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Factors Associated With General Surgery Residents' Operative Experience During the COVID-19 Pandemic.

Amanda C Purdy1, Christian de Virgilio1, Amy H Kaji2,3

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The COVID-19 pandemic significantly reduced surgical resident operative volume by 33.5% in early 2020. This decline impacted all postgraduate year levels and most case types, with Level 1 trauma centers experiencing less reduction.

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Area of Science:

  • Surgical Education
  • Public Health
  • Medical Training

Background:

  • The COVID-19 pandemic led to the suspension of elective surgeries, creating challenges for surgical resident education.
  • Quantifying the impact of the pandemic on resident operative volume is crucial for understanding its effects on training.

Purpose of the Study:

  • To assess the association between the COVID-19 pandemic and general surgical residents' operative experience.
  • To analyze the impact by postgraduate year (PGY) and case type.
  • To identify institutional characteristics associated with changes in surgical volume.

Main Methods:

  • Retrospective review of operative logs from 16 general surgery programs (2017-2020).
  • Comparison of operative volumes from March-June 2020 with the same period in 2018-2019.
  • Analysis of total major cases, case type, and PGY, using Kruskal-Wallis test.

Main Results:

  • A 33.5% reduction in total major cases occurred in March-June 2020 compared to previous years (P < .001).
  • All PGY levels and most case types were significantly affected, except for liver, pancreas, small intestine, and trauma cases.
  • Level 1 trauma centers showed a smaller reduction (27.7%) in case volume compared to non-level 1 centers (46%) (P = .03).

Conclusions:

  • The initial months of the COVID-19 pandemic significantly reduced operative experience for general surgery residents across all PGY levels.
  • Level 1 trauma centers experienced a less pronounced decrease in surgical volume compared to other centers.
  • Continued trends may have detrimental long-term effects on surgical training outcomes.