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MEDICAL SCHOOL
EVALUATION & GRADUATION

The COVID-19 Graduate Medical

Education Pandemic Response:

Innovation, Agility and Collaboration

By Woodson “Scott” Jones, MD

At the beginning of the COVID-19 pan- Chief Medical Officer at UT Health physi- were developed. The OGME ensured
demic in March 2020, the Office for Grad- cians and key unit medical directors, ad- 100% of residents and fellows received per-
uate Medical Education (OGME) at the ministrators and nursing leadership at UH sonal protective equipment (PPE) training.
Long School of Medicine, University of and the VA, developed and implemented OGME conducted virtual “town halls” to
Texas Health San Antonio (UT Health) the Cross-Department Deployment Pro- discuss the deployment preparations and
began to plan for an anticipated rapid rise gram (CDDP) to address COVID-19 pa- resources available. UT Health, UH and
in hospitalized patients at University Hos- tient care needs (i.e., palliative care, the VA worked cohesively to develop simi-
pital. At the same time, the state of Texas intensive care, inpatient wards, etc.). Clin- lar PPE protocols, health care provider par-
restricted elective medical procedures. This ical “Bucket Managers” at the VA and UH ticipation in COVID-19 patient care,
significantly reduced training opportuni- were also identified for each of these antic- testing and return to work protocols.
ties for some residents and fellows in their ipated care-lines needing additional sup- UH, our largest training site, began to ex-
assigned medical specialties. The OGME port. Their PDs classified all residents and perience a rapid rise in COVID-19 hospital-
implemented a comprehensive plan to em- fellows according to the level of supervision izations in June, with a 400% increase in
ploy residents and fellows outside of their they would need in each clinical setting, admissions, leading to the activation of the
training specialty to support critical patient should they be deployed. Department De- CDDP. Palliative care team support began
care needs at University Hospital (UH) ployment Managers (DDM), often a PD, on June 19, followed by ward and intensive
and the Audie L. Murphy Memorial Veter- were identified to oversee each depart- care team support within a few days. Our
ans Hospital (VA). ment's cross-deployments. Further educa- second largest participating site, the VA,
The OGME, in close coordination with tional resources, a just-in-time training likewise saw rapidly rising COVID-19 hos-
several GME Program Directors (PD), the intranet site and shadowing opportunities pitalizations, activating the CDDP to sup-
port additional hospitalist teams on June 22.
At its peak, the CDDP supported 16 new
patient care teams and existing services that
required additional physician support.
197 deployed residents and fellows sup-
ported UH and the VA during the duration
of the CDDP for the first surge. Internal
medicine residents provided over 1,500
hours of additional support through their
jeopardy coverage. The Surgery Program
provided up to seven residents at a time to
provide 24/7 COVID ICU support. UH
successfully cared for the surge in patients
without exceeding hospital capacity. There
was no evidence of COVID-19 transmis-
sion to the cross-deployed residents or fel-
lows, which is a testament to the thorough
training and equipping of our GME resi-
UT and UH Leadership on “Clinical Learning Environment Walks” recognizing COVID Deployers. dents and fellows.

16 SAN ANTONIO MEDICINE • June 2021