Impact of the COVID-19 Pandemic on Postgraduate Training in Radiation Oncology

PURPOSE/OBJECTIVE(S): To report the degree to which post-graduate trainees in radiation oncology perceive their education has been impacted by COVID-19. MATERIALS/METHODS: A cross-sectional online survey was administered in June 2020 to trainee members of Canadian Association of Radiation Oncology (CARO). The 82-item survey was adapted from a similar survey administered during SARS and included the Stanford Acute Stress Reaction and Ways of Coping Questionnaires. The survey was developed using best practices including expert review and cognitive pre-testing. Frequency statistics are reported. RESULTS: Thirty-four trainees (10 fellows, 24 residents) responded. Nearly half of participants indicated that the overall impact of COVID-19 on training was negative/very negative (n = 15; 46%) or neutral (n = 15; 46%) with a small number indicating a positive/very positive (n = 3; 9%). Majority of trainees agreed/strongly agreed with the following statements: “I had difficulty concentrating on tasks because of concerns about COVID-19” (n = 17; 52%), “I had fears about contracting COVID-19” (n = 17; 52%), “I had fears of family/loved ones contracting COVID-19” (n = 29; 88%), “I felt socially isolated from friends and family because of COVID-19” (n = 23; 70%), “I felt safe from COVID-19 in the hospital during my clinical duties“ (n = 15; 46%), and “I was concerned that my personal safety was at risk if/when I was redeployed from my planned clinical duties” (n = 20; 61%). The changes that had a negative/very negative impact on learning included “the impact of limited patient contact” (n = 19; 58%), “the impact of virtual patient contact” (n = 11; 33%), and “limitations to travel and networking” (n = 31; 91%). Most reported reduced teaching from staff (n = 22; 66%). Two-thirds of trainees (n = 22, 67%) reported severe (> 50%) reduction in ambulatory clinical activities, 16 (49%) reported a moderate (< 50%) reduction in new patient consultations, while virtual follow-ups (n = 25: 76%) and in-patient clinical care activities (n = 12; 36%) increased. Nearly half of respondents reported no impact on contouring (n = 16; 49%), on-treatment management (n = 17; 52%) and tumor boards (n = 14; 42%) with the majority of other respondents reporting a decrease in these activities. Electives were cancelled in province (n = 10/20; 50%), out-of-province (n = 16/20; 80%) and internationally (n = 15/18; 83%). CONCLUSION: Significant changes to radiation oncology training were wrought by the COVID-19 pandemic and roughly half of trainees perceive that these changes had a negative impact on their training. Safety concerns for self and family were significant and strategies to mitigate these concerns should be a priority.