Dear Editor:

Postgraduate medical education faced several challenges during the COVID-19 pandemic due to the need to implement an online education system. For example, training teaching staff in the use of e-learning tools and platforms or including sufficient content on such platforms to ensure that students learn appropriately. While these problems were successfully addressed during the pandemic in Peru, we believe that there are other difficulties that also need to be addressed.¹

The first challenge is the general lack of financial resources during the pandemic to cover the educational expenses associated with pursuing a graduate degree in medicine, i.e., tuition costs, as well as those related to e-learning (computer access, internet connectivity costs, etc.) as the pandemic has severely affected the world economy and many professionals have been left unemployed and/or have had to settle for a decrease in their salaries. This has resulted in increased dropout rates among graduate students because most of them are paying the tuition and other costs associated with their education on their own (i.e., without any support).^2,3

The second is the unavailability of effective training in the proper use of online educational platforms. Abruptly switching from face-to-face to remote classes is not an easy process. Therefore, undertaking a process of ongoing immersion in the use of virtual learning spaces (VLS) is fundamental since these online platforms are the very spaces where students find the necessary tools for their learning sessions and the submission of their assignments. These platforms also allow the use of other learning resources such as digital libraries and repositories, Padlet (for collaborative boards), Mentimeter (for real-time presentations), Jamboard (interactive and collaborative whiteboard), and Genially (for the creation of visual content), among others.^4,5

In addition to these challenges, there are the common internet connectivity issues in Peru, such as poor coverage and low internet speed in several regions of the country, as well as high costs associated with these services, among others, which undoubtedly affected the normal development of the online classes. It is therefore a pending task for governments to ensure the improvement of Internet bandwidth.⁶

On the other hand, due to the COVID-19 pandemic, the demand for healthcare professionals in Peru has also increased significantly, leading to burnout or work overload in many cases, with negative consequences such as lack of energy, feelings of frustration and failure, irritability and, occasionally, disinterest not only in one's own health, but also in academic projects. This is a concerning situation that could create a shortage of the necessary specialized human resources in health care, which could negatively impact the entire health care sector in the medium and long term.^7,8

In conclusion, the current global health crisis has resulted in many health professionals not being able to access graduate studies in medicine or in many of those already studying in such programs dropping out. Hence, the implementation of educational interventions and resources aimed at improving the use and understanding of online educational tools is critical to achieve adequate teaching in e-learning at this level of education given the current pandemic conditions. Likewise, a curricular restructuring that considers the development of soft skills such as emotional intelligence is required to achieve an adequate management of teaching processes in the event of health emergencies, and thus provide quality education to graduate students.