Residents and Fellows - Eastern Virginia Medical School (EVMS), Norfolk, Hampton Roads

Last Updated: 05-06-2020 11:15 a.m.

The following policies are in place to assist in the management of the graduate medical education programs during the COVID-19 pandemic in Hampton Roads. These polices will be reviewed and revised as necessary both during the pandemic and afterword. Program Directors should check this site periodically for updates. Questions should be sent to Dr. Linda Archer.

The American Board of Medical Specialties (ABMS) and the American Board of Surgery (ABOS) have posted notices regarding COVID-19 and requirements for board certification. Program directors are advised to monitor the ABMS and ABOS websites for update. It is imperative that experiences be documented carefully.

The EVMS Medical Group is providing guidance for healthcare providers treating COVID-19 patients. This approach to COVID-19 is based on the best (and most recent) available literature and the Shanghai Management Guideline for COVID.

Residents and Fellows Guidance

Residents/Fellows and Patient Care Experiences

Last Updated: 05-06-2020 11:30 a.m.

Residents and Fellows may provide care under faculty supervision to suspected or confirmed COVID-19 patients. Supervision should be in compliance with Accreditation Council for Graduate Medical Education (ACGME). The ACGME may revise supervision policies as needed to address the rapidly changing clinical scenarios related to COVID-19. The most recent communication may be found at ACGME.org in a Letter to the Community from Dr. Thomas Nasca, President and CEO of ACGME. Program directors should monitor all communications from ACGME for revisions to supervision and other ACGME requirements.

Program directors have the authority to reassign residents/fellows on research and elective rotations to the primary teams to ensure adequate care of suspected or confirmed COVID19 patients.

Exposure to Suspected or Confirmed COVID-19 Patients

Last Updated: 04-22-2020 5:12 p.m.

EVMS Human Resources (HR) is the central reporting mechanism for access to Occupational Health for resident/fellow screening for COVID-19. After discussion with the program director, the resident/fellow should contact Human Resources at 757.446.6043 for reporting and referral to Occupational Health for screening. Human Resources will provide the program director with status updates on the resident/fellow throughout the process and until the resident is deemed cleared to return to work.

EVMS has updated the post-exposure protocol for health care workers. Please remember that regardless of the hospital in which you are training, you are EVMS employees and must abide by the EVMS the post-exposure policy. Efforts are under way to bring the post-exposure protocol’s for EVMS, Sentara Norfolk General Hospital (SNGH), and Children's Hospital of The King's Daughters (CHKD) in-line with each other. As these protocols are subject to change based on evolving knowledge of COVID-19, please check the EVMS COVID-19 webpage frequently. You will receive notifications via your institutional email.

If the exposure occurs at SNGH, please also notify Dr. Timothy Lee, Occupational Health Medical Director (tnlee@sentara.com) or report though SNGHICC@sentara.com.

If the exposure occurs at CHKD, please also notify IPAC – Ms. Barbara Stein, 757.668.7230 (office) and 757.633.9283 (cell) and Occupational Health – Patricia Higazi, 757.668.7491 (office) and 757.376.3231 (cell).

Educational Assignments during Quarantine or Illness

Last Updated: 05-06-2020 12:10 p.m.

Program directors have the authority to provide alternative educational assignments for residents on quarantine or illness due to COVID-19. If the resident/fellow is assigned home duty due to quarantine or illness, the program director should report such to EVMS Human Resources and complete the Telework and Remote Work form.

These situations may include residents returning from travel, or those with exposure to suspected or confirmed patients, and those who develop suspicious symptoms before rapid testing is available.

For residents/fellows on quarantine, program directors may provide remote educational assignments if the resident/fellow is well enough to work, to engage in, and/or support clinical care. These remote educational assignments will be specialty specific, but some possible assignments are:

Phone triage
Management of Follow My Health messages and other patient care related tasks (medication refills, communication about test results, etc.)
Tehealth visits (follow department/mdical group procedures)

Supervision of these remote educational assignments should be in compliance with the Accreditation Council for Graduate Medical Education (ACGME) supervision requirements.

All resident/fellow remote educational assignments must be reported to EVMS Human Resources (757.446.6043) and appropriate documentation completed.

Residents or Fellows with Serious Chronic Health Conditions

Last Updated: 03-26-2020 10:08 a.m.

Residents with serious chronic health conditions should report such to their program directors. Program directors should contact HR to determine what accommodations may be necessary.

Personal Protective Equipment (PPE)

Last Updated: 04-13-2020 4:37 p.m.

For now, all sites are following CDC guidance for N95 respirators, plus facemask or goggles, and contact (gown, gloves) when treating these patients. Online updates on how to don and doff the N95 respirators will be made available on the EVMS website. Due to a shortage of N95 masks, on-site fit testing will not be conducted. Residents/fellows with beards/mustaches are encouraged to remove the facial hair to help ensure an appropriate mask fitting.

Please not that shortages of PPE may determine how the PPE is distributed. Please ask the attending supervisor or the nursing supervisor if you have any questions.

Laundering of Clinical Attire

Last Updated: 04-01-2020 1:14 p.m.

Each of the residency/fellowship programs has been asked to develop a protocol for professional clinical attire during the COVID-19 pandemic. Given that many residents/fellows are not provided scrubs and are laundering clothes at home or in a commercial washer, please review the CDC guidelines for laundering clothing. We are developing specific guidelines for physician and laundering of professional attire.

VitalTalks

Last Updated: 04-06-2020 4:22 p.m.

As front line clinicians, there will be difficult conversations over the next weeks/months with patients seeking testing for COVID-19, those diagnoses and with the families. The Center to Advance Palliative Care has developed VitalTalks which is a primer on how to talk with patients and includes Screening, Triaging, Admitting, Resourcing, Anticipating, and Grieving dialogs. Please take a moment to see what is available and determine if it would be helpful for you as we move through the next few weeks/months.

Additional Resources and Links

Last Updated: 04-13-2020 4:38 p.m.

AMA COVID-19 Physician Resource Center: Evidence-Based perspecitives from the world's top researchers, AMA's phsycian leaders and subject matter experts.
Well-being: Headspace has expanded access to all US-based healthcare professionals working in a public health setting through the end of the year.