COVID crisis and decrease in the quality of cardiology training

[alternatego]

Have you guys experienced a huge decrease in volume in general cardiology consults and/or schedule changes that you feel may negatively impact your cardiology training?

I'm training in an region with lots of COVID-19 cases and 1/3rd of the fellow pool is expected to be assigned to work for the COVID units, and the the volume of consults and STEMIs have decreased in general. I'm perfectly OK with being sent to take care of COVID patients (given they provide us with adequate PPE, of course) but I can't help but wonder if this is going to make me a worse clinical cardiologist (I'm on the first year of my training, though).

Has anyone had a similar experience?

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[aafisahar]

85% of general cardiology consults can be answered by a PGY 2 with a brain.

 

[Instatewaiter]

Your volume of echos, caths, card cts, cmr, nucs, and consults are all going to decrease. Luckily you are a pgy4 and have many years to make that up. Feel bad for the folks who are in a 1 year superfellowship.

None of us signed up for this but we have to make the best of a bad situation.

 

[NYknicks44]

I am a current interventional fellow. We stopped doing elective cases about two weeks ago, and acute MI volume has had a notable decrease. No one knows when things will go back to “normal.” Likely not for month or two.

Thankfully, I have minimum numbers required to graduate but I will graduate with less experience than people in prior years.

On a bigger perspective, it is terrible to see the devastation that is going on.

 

[gutonc]

I am a current interventional fellow. We stopped doing elective cases about two weeks ago, and acute MI volume has had a notable decrease. No one knows when things will go back to “normal.” Likely not for month or two.

Thankfully, I have minimum numbers required to graduate but I will graduate with less experience than people in prior years.

On a bigger perspective, it is terrible to see the devastation that is going on.

WARNING: Totally OT Post

Similar sentiment has been expressed in the EM forum. I'm wondering WTF is going on here? Are people just not going to ED with chest pain these days and dying at home?

[/digression]

 

[NYknicks44]

WARNING: Totally OT Post

Similar sentiment has been expressed in the EM forum. I'm wondering WTF is going on here? Are people just not going to ED with chest pain these days and dying at home?

[/digression]

Yes, that seems to be the favored hypothesis: that people with chest pain are just staying home and not coming to the hospital.

It will interesting if there will be an increase in mortality and heart failure admissions down the line. Though it might be very hard to tease it out from everything else that is going on.

 

[aafisahar]

I am a current interventional fellow. We stopped doing elective cases about two weeks ago, and acute MI volume has had a notable decrease. No one knows when things will go back to “normal.”

Not sure about practice patterns, but at our institutions, even NSTEMIs we are managing medically unless they are high risk. Just discharged a guy with a trop of 4 but resolved chest pain, no chest pain on ambulation, normal EF on TTE. Nobody wants to do procedures right now to protect themselves from exposure. We had an interventional attending + cirulators get sidelined for 2+ weeks after exposure to a COVID patient without PPE. Patient had a diagnostic cath done, developed fevers in pre/post, work-up revealed COVID. I think that spooked a lot of people.

 

[xoggyux]

Probably many factors. I surely think that many of my "frequent fliers" that have made a lifestyle out of coming to the hospital and being admitted for non-sensical stuff are probably staying put at home/nursing home, because after all, they wouldn't enjoy getting actually sick (or their family won't enable them or the nursing home for that matter).
Probably there is also a handful of those that are really sick, should really come to the hospital but blow it off. I suspect I'd see many people that will wait until the very last moment (and perhaps earn themselves an ICU admission or intubation) for waiting.
Then there are the ESRD that might skip HD for one reason or another.
The silver lining is that it seems the worse will come at the end of the "academic year" for those residents/interns/fellow, meaning that at least they got 80% of the year already. The bad part would be if it extends significantly into next academic year.
I can't imagine how chaotic it would be July if the current status quo continues until then.

 

[go lakers]

Yes. Training will suffer a bit for trainees. Reimbursement will suffer a bit for those in practice.

All we can do is make lemonade out of the lemons