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The Effect of COVID-19 on Training and Case Volume of Vascular Surgery Trainees
Nicole Ilonzo1, Issam Koleilat2, Vivek Prakash1
1Division of Vascular Surgery, Department of Surgery, 5925The Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Insights
The COVID-19 pandemic significantly reduced vascular surgery training cases, impacting trainee experience and raising concerns about completing ACGME requirements. Further studies are needed to assess training supplements.
Area of Science:
- Vascular Surgery
- Medical Education
- Public Health
Background:
- The COVID-19 pandemic led to the suspension of elective surgeries in many healthcare facilities.
- This study investigates the impact of these suspensions on the surgical training of vascular surgery residents.
Purpose of the Study:
- To determine the effect of the COVID-19 pandemic on the surgical experience of vascular trainees.
- To assess changes in case volume, case breadth, and trainee-reported experiences.
Main Methods:
- Retrospective review of surgical case volume and trainee levels at three major New York City hospitals.
- Comparison of procedures performed during pre-pandemic and peak pandemic periods in 2020 versus 2019.
- Surveys were distributed to trainees to evaluate their subjective experiences.
Main Results:
- Total case volume decreased by 12% in the month leading up to the pandemic peak and by 74% during the peak period.
- The types of procedures shifted, with fewer endovascular cases and more amputations for acute limb ischemia during the pandemic.
- Residents reported a significant decrease in case volume and 20% expressed concern about meeting accreditation requirements.
Conclusions:
- Vascular surgery training, including clinical and operative experiences, was substantially limited during pandemic-related redeployment efforts.
- There is a need to quantify the precise impact on training outcomes.
- The efficacy of supplementary training methods like teleconferences and simulation requires further evaluation.
Background:
In many facilities, the coronavirus disease (COVID-19) pandemic caused suspension of elective surgery. We therefore sought to determine the impact of this on the surgical experience of vascular trainees.
Methods:
Surgical case volume, breadth, and the participating trainee post-graduate level from 3 large New York City Hospitals with integrated residency and fellowship programs (Mount Sinai, Montefiore Medical Center/Albert Einstein College of Medicine, and New York University) were reviewed. Procedures performed between February 26 to March 25, 2020 (pre-pandemic month) and March 26 to April 25, 2020 (peak pandemic period) were compared to those performed during the same time period in 2019. The trainees from these programs were also sent surveys to evaluate their subjective experience during this time.
Results:
The total number of cases during the month leading into the peak pandemic period was 635 cases in 2019 and 560 cases in 2020 (12% decrease). During the peak pandemic period, case volume decreased from 445 in 2019 to 114 in 2020 (74% reduction). The highest volume procedures during the peak pandemic month in 2020 were amputations and peripheral cases for acute limb ischemia; during the 2019 period, the most common cases were therapeutic endovascular procedures. There was a decrease in case volume for vascular senior residents of 77% and vascular junior and midlevel residents of 75%. There was a 77% survey response rate with 50% of respondents in the senior years of training. Overall, 20% of respondents expressed concern about completing ACGME requirements due to the COVID-19 pandemic.
Conclusions:
Vascular surgery-specific clinical educational and operative experiences during redeployment efforts have been limited. Further efforts should be directed to quantify the impact on training and to evaluate the efficacy of training supplements such as teleconferences and simulation.
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