Effects of COVID-19 on Residency and Fellowship Training: Results of a National Survey.

Background: The COVID-19 pandemic has affected every facet of American health care, including graduate medical education (GME). Prior studies show that COVID-19 resulted in reduced opportunities for elective surgeries, lower patient volumes, altered clinical rotations, increased reliance on telemedicine, and dependence on virtual didactic conferences. These studies, however, focused on individual specialties. Because the Accreditation Council for Graduate Medical Education (ACGME) routinely collects information from all programs it has an obligation to use these data to inform the profession about important trends affecting GME. Objective: To describe how the pandemic influenced resident training across all specialty programs in areas of clinical experiences, telemedicine, and extended trainings. Methods: The ACGME validated a questionnaire to supplement the Annual Update reporting requirements of all accredited programs. The questionnaire was tested to ensure easy interpretation of instructions, question wording, response options, and to assess respondent burden. The questionnaire was administered through the Accreditation Data System, which is a password-protected online environment for communication between the ACGME and ACGME-accredited programs. Results: We received a response rate of 99.6% (11 290 of 12 420). Emergency medicine, family medicine, internal medicine, and obstetrics and gynecology programs experienced the most significant impact. Most programs reported reduced opportunities for in-person didactics and ambulatory continuity rotations. Hospital-based programs on the "frontline" of COVID-19 care relied least on telemedicine. Family medicine and internal medicine programs accounted for the greatest number of extended trainings. Conclusions: COVID-19 has affected GME training, but its consequences are unevenly distributed across program types and regions of the country.