key: cord-0938582-zcuox8kt
authors: White, Christopher J.
title: RESPONSE: COVID-19 and Challenges to Cardiovascular Graduate Medical Education
date: 2020-09-08
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.07.042
sha: 168527e08cf88c12f7d5410bf0ab86ff6871d90c
doc_id: 938582
cord_uid: zcuox8kt

nan

We find ourselves today in a world that no one could have imagined. We definitely are "not in Kansas anymore." This virus heterogeneously surges and abates across the country, and without a coordinated national response, it will continue indefinitely until a vaccine is available.

We have little experience to draw upon in responding to the unique challenges posed by COVID-19. Hurricane Katrina also caused a major disruption in medical education, but was a focal event confined to a specific region. Katrina's negative impact was mitigated by the ability of unaffected institutions to relocate trainees from decimated training programs. In contrast, because there are no unaffected regions during this pandemic, we must "shelter in place" and adapt to the exigencies of this new situation.

To the authors' first point, gaining training and experience in the "allocation of health care resources" is a particularly critical skill in making U.S. health care affordable as we prioritize value over volume. Moving forward, beyond the burden of this pandemic, trainees will practice medicine in an environment of shrinking health care dollars.

Reducing waste (unnecessary, inefficient, or inappropriate care) and prioritizing resource utilization (the right patient, the right procedure, the right time) will be rewarded. To the extent it accelerates this educational change, the pandemic may be a catalyst for positive change.

Second, this will not be the last worldwide infec- COVID-19 forces us to respond to unforeseen challenges and requires that we adapt to a "new normal." The negative impact of COVID-19 on traditional health care education is being discussed, analyzed, and hopefully mitigated by our resilience (1) . As Nietzsche wrote, "what doesn't kill you, makes you stronger" (2). I don't think COVID-19 is going to kill cardiovascular education as we know it, but it will require that we adapt to drastic changes in our environment. Virtual learning and virtual meetings are here to stay. Certainly not to replace in-person learning, but to enhance it and make learning more widely available at a lower cost.

Fellowship in the time of coronavirus disease 2019 (COVID-19): a time to adapt

Fellows-in-Training & Early Career Section