Cardiology Fellows Adapt During COVID-19

What your doctor is reading on Medscape.com:

APRIL 22, 2020 — Cardiology fellows-in-training, launching their careers just as the pandemic transforms cardiovascular units into COVID-19 wards, report on the challenges, unexpected opportunities, and a few lessons on how training programs could be better prepared for the next pandemic, in a series of new publications.

“I think the pandemic has inspired a great deal of innovation and creativity in medical education thus far,” Nosheen Reza, MD, a fellow in the Cardiovascular Division at Penn Medicine, in Philadelphia, told Medscape Medical News.

“Going forward, I think cardiovascular educators will think deeply about how to combine the benefits of the ‘hands-on’ training of a traditional fellowship with the different virtual learning options we have created for continuing medical education in this environment,” said Reza, who coauthored one of three papers on fellows-in-training published online April 14 in the Journal of the American College of Cardiology (JACC).

Learning in COVID-19 Valuable — Providing PPE is Adequate

In their report, Reza and her colleagues note that, whether fellows are reassigned or not due to the pandemic, opportunities for experiential learning are plentiful.

“Fellows-in-training are enthusiastically learning about cardiovascular manifestations of COVID-19, including myocardial injury, myopericarditis, heart failure, arrhythmias, and thrombophilias in real-time and through international reports,” they write.

Those reassigned to noncardiology services “will be challenged with infection control, airway management, appraisal and use of experimental therapies,” they add.

Fellows-in-training should further be encouraged to take part in clinical, research, and quality improvement protocols involving COVID-19.

“These experiences are valuable, so long as settings ensure proper personal protective equipment and supervision,” the authors note.

Penn Medicine is among those that have declared Pandemic Emergency Status, and while that has meant that most fellows are participating in virtual programs, the training is still rigorous, Reza said.

“We have maintained only core/essential fellows at our three primary teaching hospital sites, and the majority of fellows are participating in ‘at home’ rotations,” she said.

“These rotations include the remote reading of electrocardiograms and echocardiograms, triaging and screening clinical studies for appropriateness, and independent study/board review.”