By the middle of March, 2020, COVID-19 had upended the traditional training experience in the UNC Internal Medicine Residency Program. Didactic coursework and clinical skills training had to be quickly converted to an online format and clinical rotations were suspended as decisions were quickly made to ensure residents had meaningful and robust curricular activities during the clinical suspensions. It was against this backdrop that a new COVID-19 elective was formalized.
“Residents at any level can now sign up for this new elective and get great exposure to acute respiratory distress syndrome,” said Ashley Henderson, MD, associate professor in the division of pulmonary and critical care medicine.
“The goal is to teach oxygen and ventilator strategies for COVID-19 and give residents experience providing direct patient care so that they can gain a deeper understanding of the pathophysiology and management of ARDS related to COVID-19. In addition, they can have first-hand experience at treating the multi-organ effects of COVID-19.”
The newly-launched elective offers three options for residents. They can choose two weeks in the ICU on the COVID-19 team, two weeks on Med Z (the COVID floor), or one week with the ICU COVID team followed by one week with Med Z. Residents will learn the basic principles of mechanical ventilation while working with staff to write orders and support daily communications.
Depending on the interest level, preference may be given to residents entering careers in infectious diseases, pulmonary and critical care medicine and hospitalist medicine.
While residency training has traditionally provided limited respiratory training, having multiple medical providers able to apply ARDS skills will be increasingly important as the pandemic continues. During this time of social distancing and uncertainty, an important ancillary benefit may also be the opportunity to join UNC’s community effort against COVID.
Jennifer McEntee, MD, associate professor in the division of hospital medicine and associate program director for the UNC Internal Medicine residency program, developed and operationalized the new elective with Henderson.
“Through this elective, we hope to meet the needs of residents who are interested in providing direct patient care to those with COVID-19, and the options we’ve presented will allow the elective to be learner/resident centered,” McEntee said. “In addition to learning about viral pathophysiology, residents will gain an understanding of UNC Health operations and system changes which have been initiated, that are constantly being evaluated to address this public health emergency.”
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