Teresa Chapman, MD, Program Director, Diagnostic Radiology Residency, University of Washington
A recent statement by Tom Nasca, MD, president and chief executive officer of the ACGME, acknowledged the many changes we are experiencing across the country and specifically addressed the use of telemedicine and the impact of COVID-19 on clinical volume [1]. His communication emphasizes that as needs and policies evolve, the program director, with consideration of the program’s Clinical Competency Committee, will assess the competence of each individual trainee before graduation. Program directors must remain committed to providing excellent training to residents and fellows despite our current challenges.
In response to the need for social distancing, the first adaptation in our educational environment was to eliminate side-by-side supervision and to reduce congestion in reading rooms by establishing remote office spaces and home workstations. Faculty and trainees have quickly become facile using screen-sharing software for teaching. This rapid and widespread change in behavior has both immediate and long-lasting benefits. The ability to share a teaching session allows medical students and visiting learners to participate remotely. Furthermore, setting up a text page system for announcing upcoming interesting case conferences can bring residents together, thereby benefitting education and overall well-being.
Postponing nonurgent and elective procedures has led to a profound decrease in clinical work for some subspecialties leading to a reduced daily workforce, including trainees. While at home, residents are available to assist at any moment and can also participate in readout sessions, lectures, and multidisciplinary sessions remotely. Multiple radiology societies, including the ACR, Association of University Radiologists (AUR), Association of Program Directors in Radiology (APDR), and RSNA, quickly organized and disseminated free learning material for residents with the aim of providing a core resident curriculum. In addition, senior residents with an interest in radiology education can help develop curricular materials in their area of interest when they are on a remote study rotation.
The impact of decreased clinical volumes as it relates to meeting graduation and program requirements is of concern to both trainees and program directors. ACGME has posted communications from several specialties, including radiology [2]. Accrediting and certifying bodies, including the ABR, ACGME, FDA, and Nuclear Regulatory Commission (NRC), recognize the impact of this pandemic on trainees’ education, and specific allowances may be granted for those residents impacted by COVID-19. For example, creative solutions such as interpretation of blinded, historical patient cases may become necessary for some senior residents. As always and especially at this time, program directors should pay close attention to senior residents’ clinical experiences and ensure their readiness to practice independently.