Background: The unexpected COVID-19 crisis has disrupted medical education and patient care
in unprecedented ways. Despite the challenges, the health-care system and patients have been
both creative and resilient in finding robust “temporary” solutions to these challenges. It is not
clear if some of these COVID-era transitional steps will be preserved in the future of medical
education and telemedicine.
Objectives: The goal of this commentary is to address the sometimes substantial changes in
medical education, continuing medical education (CME) activities, residency and fellowship
programs, specialty society meetings, and telemedicine, and to consider the value of some of these
profound shifts to “business as usual” in the health-care sector.
Methods: This is a commentary is based on the limited available literature, online information,
and the front-line experiences of the authors.
Results: COVID-19 has clearly changed residency and fellowship programs by limiting the amount
of hands-on time physicians could spend with patients. Accreditation Council for Graduate Medicine
Education has endorsed certain policy changes to promote greater flexibility in programs but still rigorously
upholds specific standards. Technological interventions such as telemedicine visits with patients, virtual
meetings with colleagues, and online interviews have been introduced, and many trainees are “technoomnivores” who are comfortable using a variety of technology platforms and techniques. Webinars
and e-learning are gaining traction now, and their use, practicality, and cost-effectiveness may make
them important in the post-COVID era. CME activities have migrated increasingly to virtual events and
online programs, a trend that may also continue due to its practicality and cost-effectiveness. While
many medical meetings of specialty societies have been postponed or cancelled altogether, technology
allows for virtual meetings that may offer versatility and time-saving opportunities for busy clinicians.
It may be that future medical meetings embrace a hybrid approach of blending digital with face-toface experience. Telemedicine was already in place prior to the COVID-19 crisis but barriers are rapidly
coming down to its widespread use and patients seem to embrace this, even as health-care systems
navigate the complicated issues of cybersecurity and patient privacy. Regulatory guidance may be
needed to develop safe, secure, and patient-friendly telehealth applications. Telemedicine has affected
the prescribing of controlled substances in which online counseling, informed consent, and follow-up
must be done in a virtual setting. For example, pill counts can be done in a video call and patients can
still get questions answered about their pain therapy, although it is likely that after the crisis, prescribing
controlled substances may revert to face-to-face visits.
Limitations: The health-care system finds itself in a very fluid situation at the time this was
written and changes are still occurring and being assessed.
Conclusions: Many of the technological changes imposed so abruptly on the health-care system
by the COVID-19 pandemic may be positive and it may be beneficial that some of these transitions
be preserved or modified as we move forward. Clinicians must be objective in assessing these
changes and retaining those changes that clearly improve health-care education and patient care
as we enter the COVID era.
Key words: Continuing medical education, COVID-19, fellowship program, medical education,
medical meetings, residency program, telehealth, telemedicine
General Practitioners' Willingness to Pay for Continuing Medical Education in A Fee-for-Service Universal Coverage Health Care System
