COVID-19 Elective Surgery Shutdown and Operative Experience for Graduating Plastic Surgery Independent Residents

The initial wave of the COVID-19 pandemic led to a temporary shutdown of elective procedures. The purpose of this study is to evaluate how the elective surgery shutdown impacted case log numbers for graduating plastic surgery independent residents.

The Accreditation Council of Graduate Medical Education graduate self-reported case logs were retrospectively compiled for graduating independent track plastic surgery residents for the year before the pandemic (2019), 4 months into the pandemic (2020) and 16 months into the pandemic (2021). Procedures were grouped into resident review committee area and totals for each area were used for analysis. Average number of cases and standard deviations were compiled. Percent change was calculated comparing each year to the prepandemic baseline. Statistical significance was determined with Student t tests comparing average number of cases. Coefficients of variation were calculated to assess for changes in interprogram variation. Average case numbers were then compared with minimum case requirements necessary for graduation.

The Accreditation Council of Graduate Medical Education graduation case log statistics were available for 238 independent residents. There were no statistically significant differences in average case number for graduating independent residents for total reconstructive breast, trunk, hand and upper extremity, or total reconstructive procedures between graduation years. The average case number of total lower extremity reconstruction increased from 2019 to 2020 (average = 83-97.4, P = 0.02). The average total number of breast aesthetic cases increased between all years (average = 92, 98, 114), with the average increase from 2019 to 2021 being statistically significant ( P = 0.02). Differences in head and neck aesthetic deformities and trunk and extremity deformities between years were not statistically significant. The average case number for all graduating plastic surgery independent residents exceeded the minimum case log requirements.

The temporary hold on elective procedures during the pandemic decreased the opportunity for plastic surgery trainees to meet minimum case log requirements. Case log data for graduating plastic surgery independent residents demonstrate that despite the temporary suspension, the pandemic did not greatly impact the average resident case numbers.