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PURPOSE: The COVID-19 pandemic led to unprecedented challenges in medical training, and we sought to assess the specific impact of COVID-19 on hematology-oncology (HO) fellowship programs. METHODS: We conducted a cross-sectional anonymous online survey of 103 HO program directors (PDs) in conjunction with the American Society of Hematology (ASH) and ASCO. We sought to assess the specific impact of COVID-19 on HO fellowship programs' clinical, educational, and research activities, evaluate perceptions regarding PD and trainee emotional and mental health, and identify ways to support programs. Data were analyzed using descriptive statistics, parametric and nonparametric tests, and multivariable logistic regression models. Responses to open-ended questions were analyzed with thematic analysis. RESULTS: Significant changes to fellowship activities included transitioning fellow training from outpatient clinics to telehealth (77.7%), shifting to virtual education (94.2%), and moving to remote research work (63.1%). A minority (21.4%) of PDs reported that their fellows were redeployed to cover non-HO services. Most PDs (54.4%) believed COVID-19 had a slight negative impact on fellowship training. PD self-reported burnout increased significantly from 15.5% prepandemic to 44.7% during the pandemic, and most PDs witnessed minor signs of fellow burnout (52.4%). Common PD concerns included inadequate supervision for telehealth activities, reduced opportunities for fellow advancement and promotion, lack of professional development activities, limited research operations and funding, program financial constraints, and virtual recruitment. CONCLUSION: We encourage institutions and national societies to allocate resources and develop programs that can support fellowships and mitigate the potential negative effects of COVID-19 on trainee and PD career development.

PURPOSE: Graduate medical and research training has drastically changed during the COVID-19 pandemic, with widespread implementation of virtual learning, redeployment from core rotations to the care of patients with COVID-19, and significant emotional and physical stressors. The specific experience of hematology-oncology (HO) fellows during the COVID-19 pandemic is not known. METHODS: We conducted a mixed-methods study using a survey of Likert-style and open-ended questions to assess the training experience and well-being of HO fellows, including both clinical and postdoctoral trainee members of the American Society of Hematology and ASCO. RESULTS: A total of 2,306 surveys were distributed by e-mail; 548 (23.8%) fellows completed the survey. Nearly 40% of fellows felt that they had not received adequate mental health support during the pandemic, and 22% reported new symptoms of burnout. Pre-existing burnout before the pandemic, COVID-19–related clinical work, and working in a primary research or nonclinical setting were associated with increased burnout on multivariable logistic regression. Qualitative thematic analysis of open-ended responses revealed significant concerns about employment after training completion, perceived variable quality of virtual education and board preparation, loss of clinical opportunities to prepare for independent clinical practice, inadequate grant funding opportunities in part because of shifting research priorities, variable productivity, and mental health or stress during the pandemic. CONCLUSION: HO fellows have been profoundly affected by the pandemic, and our data illustrate multiple avenues for fellowship programs and national organizations to support both clinical and postdoctoral trainees.

Background: Each year 1.4 million adults are diagnosed with diabetes, and in 2022 more than 1.9 million Americans will be diagnosed with cancer. There is a strong link between type 2 diabetes (T2D) and several types of cancer, and both conditions are known for health disparities. Unrecognized or poorly managed T2D is associated with higher staged cancer at diagnosis and cancer mortality rates with reduced overall survival. Yet, it is not standard oncology practice to test newly diagnosed cancer patients for T2D. Nurses are well positioned to facilitate testing and management of T2D.Aim: The purpose of this study was to examine the feasibility of a nurse-led intervention for adults with newly diagnosed cancer and undiagnosed T2D.Method: In a randomized feasibility pilot study conducted within a large academic medical oncology center, we used EPIC to identify adults with newly diagnosed cancer (< 3 months). The intervention group received immediate initiation of metformin and T2D management education. The standard care group received referral back to their primary care provider. The study measures included HbA1c and feasibility metrics (i.e., population availability, recruitment efficiency and sample retention).Results: Two days a week, over an 11-month timeframe, we pre-screened 379 adults (78.4% non-Hispanic White, 12.9% Black, 1.6% Asian, .5% American Indian, 7.1% other) for study eligibility. Of those pre-screened only 55 (14.5%) patients were eligible for HbA1c screening. The rest were excluded due to current use of metformin (16%), abnormal labs (AST/ALT, eGFR) (16%), or poor prognosis (e.g., pancreatic cancer or leukemia; 18%). Of the 55 patients screened, one non-Hispanic White man, one non-Hispanic White woman, and one Black woman met HbA1c ≥ 6.5% eligibility for the intervention (mean age 58.3, two patients had breast cancer and one patient had rectal cancer); one patient was randomized to the intervention group and two patients were randomized to the standard care group. The initial HbA1c for the intervention group patient was 6.7% and decreased to 5.1% after 3 months (primary endpoint). For the two standard care group patients, the HbA1c was 7.2% and 6.7% and decreased to 5.5%, 5.9%, respectively, after 3 months. No patients were lost to follow-up. All three patients indicated that they enjoyed participating in the study, the length of the study was good, and felt the study would be well received by other patients. The study was subsequently closed due to failing feasibility metrics. Conclusion: Despite study acceptability to patient, this T2D screening protocol was deemed not feasible due to recruitment inefficiency including cost, time, and personnel to screen at the point of care. Integrating routine HbA1c tests for all newly diagnosed cancer patients would simplify screening for study, which would allow another feasibility study of a promising intervention to improve management of undiagnosed T2D among newly diagnosed patients with cancer. Citation Format: Lisa Scarton, Tarah Nelson, Yingwei Yao, Shavondra Huggins, Ara Jo, LaToya J. O'Neal, Thomas J. George, Juan M. Munoz-Pena, Merry J. Markham, Martina C. Murphy, Jonathan A. Chatzkel, Sherise Rogers. Feasibility metric outcomes: A nurse-led intervention to identify and manage undiagnosed type 2 diabetes in patients with newly diagnosed cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B130.