COVID19 GME Policies - Eastern Virginia Medical School (EVMS), Norfolk, Hampton Roads

*Updated 4.13.2020

These policies are in place to assist in the management of the graduate medical education programs during the COVID-19 Pandemic in Hampton Roads. These polices will be reviewed and revised as necessary both during the COVID-19 Pandemic in Hampton Roads and afterword. Program Directors should check this site periodically for updates. Note: This information is also available on EVMS COVID-19 Advisories web page, found at https://www.evms.edu/covid-19/.

The American Board of Medical Specialties (ABMS) and the American Board of Surgery (ABOS) have posted notices regarding COVID-19 and requirements for board certification. Program directors are advised to monitor the ABMS and ABOS websites for update. It is imperative that experiences be documented carefully.

Quick Links:

The EVMS Medical Group is providing guidance for healthcare providers treating COVID-19 patients. This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID. Visit www.evms.edu/covidcare for the latest information.

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Residents/Fellows and Patient Care Experiences

Residents and Fellows may provide care under faculty supervision to suspected or confirmed COVID-19 patients. Supervision should be in compliance with Accreditation Council for Graduate Medical Education (ACGME). The ACGME may revise supervision policies as needed to address the rapidly changing clinical scenarios related to COVID-19. The most recent communication may be found at ACGME.org in a Letter to the Community from Dr. Thomas Nasca, President and CEO of ACGME. Program directors should monitor all communications from ACGME for revisions to supervision and other ACGME requirements.

Program directors have the authority to reassign residents/fellows on research and elective rotations to the primary teams to ensure adequate care of suspected or confirmed COVID19 patients.

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Resident/Fellow Exposure to Suspected or Confirmed COVID-19 Patients*

EVMS Human Resources (HR) is the central reporting mechanism for access to Occupational Health for resident/fellow screening for COVID-19. After discussion with the program director, the resident/fellow should contact EVMS HR (757-446-6043) for reporting and referral to Occupational Health for screening. EVMS HR will provide the program director with status updates on the resident/fellow throughout the process and until the resident is deemed cleared to return to work. Regardless of the affiliated institution in which the resident/fellow is training, EVMS HR should be contacted. The facilities Infection Control Officer should also be notified.

If the exposure occurs at CHKD, please also notify:
IPAC – Ms. Barbara Stein, 668-7230 (office), 633-9283 (cell), and
Occ Health – Patricia Higazi, 668-7491 (office), 376-3231 (cell)

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Process for Educational Assignments during Quarantine or Illness

Program directors have the authority to provide alternative educational assignments for residents on quarantine or illness due to COVID-19. If the resident/fellow is assigned home duty due to quarantine or illness, the program director should report such to EVMS HR and complete the EVMS HR forms for home Remote Educational Assignments for Residents/Fellows on Home Quarantine.

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Considerations for Educational Assignments during Quarantine or Illness

Considerations for Educational Assignments during Quarantine or IllnessVarious scenarios may require home quarantine of a portion of our workforce just as we are facing surges in patient volumes. These situations may include residents returning from travel, or those with exposure to suspected or confirmed patients, and those who develop suspicious symptoms before rapid testing is available.

For residents/fellows on quarantine, program directors may provide remote educational assignments if the resident/fellow is well enough to work, to engage in, and/or support clinical care. These remote educational assignments will be specialty specific, but some possible assignments are:

Phone triage
Management of Follow My Health messages and other patient care related tasks (medication refills, communication about test results, etc.)
Tehealth visits (follow department/mdical group procedures)

Supervision of these remote educational assignments should be in compliance with the ACGME supervision requirements. Please review the recent Letter to the Community from Dr. Thomas Nasca, President and CEO of ACGME relating to this topic.

All resident/fellow remote educational assignments must be reported to EVMS Human Resources (757-446-6043) and appropriate documentation completed.

Residents/fellows on quarantine who are too ill for remote educational assignments should also be reported to EVMS Human Resources (757-446-6043).

