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Background: The COVID-19 pandemic led to training programs abruptly stopping in-person learning and redesigning curricula. Trainees had decreased patient contact. Trainee well-being became even more vital with social isolation and fears of infecting loved ones increased. Our study evaluated impacts of COVID-19 on Pediatric Emergency Medicine (PEM) fellowship programs, including effects on fellows’ clinical and didactic experiences, and effects on fellows’ well-being.

Methods: In this cross-sectional study, two surveys inquiring about the impact of COVID-19 on PEM fellowship training were developed using an iterative process: one for Program Directors (PDs) and one for fellows. Survey questions, which consisted of multiple choice, five-point Likert scale, and free text responses, included assessment of fellows’ clinical rotations, didactics, administrative changes, and health and well-being. Anonymous, electronic surveys were distributed a total of three times between March and April 2021. Descriptive statistics were employed and responses of PDs and fellow compared.

Results: PDs had a 56.8% (50/88) response rate, fellows 34.6% (144/416). All PDs reported a decrease in pediatric patient volumes during the initial height of the pandemic. Participants commonly reported changes in rotations and block schedules, didactics moving to a virtual platform, increased frequency of speakers from outside the institution, and additional mental health services for providers. PDs and trainees reported being required to provide service to COVID patients outside of a pediatric ED, commonly in the adult ED and medical intensive care unit.

Conclusion: The impact of COVID-19 on PEM fellowship training, particularly for fellows who started training at the start of the pandemic, remains unclear. Initial decreases in pediatric patient volumes, canceled electives, care of adults, and altered didactics/conferences in accordance to CDC guidelines may have adversely affected training. Future research might assess pandemic-related differences on certification exam scores or how prepared fellows, particularly those who trained throughout the pandemic, feel for unsupervised practice.

Journal Title

Annals of Pediatrics





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Pediatric emergency medicine; Fellowship training; Knowledge acquisition; Health and well-being; COVID-19


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