-Author name in bold denotes the presenting author
-Asterisk * with author name denotes a Non-ASH member
Clinically Relevant Abstract denotes an abstract that is clinically relevant.

PhD Trainee denotes that this is a recommended PHD Trainee Session.

Ticketed Session denotes that this is a ticketed session.

1572 The Impact of COVID-19 on Hematology-Oncology Fellowship Programs: Program Director Perspectives

Program: Oral and Poster Abstracts
Session: 901. Health Services Research—Non-Malignant Conditions: Poster I
Hematology Disease Topics & Pathways:
Coronaviruses, SARS-CoV-2/COVID-19
Saturday, December 5, 2020, 7:00 AM-3:30 PM

Ana I. Velazquez Manana, MD, MSc1,2, Urshila Durani, MD, MPH3, Robby Reynolds, MPA4, Ashok Kumbamu, PhD5*, Devika G. Das, MD6*, Martina C. Murphy, MD7, Elizabeth Henry, MD8,9*, Alfred Ian Lee, MD, PhD10 and Ariela L. Marshall, MD11,12

1Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA
2National Clinician Scholars Program, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA
3Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
4American Society of Hematology, Washington, DC
5Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
6Division of Hematology and Oncology, University of Alabama Medical Center, Birmingham, AL
7Division of Hematology and Oncology, University of Florida, Gainesville, FL
8Department of Medical Education, Loyola University Medical Center, Maywood, IL
9Division of Hematology and Oncology, Loyola University Medical Center, Maywood, IL
10Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, New Haven, CT
11Division of Hematology, Mayo Clinic, Rochester, MN
12Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN


The COVID-19 pandemic has significantly affected many aspects of healthcare, including medical education and training. Its impact on hematology/oncology (HO) fellowship programs has not yet been characterized.


The American Society of Hematology (ASH) and American Society of Clinical Oncology (ASCO) sent an anonymous survey in June 2020 to all HO program directors (PDs) addressing program changes during the COVID-19 pandemic and their perception of impact on trainees’ experience, education, and mental health. The survey included 32 multiple-choice and open-ended questions. Participants who completed the survey received a $10 gift card. Quantitative descriptive analyses of multiple-choice questions were conducted. Open-ended responses were analyzed qualitatively using NVivo software.


Of 233 invited PDs, 103 (44%) respondents completed the survey; 22 additional surveys were incomplete and not included in the analysis. Table 1 summarizes PDs and program characteristics. In response to the pandemic, 42% (N=43) of programs removed fellows from outpatient clinics and 63% (N=65) changed research location to home (Figure 1). Most PDs reported their fellows were participating in telehealth for HO care (79%, N=81) and 21% (N=22) had their fellows re-deployed to cover medicine and other non-HO services. To support fellows’ mental health most programs held additional virtual meetings (76%, N=78) and social events (52%, N=54). Twenty one percent of PDs (N=22) reported their program's professional development funds were completely cut or frozen and 17% (N=17) had funds cut slightly. Most PDs reported the pandemic negatively impacted fellowship overall (67% slight to significant negative impact, N=69), 72% identified clinical education as negatively impacted (72% slight to significant negative impact, N=74), and 35% (N=36) reported significant negative impact on research training/productivity.

Twenty three percent (N=24) of PDs thought their fellows were not able to make good use of their time during the pandemic, professionally speaking. One third (33%, N=34) of PDs anticipated the pandemic would lead to lack of fellow clinical preparedness, 24% (N=25) with need to make up clinical rotations, and 15% (N=15) anticipated a negative impact on HO board pass rates. Post-pandemic, most PDs plan to maintain some virtual educational sessions (73%, N=75) and telehealth in fellows' continuity clinic (55%, N=57).

Among PDs, the prevalence of burnout increased from 16% (N=16) pre-pandemic to 45% (N=46) during the pandemic (p<0.0001). Seventeen percent (N=18) of PDs witnessed moderate signs of fellow burnout and 52% (N=54) witnessed minor signs of fellow burnout during the pandemic.

Several educational and research constraints were identified via qualitative analysis: limited in-person clinical rotations, supervision of telehealth encounters, training year promotion and making up clinical time, limited professional development activities, board exam cancellations, and inability to perform research. Additional PD-identified trainee concerns included: ability to obtain childcare, separation from family, and Visa concerns among international fellows.

PDs anticipated that financial constraints leading to cuts or removal of discretionary funds may have negative consequences for fellows’ professional development activities and could force PDs to decrease program size in the future.

PD recommendations for ASH and ASCO included: reducing or eliminating fellow membership fees, providing free access to educational materials and meetings, eliminating in-training examination fees, providing virtual sessions on career development, telehealth and wellness, virtual journal clubs, PD webinars focused on navigating fellowship issues and virtual interviews, and extending ASCO YIA funding for a second year.


PDs reported that their fellowship programs’ clinical, educational, and research experiences have been impacted by the COVID-19 pandemic. PDs are concerned about the impact of budget cuts on fellows’ professional and career development. PD burnout increased during the pandemic and most PDs observed at least mild burnout among their fellows. Professional societies can support fellowship programs by limiting fees and costs associated with membership, exams, and meetings, and increasing virtual opportunities for both fellows and PDs.

Disclosures: Velazquez Manana: Portola Pharmaceuticals: Other: Immediate family member stock ownership; Midatech: Other: Immediate family member stock ownership; Corbus Pharmaceuticals: Other: Immediate family member stock ownership.

*signifies non-member of ASH