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Residents/Fellow with Serious Chronic Health Conditions

Residents with serious chronic health conditions should report such to their program directors. Program directors should contact EVMS Human Resources to determine what accommodations may be necessary.

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Personal Protective Equipment

For now, all sites are following CDC guidance for N95 respirators, plus facemask or goggles, and contact (gown, gloves) when treating these patients. Online updates on how to don and doff the N95 respirators will be made available on the EVMS website. Due to a shortage of N95 masks, on-site fit testing will not be conducted. Residents/fellows with beards/mustaches are encouraged to remove the facial hair to help ensure an appropriate mask fitting.

Please not that shortages of PPE may determine how the PPE is distributed. If in question, ask the attending supervisor or the nursing supervisor.

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American Board of Medical Specialties

Statement to Designated Institutional Officials Regarding

Coronavirus Disease 2019 (COVID-19)

The American Board of Medical Specialties (ABMS) and its 24 Member Boards appreciate the extraordinary efforts of our specialty medical professionals and trainees who are working tirelessly to treat and monitor those exposed to or diagnosed with Coronavirus Disease 2019 (COVID-19), and we recognize the associated enhanced health risks and the potential for training disruptions. As with others in our community, our primary concern is for the health and well-being of these individuals and patients and the desire to maintain a strong and effective health care workforce. In most cases, specialty boards’ existing leave policies will cover training disruptions caused by quarantine, and boards are supportive of creative strategies to recognize learning opportunities that can take place during such times. In situations in which quarantine impedes completion of on-time training, boards are receptive to case-by-case discussions and do not wish to penalize trainees for situations beyond their control. We encourage those with questions to contact their respective ABMS Member Board for details and updates regarding COVID-19 related leave policies and the status of board examinations.

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American Board of Surgery

Modifications to Training Requirements

March 26, 2020 MEDIA CONTACT: ALYSON MALONEY , 215-568-4000

The ABS and all of our specialty boards recognize that these are extraordinary times. Our health systems, surgeons, patients, and the public are under a kind of strain we have never experienced. We also know that this inevitably impacts the ability of trainees to meet our traditional requirements. In recognition of this fact, the ABS is making the following global recommendations and changes across specialties:

Non-voluntary offsite time that is used for clinical or educational purposes can be counted as clinical time. The types of activities done in this time should be documented by the program.
The ABS will accept 44 weeks of clinical time (including the non-voluntary time) for the 2019-20 academic year, without the need for pre-approval, permission or explanation. This represents approximately a 10% decrease in time requirements.
For those specialties with case requirements, the ABS will accept a similar 10% decrease in total cases without the need for further documentation.
Program directors are entrusted, as they always are, to make a decision about the readiness of the resident for independent practice. If a resident falls below the 90% mark for cases or the 44 week mark for time in training, and the PD nevertheless endorses them as ready for independent practice, the ABS will seek a more detailed supporting statement. This might include information from the CCC, milestones achievements, entrustment through EPAs, ITE scores, evidence of leadership during this crisis, or other information.
Residents should assess their own progress towards the standard requirements in terms of rotations, cases, and specialty specific requirements. Residents should make a remediation proposal for gaps, and share with their PDs.
The QE applications (and CE application for SCC) are being modified to be all online, and to allow for these variances.

The ABS stands behind our existing training standards. Every effort should be made to meet them, to the extent possible. These modifications are hardship modifications, and are not a permanent change going forward.

Thank you to all of you who work on the front lines. The qualities that make you the surgeons that you are also make you incredibly valuable leaders in these challenging times.

Specialty-specific FAQs will be available in the near future.

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Additional Resources and Links

AMA COVID-19 Physician Resource Center: Evidence-Based perspecitives from the world's top researchers, AMA's phsycian leaders and subject matter experts.
Well-Being: Headspace has expanded access to all US-based healthcare professionals working in a public health setting through the end of the year: https://www.headspace.com/health-covid-19