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

Abstract

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.

Impact of COVID-19 on Hematology-Oncology Fellowship Programs: A Quantitative and Qualitative Survey Assessment of Fellowship Program Directors

“…18,19 Both oncology and nononcology GME programs have reported adopting the use of virtual platforms for trainees' clinical and educational activities. 4,5,20-22 However, our findings highlight HO PD concerns regarding how to modify the evaluation and supervision of trainees to the virtual environment. PDs identified the lack of standardized practices and established guidance on virtual evaluation and supervision and suggested national societies could provide guidance on best practices for telehealth use and create environments for sharing experiences among PDs.…”

“…3 Out of necessity, many HO fellowships and divisions implemented changes to their clinical, educational, and research environments. [4][5][6][7][8] However, the impact of COVID-19 on HO fellowship programs and PDs across the nation has not yet been rigorously characterized.…”

“…Clinical training in HO drastically changed as outpatient specialty visits transitioned to telehealth, inpatient consult volumes fluctuated, inpatient specialty units converted to COVID-19 units, and trainees were redeployed to new (often non-HO) roles in response to local COVID-19 surges. 4,6,9 Limited reports describe program and fellow experience with the transition of education sessions to virtual platforms. 10 Regarding changes to research infrastructure, the published media and literature broadly document the negative impact of COVID-19 on cancer research with the closure of laboratories, restrictions in research operations, changes to clinical trial infrastructure, and a decrease in the number of newly opened clinical trials.…”

Impact of COVID-19 on Hematology-Oncology Trainees: A Quantitative and Qualitative Assessment

“…Some studies have found positive responses to virtual learning among trainees, including a survey of first-year HO fellows at Dana Farber Cancer Institute, which found higher attendance rates and more interactive sessions with virtual conferences compared with in-person lectures. 27 Similarly, the majority of HO fellows at MD Anderson felt that an online-based lecture program was as effective as in-person learning and considerably more flexible. 28 However, not all training programs were able to transition seamlessly to virtual learning.…”

“… 12 Institutions have reported on efforts to improve the experience of HO fellows during the pandemic. 27 Because of the surge in Boston, Dana Farber fellows were pulled from various outpatient rotations to cover COVID-19–related services. However, fellows were rotated 4 days on and at least 4 days off to distribute the work more evenly, and COVID-19–related updates were given to fellows on a weekly basis, which was well received among first-year fellows.…”