OA03 Impact of the COVID-19 pandemic on rheumatology training: results of the regional survey from the North West of England
Authors: Chua Ezolene P , Tan Yvonne , Mercer Louise K , Wig Surabhi 
Published: April 2022

Abstract

Background/Aims
The COVID-19 pandemic has disrupted healthcare delivery and provision of medical education and training worldwide. We assessed the impact of the COVID-19 pandemic on rheumatology training experience in the Northwest and Merseyside deaneries of England.

Methods
Rheumatology trainees from the Northwest and Merseyside deaneries were issued links to an anonymous web-based survey on their training experience between August 2020 to April 2021, during the 2nd wave of the Covid-19 pandemic.

Results
34 of 42 trainees completed the survey. 31 were in clinical training: 13 (42%) in a pure rheumatology post and 18 (58%) in a dual post with general medicine. Most trainees attended 3-4 clinics per week (58%), with 23% attending ≤2 clinics and 19% attending 5 clinics. The proportion of face-to-face clinics ranged from 20% to 100% (median 60%). The reduced face-to-face clinical experience was not due to trainees’ needs to shield. The range of proportion of phone consultations was 0% to 80% (median 40%). Remote consultations were conducted by telephone only for 26 (84%) trainees and by video or phone for 3 (10%). The durations for both face-to-face and virtual consultations were ranged similarly at 15 to 45 minutes (median 30minutes) for new cases and 15 to 30 minutes (median 20 minutes) for follow-ups. Only 5 (16%) trainees felt confident with assessing new patients by remote consultation. 8 (26%) trainees had some form of formal training in a virtual consultation. However, only 4 (13%) reported being “aware” of how to guide a patient through self-examination of the joints, 17 (55%) trainees were “somewhat aware”, and 10 (32%) were “not aware”. 20 (65%) trainees reported reliance on radiological and serological investigations rather than clinical skills during remote consultations. Development of skills for patient communication, joint injections, time management, and prescribing immune-suppressive medications were mainly hampered. The majority of trainees agreed that virtual educational programs had improved opportunities for attendance at structured deanery teaching sessions.

Conclusion
The impact of the COVID-19 pandemic on rheumatology training has been significant both in terms of current rheumatology education programme delivery and training requirements. Our regional survey shows less than a third of trainees had formal training in conducting remote consultations resulting in low levels of confidence in assessing patients remotely. Less face-to-face patient contact negatively impacted clinical and procedural skills development. Restructuring the rheumatology curricula to include training in rheumatology-specific remote consultations and ensuring clinical and procedural competencies by including novel support modalities like simulation sessions may be options for consideration going forwards. Delivery of some structured teaching sessions through the virtual platform is here to stay.

Disclosure
E.P. Chua: None. Y. Tan: None. L.K. Mercer: None. S. Wig: None.