In Response to COVID-19: Current Trends in Orthopaedic Surgery Sports Medicine Fellowships

Abstract

Background: The COVID-19 (SARS-COV-2) pandemic has brought unprecedented challenges to the health care system and education models. The reduction in case volume, transition to remote learning, lack of sports coverage opportunities, and decreased clinical interactions have had an immediate effect on orthopaedic sports medicine fellowship programs. Purpose/Hypothesis: Our purpose was to gauge the response to the pandemic from a sports medicine fellowship education perspective. We hypothesized that (1) the COVID-19 pandemic has caused a significant change in training programs, (2) in-person surgical skills training and didactic learning would be substituted with virtual learning, and (3) hands-on surgical training and case numbers would decrease and the percentage of fellows graduating with skill levels commensurate with graduation would decrease. Study Design: Cross-sectional study. Methods: In May 2020, a survey was sent to the fellowship directors of all 90 orthopaedic sports medicine fellowships accredited by the Accreditation Council for Graduate Medical Education; it included questions on program characteristics, educational lectures, and surgical skills. A total of 37 completed surveys (41%) were returned, all of which were deidentified. Responses were compiled and saved on a closed, protected institutional server. Results: In a majority of responding programs (89%), fellows continued to participate in the operating room. Fellows continued with in-person clinical visits in 65% of programs, while 51% had their fellows participate in telehealth visits. Fellows were “redeployed” to help triage and assist with off-service needs in 21% of programs compared with 65% of resident programs having residents rotate off service. Regarding virtual education, 78% of programs have used or are planning to use platforms offered by medical societies, and 49% have used or are planning to use third-party independent education platforms. Of the 37 programs, 30 reported no in-person lectures or meetings, and there was a sharp decline in the number of programs participating in cadaver laboratories (n = 10; 27%) and industry courses (n = 6; 16%). Conclusion: Virtual didactic and surgical education and training as well as telehealth will play a larger role in the coming year than in the past. There are effects to fellows’ exposure to sports coverage and employment opportunities. The biggest challenge will be how to maintain the element of human interaction and connect with patients and trainees at a time when social distancing is needed to curb the spread of COVID-19.