclusions: Testosterone use was associated with increased hematocrit levels; otherwise, cross-gender hormone administration in adolescents was not associated with significant differences in the selected metabolic parameters over time.Acknowledgement: Funding for statistical analysis is from the Medstar

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