Effects of the COVID-19 pandemic on a general surgery residency program

The onset of the COVID-19 pandemic in 2020 led to a major reorganization of the health care system, including the suspension of elective surgical procedures. This reduction in operative activity may have affected general surgery training. The aim of this study was to assess the impact of the pandemic on the volume and profile of surgical procedures performed at a university hospital.

This retrospective, observational, comparative study examined records of procedures performed by the General Surgery Department of a university hospital between March 2018 and February 2021. Demographic variables (age and sex) and procedural characteristics (type and complexity) were analyzed. Statistical significance was set at p < 0.05.

Medical records from 1,619 patients were analyzed. The study periods were categorized into three intervals: two pre-pandemic (2018-2019 and 2019-2020) and one pandemic (2020-2021). The mean patient age was 49.5 ± 14.8 years, with a female patient majority of 61.3%. During the pandemic period, the mean patient age was significantly lower (p = 0.003) and there were no sex-related differences. Cholecystectomies accounted for 46.0% of procedures, with intermediate-complexity operations predominating (69.2%). A marked reduction in total surgical volume was observed during the pandemic period (344 procedures), compared to the previous 2 years (569 and 706 procedures). Significant increases were observed in appendectomies (p = 0.031), debridement procedures (p = 0.030), and tracheostomies (p < 0.001), whereas excisional procedures decreased significantly (p < 0.001), particularly lipoma (p < 0.001) and skin tumor (p = 0.028) excisions.

The COVID-19 pandemic resulted in a substantial reduction in elective surgical procedures and an increase in critical care-related interventions, such as tracheostomies. These findings demonstrate a quantitative shift in procedural exposure during surgical residency training.