MEDICAL SCHOOL EVALUATION & GRADUATION
The COVID-19 Graduate Medical Education Pandemic Response: Innovation, Agility and Collaboration By Woodson “Scott” Jones, MD
At the beginning of the COVID-19 pandemic in March 2020, the Office for Graduate Medical Education (OGME) at the Long School of Medicine, University of Texas Health San Antonio (UT Health) began to plan for an anticipated rapid rise in hospitalized patients at University Hospital. At the same time, the state of Texas restricted elective medical procedures. This significantly reduced training opportunities for some residents and fellows in their assigned medical specialties. The OGME implemented a comprehensive plan to employ residents and fellows outside of their training specialty to support critical patient care needs at University Hospital (UH) and the Audie L. Murphy Memorial Veterans Hospital (VA). The OGME, in close coordination with several GME Program Directors (PD), the
Chief Medical Officer at UT Health physicians and key unit medical directors, administrators and nursing leadership at UH and the VA, developed and implemented the Cross-Department Deployment Program (CDDP) to address COVID-19 patient care needs (i.e., palliative care, intensive care, inpatient wards, etc.). Clinical “Bucket Managers” at the VA and UH were also identified for each of these anticipated care-lines needing additional support. Their PDs classified all residents and fellows according to the level of supervision they would need in each clinical setting, should they be deployed. Department Deployment Managers (DDM), often a PD, were identified to oversee each department's cross-deployments. Further educational resources, a just-in-time training intranet site and shadowing opportunities
UT and UH Leadership on “Clinical Learning Environment Walks” recognizing COVID Deployers.
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SAN ANTONIO MEDICINE • June 2021
were developed. The OGME ensured 100% of residents and fellows received personal protective equipment (PPE) training. OGME conducted virtual “town halls” to discuss the deployment preparations and resources available. UT Health, UH and the VA worked cohesively to develop similar PPE protocols, health care provider participation in COVID-19 patient care, testing and return to work protocols. UH, our largest training site, began to experience a rapid rise in COVID-19 hospitalizations in June, with a 400% increase in admissions, leading to the activation of the CDDP. Palliative care team support began on June 19, followed by ward and intensive care team support within a few days. Our second largest participating site, the VA, likewise saw rapidly rising COVID-19 hospitalizations, activating the CDDP to support additional hospitalist teams on June 22. At its peak, the CDDP supported 16 new patient care teams and existing services that required additional physician support. 197 deployed residents and fellows supported UH and the VA during the duration of the CDDP for the first surge. Internal medicine residents provided over 1,500 hours of additional support through their jeopardy coverage. The Surgery Program provided up to seven residents at a time to provide 24/7 COVID ICU support. UH successfully cared for the surge in patients without exceeding hospital capacity. There was no evidence of COVID-19 transmission to the cross-deployed residents or fellows, which is a testament to the thorough training and equipping of our GME residents and fellows.
