Table 3 Illustrative quotes from survey respondents to the open-ended question: In what other ways has fellowship education changed during the COVID-19 pandemic?

Practical skills

  • “Procedural training has been affected.” (fellow)

  • “Less hands-on workshop time was definitely detrimental for our incoming fellows.” (fellow)

  • “Worrisome for less rotations, less intubations.” (fellow)

  • “Rotations that were not supposed to be ICU turned into ICU rotations. This is one extra ICU month for someone that has at least 9 months of ICU / year. Expectations and evaluations regarding practical skills were the same as prior to the pandemic. However, we had less opportunity to do so due to the pandemic and were harshly evaluated. No procedure workshop or ultrasound bootcamp was done. However, the expectation that fellows needed to be proficient was still there. If the program didn't provide the proper educational resources early in the year it is unreasonable to expect proficiency without teaching.” (fellow)

  • “Less pulmonary rotations including procedures like EBUS.” (fellow)

  • “Increased POCUS learning and ARDS knowledge.” (fellow)

General education

  • “Lack of case variety.” (fellow)

  • “Less time for spontaneous teaching on rounds.” (fellow)

  • “All education is now online.” (fellow)

  • “Decreased informal gatherings to discuss cases and literature.” (attending)

  • “Reduction of direct patient contact is an important issue.” (attending)

  • “Decreased exposure to non-COVID and non-ICU topics of importance. Disruption of didactic curriculum.” (attending)

  • “Outpatient clinics have evolved into more telemedicine which is as many things in life, good and bad.” (attending)

  • “There is less diversity of cases seen by the fellows this however has been associated with increased exposure to ARDS and its complications.” (attending)

  • “Less diversity of cases.” (attending)

  • “Better lectures from outside well renowned lecturers.” (attending)

  • “The education has improved.” (attending)

Mental health

  • “Much less social interaction. It took almost 6 months to meet 1st year fellows which had a significant impact on morale and therefore motivation.” (fellow)

  • “Less interaction with peers has led to a loss of perspective on day-to-day life in the ICU.” (fellow)

  • “Increased burnout/moral distress given PCCM fellows and faculty carry brunt of COVID ICU care.” (fellow)

  • “Less interaction between faculty and fellows.” (fellow)

  • “Impersonal. Less interaction with family.” (fellow)

  • “Less time off, less conference, less exposure to outside networking. Job hunting mostly online. Pandemic was terrible.” (fellow)

  • “Stress level, increased mortality, moral distress particularly around families not able to visit.” (attending)

  • “Less camaraderie, more "in the dark" as to what is happening so feels less like a family.” (attending)

  • “Less interaction.” (attending)

Scholarship

  • “Less elective/research and pulmonary rotations.” (fellow)

  • “Decreased research opportunities.” (fellow)

  • “Less focus on research and teaching residents/med students.” (fellow)

  • “Less opportunity for scholarship at this point.” (attending)

  • “Less time for research.” (attending)