While the coronavirus disease (COVID-19) pandemic paused much of our daily activity, many people with Parkinson’s and their families saw firsthand how care and research continued in an adapted way. Somewhat “behind the scenes,” the education of new Parkinson’s doctors also continued. The Michael J. Fox Foundation’s Edmond J. Safra Fellows — a distinguished group of neurologists training to become movement disorder clinician-researchers — shared how they and their mentors found new ways to care for patients, move research forward, teach and learn during this extraordinary moment in public health.
Continuing Care through Telemedicine
When in-person visits for routine, non-urgent care temporarily were not an option, many patients and doctors shifted to telemedicine: meeting via computers or smartphones. And even though Edmond J. Safra Fellows led the transition in many locations, it came with a steep learning curve. Doctors were learning to use new technology, train staff to assist, and examine patients through video. (Patients, too, were finding new patience and flexibility in this environment.) But these doctors now will be prepared for telemedicine to — hopefully — become a standard part of care in the years ahead. And now that in-person appointments are resuming, many of the physicians who helped in the transition are advocating for long-term, widespread availability of telemedicine, especially for people who have difficulty accessing a movement disorder specialist.
Marissa Dean, MD, Assistant Professor of Neurology at the University of Alabama at Birmingham (Edmond J. Safra Fellowship Class of 2018) says, “Overall, there has been a large change in the delivery of medical care across the entire country, and this has given the Edmond J. Safra Fellows an opportunity to adapt and gain more experience in providing telemedicine care to our patients. The clinical training is continuing uninterrupted but is quickly adapting into new ways to provide care, which will likely define a new normal for health care delivery after COVID-19.”
Adapting and Expanding Research Opportunities
Even though much in-person research was on hold, the fellows moved science forward where possible. Online studies or those with telemedicine components continued and, in some cases, expanded. New research opportunities, such as an online patient satisfaction survey about telemedicine, were sought. Fellows used “extra” time to analyze data, apply for grants, write manuscripts, and draft or amend research protocols. One physician revised his study plan on the behavioral effects of DBS to make it a home-based, “COVID-19 proof” trial which, ultimately, will allow enrollment of more participants.
Moving Educational Experiences Online
During training, fellows have regular opportunities to learn by teaching medical students and residents, presenting their research, and discussing complex patient cases or interesting journal articles. During the pandemic, fellows and mentors met online for weekly journal clubs, video case discussions, Grand Rounds lectures and other virtual conferences. Some fellows were offered additional opportunities to present at their own institution as well as others around the world — unconstrained by geography, the digital approach broadly expanded collaboration and learning opportunities. (See what the Edmond J. Safra Fellowship Class of 2021 presented on MJFF’s annual fellows’ webinar.)
Describing her experience throughout this time, Judith van Gaalen, MD, Edmond J. Safra Fellow Class of 2021, says, “Luckily, despite the fact that we had to reorganize care differently, I haven’t experienced any gaps in my clinical or research training. Interestingly, [the pandemic] has provided me with the opportunity to gain experience with telemedicine and teleconferencing, which I will very likely adopt in my future role as movement disorders neurologist.”