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

Abstract

PURPOSE: The COVID-19 pandemic led to unprecedented challenges in medical training, and we sought to assess the specific impact of COVID-19 on hematology-oncology (HO) fellowship programs. METHODS: We conducted a cross-sectional anonymous online survey of 103 HO program directors (PDs) in conjunction with the American Society of Hematology (ASH) and ASCO. We sought to assess the specific impact of COVID-19 on HO fellowship programs' clinical, educational, and research activities, evaluate perceptions regarding PD and trainee emotional and mental health, and identify ways to support programs. Data were analyzed using descriptive statistics, parametric and nonparametric tests, and multivariable logistic regression models. Responses to open-ended questions were analyzed with thematic analysis. RESULTS: Significant changes to fellowship activities included transitioning fellow training from outpatient clinics to telehealth (77.7%), shifting to virtual education (94.2%), and moving to remote research work (63.1%). A minority (21.4%) of PDs reported that their fellows were redeployed to cover non-HO services. Most PDs (54.4%) believed COVID-19 had a slight negative impact on fellowship training. PD self-reported burnout increased significantly from 15.5% prepandemic to 44.7% during the pandemic, and most PDs witnessed minor signs of fellow burnout (52.4%). Common PD concerns included inadequate supervision for telehealth activities, reduced opportunities for fellow advancement and promotion, lack of professional development activities, limited research operations and funding, program financial constraints, and virtual recruitment. CONCLUSION: We encourage institutions and national societies to allocate resources and develop programs that can support fellowships and mitigate the potential negative effects of COVID-19 on trainee and PD career development.

Perceptions of the stressful job search for pediatric hematology/oncology fellows

“…Prior to the COVID‐19 pandemic, this percentage might have been higher at this timepoint in the academic year. Several trainees and medical educators have commented on the specific difficulties of the job search due to the pandemic similarly to our respondents, including the virtual interview format and hiring freezes 11–13 . Outside of the pandemic, fellows and program leadership perceive a variety of barriers to the job search.…”

“…[11][12][13] Outside of the pandemic, fellows and program leadership perceive a variety of barriers to the job search. Perceived career development resource needs to help with the job search…”

Mentorship Experiences Are Not All the Same: A Survey Study of Oncology Trainees and Early-Career Faculty

“…For instance, in HO, several studies have shown increased self-reported symptoms of burnout, stress, and worry regarding loss of clinical opportunities, grant funding, and variable productivity related to the COVID-19 pandemic, which may have influenced our findings. 29,30 For the bivariate association analysis, we reported the primary analysis results, where we included missing values as the not reported category. Our sensitivity analyses suggested that several findings from the primary analyses were not stable.…”

“…For instance, in HO, several studies have shown increased self-reported symptoms of burnout, stress, and worry regarding loss of clinical opportunities, grant funding, and variable productivity related to the COVID-19 pandemic, which may have influenced our findings. 29,30…”

Innovations in Cardio-oncology Resulting from the COVID-19 Pandemic

“…The cardio-oncology fellows can actively engage in multi-center research projects, including collaboration with mentors virtually. Nevertheless, it is worth mentioning that the continuation of the COVID-19 pandemic has impacted physical, academic, as well as mental wellbeing of current cardio-oncology trainees [ 56 ]. Education institutions will need to remain vigilant and attentive on the mental and physical wellbeing of trainees to prevent unnecessary burnout [ 57 •].…”