American Council of Academic Plastic Surgeons
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The Evolving Trend in Residency and Fellowship Leave of Absence Policies in the COVID-19 Era
Michael Ha, MA Cantab MB BChir1; Ledibabari M. Ngaage, MA Cantab MB BChir1,2; Mimi R. Borrelli, MBBS MSc3; Wilmina N. Landford, MD2; Katie L. McGlone, BS1; Sheri Slezak, MD1; Yvonne M Rasko, MD1
1Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, 2Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, MD, 3Department of Plastic and Reconstructive Surgery, Brown University, Providence, RI

Background: Specialty board organizations set time-based training requirements and minimum case numbers to determine board eligibility. The ongoing COVID-19 outbreak has created difficulties in meeting these benchmarks. However, the literature is void on how American Board of Medical Specialty (ABMS) organizations are adapting training requirements in the face of the pandemic
Methods: We accessed 24 ABMS board websites and identified training LOA and COVID-19 related policies at three timepoints: the first pandemic wave (May 2020), introduction of the vaccine (January 2021), and during a viral resurgence (September 2021). We collected details on the presence and duration of COVID-19 related LOA policy, and any alterations to minimum clinical experience requirements. We then analyzed how these policies changed over the time period
Results: During the initial pandemic wave, 21 ABMS Boards (88%) held COVID-19 related LOA policies. One in four (25%, n=6) permitted additional leave, and 9 (38%) included COVID-19 leave as part of their existing LOA policy. Fewer than half of the Boards (42%, n=10) allowed time away from on-site training, at home or redeployed to other services, to count as clinical hours. Strikingly, only one ABMS Board reduced the minimum case volume requirement. By January 2021 (after vaccine introduction), only 13% (n=3) of ABMS Boards had expanded their policies to increase permitted leave, reduce minimum case requirements, or endorsed redeployed time as part of clinical duty. By the time of the viral resurgence in September 2021, half (50%, n=12) of ABMS Boards had updated their LOA policies to increase the duration of permitted leave, incorporated a virtual platform into their curricula, or altered the minimum case volume
Conclusion: At the onset of the COVID-19 pandemic, many ABMS organizations had not adapted to the new learning environment. However, their policies have evolved throughout the crisis and are trending to a competency-based learner model that individualizes the training process.

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