Research Letter
org
Impact of the COVID-19 pandemic on fellowship
research
OBJECTIVE: The start of 2020 brought on a new pandemic
in the form of COVID-19 (SARS-CoV-2) during which our
nation witnessed a large disruption in the balance of
scheduled activities within surgical fellowship training
programs.1,2 Unprecedented challenges and disturbances in
physician training as a consequence of the pandemic have
been documented across the world by multiple studies in
various specialties.3,4 Obstetrics-gynecology program
requirements and certification standards include a minimum
of 12 months of protected research within the 4
subspecialties.5 None of the published studies about
fellowship training disruptions have specifically investigated
the impact of the COVID-19 pandemic on subspecialty
research experience and completion of a thesis. The purpose
of this study was to gather fellows’ insights on the disruption
to research during fellowship training caused by the COVID-
19 pandemic for purposes of fairness in the American Board
of Obstetrics and Gynecology (ABOG) certification processes,
specifically in relation to the assessment of the thesis.
STUDY DESIGN: Voluntary online surveys were adminis-
tered to all fellows upon completion of the 2022 ABOG
FIGURE
Extent of perceived pandemic disruption on OB/GYN fellowship training programs
Shivraj. Research disruption during COVID-19. Am J Obstet Gynecol 2024.
e12 American Journal of Obstetrics & Gynecology JULY 2024
ajog.
Subspecialty Qualifying Examinations (QE) within the ABOG
QE administration platform. The survey had questions about
the perceived impact of COVID-19 on fellowship activities
and the year of completion of the fellowship. Data
collection occurred on the July 25, 2022, after institutional
review board approval (exempt IRB protocol Pro00055679;
given anonymized data collection and aggregate reporting).
Data were analyzed using descriptive and comparative
statistics. A copy of the survey questions can be found in
the Supplemental Table.
RESULTS: The aggregate response rate across the 4 sub-
specialties for the survey was 81.1% (n¼297) with response
rates within each subspecialty ranging between 56.2% and
90%. Almost four-fifths (79.9%) of respondents across the
fellowship training programs reported minor to major
disruption in their research activities (Figure). More than
half (53.2%) of the respondents reported at least 3 months
(or more) of research disruption during their fellowship.
Only 16.4% of respondents across the obstetrics-gynecology
subspecialty fellowship training programs had minimal to
no impact on their research activities specifically related to
ajog.org Research Letter

their thesis. There were significant differences across the 4 Rajat Chadha, PhD
subspecialty training program respondents in the perceived Assessments
length of disruption (P¼.011). For example, 40% of National Board of Certification & Recertification for Nurse
gynecologic oncology fellows reported disruptions of 3 to 6 Anesthetists
Chicago, IL
months, whereas 37.1% of maternal-fetal medicine fellows
reported disruptions of more than 6 months (Supplemental Heath Kincaid, BS
Figure). Anthony Sparks, PhD
Assessments
American Board of Obstetrics and Gynecology
CONCLUSION: This study found that a large proportion of 2727 Laclede Street
respondents across the fellowship training programs reported Dallas, TX 75204
minor to major disruptions in their research activities, and asparks@abog.org
more than half the respondents reported at least 3 months (or
Amanda Novak, MEd
more) of research disruption within the year. Survey results
Operations
confirmed that the COVID-19 pandemic differentially American Board of Obstetrics and Gynecology
impacted research activities (specifically for the thesis) for Dallas, TX
most fellows. These differential impacts by subspecialty may
George D. Wendel Jr, MD
be a consequence of what procedures were considered
Administration
elective during the pandemic, which may have impacted
American Board of Obstetrics and Gynecology
what types of research could occur. Dallas, TX
One of the limitations of this study is the sole use of
The authors report no conflict of interest.
quantitative data to understand fellowship disruptions.
Future research should collect qualitative data on the Patient consent was not required because no personal information or
specific reasons for such disruptions, which could provide details were included.
additional insights into the nature of the disruptions and
help to guide the ABOG and fellowship program directors. This study did not receive any funding.
Given that research during the fellowship is assessed using
a thesis within the ABOG subspecialty CE, the findings REFERENCES
have strong implications for fairness in terms of how the 1. Potts JR. Residency and fellowship program accreditation: effects of
thesis could be assessed during the CE. The ABOG will the novel coronavirus (COVID-19) pandemic. J Am Coll Surg 2020;230:
need to re-conceptualize the most psychometrically 1094–7.
defensible and fair way in which to assess the thesis without 2. COVID-19: recommendations for management of elective surgical
procedures. American College of Surgeons. Available at: https://www.
providing an unfair advantage for fellows who have had
facs.org/covid-19/clinical-guidance/elective-surgery. Accessed October
minimal to no disruption during this pandemic. The next 1, 2021.
steps for research include monitoring the performance of 3. Amparore D, Claps F, Cacciamani GE, et al. Impact of the COVID-19
this cohort of examinees in their CE in 2024 to better pandemic on urology residency training in Italy. Minerva Urol Nefrol
understand their readiness to conduct research and to 2020;72:505–9.
4. Warhadpande S, Khaja MS, Sabri SS. The impact of COVID-19 on
provide opportunities for professional development if we
interventional radiology training programs: what you need to know. Acad
find deficiencies. Radiol 2020;27:868–71.
5. Subspecialty certification bulletins. American Board of Obstetrics
Pooja Shivraj, MS, PhD and Gynecology. Available at: https://www.abog.org/subspecialty-
certification/bulletins. Accessed September 30, 2021.
Assessments
American Board of Obstetrics and Gynecology ª 2024 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.ajog.
Dallas, TX 2024.02.294

JULY 2024 American Journal of Obstetrics & Gynecology e13

Research Letter ajog.org

SUPPLEMENTAL FIGURE
Length of disruption by subspecialty

Shivraj. Research disruption during COVID-19. Am J Obstet Gynecol 2024.

SUPPLEMENTAL TABLE
Survey Questions
Question Response options
What year did you graduate from fellowship? Prior to or during 2019
2020
2021
2022
At the time when the COVID-19 pandemic had a N/A e graduated prior to the pandemic.
maximum impact on your fellowship program, how do No Disruption
you perceive the severity of disruption to the following Minor Disruption
areas? Major Disruption
- Core Clinical Experience
- Research (Thesis)
- Electives
At the time when COVID-19 pandemic had maximum N/A e graduated prior to the pandemic.
impact on your program, approximately how long was No Disruption
the disruption in the following areas? Less than 1 month
- Core Clinical Experience 1-3 months
- Research (Thesis) 3-6 months
- Electives >6 months
In what ways were your research activities (thesis) -N/A e graduated prior to the pandemic.
impacted by the COVID-19 pandemic (please select -Could not complete original thesis project.
all that apply)? -Delayed IRB approval process
-Altered study design/methods.
-Slowed or delayed enrollment of study participants; limited elective procedures.
-Clinical assignment interrupted research time.
-Delayed or limited feedback from mentor/program/colleagues
-Lab closures; limited bench time
-Funding issues for research time
Minimal or no impact
IRB, institutional review board.
Shivraj. Research disruption during COVID-19. Am J Obstet Gynecol 2024.

e14 American Journal of Obstetrics & Gynecology JULY 2024