Effect of COVID-19 on Surgical Training Across the United States: A National Survey of General Surgery Residents

Abstract

Introduction COVID-19 emerged as a global pandemic in 2020 and has affected millions of lives. Surgical training has also been significantly affected by this pandemic, but the exact effect remains unknown. We sought to perform a national survey of general surgery residents in the United States to assess the effect of COVID-19 on surgical resident training, education, and burnout. Methods An anonymous online survey was created and distributed to general surgery residents across the United States. The survey aimed to assess changes to surgical residents’ clinical schedules, operative volume, and educational curricula as a result of the COVID-19 pandemic. Additionally, we sought to assess the impact of COVID-19 on resident burnout. Results One thousand one hundred and two general surgery residents completed the survey. Residents reported a significant decline in the number of cases performed during the pandemic. Educational curricula were largely shifted toward online didactics. The majority of residents reported spending more time on educational didactics than before the pandemic. The majority of residents feared contracting COVID-19 or transmitting it to their family during the pandemic. Conclusions COVID-19 has had significant impact on surgical training and education. One positive consequence of the pandemic is increased educational didactics. Online didactics should continue to be a part of surgical education in the post-COVID-19 era. Steps need to be taken to ensure that graduating surgical residents are adequately prepared for fellowship and independent practice despite the significantly decreased case volumes during this pandemic. Surgery training programs should focus on providing nontechnical clinical training and professional development during this time.

Analysis of the impact of the pandemic on surgical residency programs during the first wave in Argentina: A cross – sectional study

“…Considering the National Decree 718/2020 (extension on the graduation of the residents of the last year of the educational program) and the recommendation that the evaluations of cases and surgeries should be left in the hands of the professionals with more experience, the exposure of the residents in the operating room was limited, generating a reduction in surgical experience, mainly in residents of lower years (PGY – 1 and PGY – 2). These results are similar to other studies [ [16] , [17] , [18] , [19] ]. However, before the current global pandemic, surgical education has had to respond with new technologies, treatments and procedures to the dynamic changes in the knowledge of surgical disease, the demand in the supervision of resident doctors, and the demands for the patient safety [ 20 ].…”

“…Another important discovery in this analysis was regarding the well-being and burnout of residents of surgical programs during the pandemic. The depletion rate was higher than the traditional rates reported in the literature [ 16 , 22 , 23 ]. A national survey of general surgery residents in the United States reported a burnout rate of 33.1% [ 16 ].…”

“…The depletion rate was higher than the traditional rates reported in the literature [ 16 , 22 , 23 ]. A national survey of general surgery residents in the United States reported a burnout rate of 33.1% [ 16 ]. However, in our study 52.1% of the survey respondents reported greater exhaustion than usual during the COVID – 19 pandemic.…”

The impact of COVID-19 on surgical training: a systematic review

“…In the United States, 106 urology trainees included in a cross-sectional survey also reported a decrease in surgical volume dependent upon the local prevalence of COVID-19 [ 13 ], with 76% of those working in a high COVID-19 area reporting decreased surgical volume compared to 22% in low COVID-19 area ( p = 0.01). Aziz et al reported a significant reduction in self-reported operative case volume amongst 1102 general surgery trainees in the United States [ 17 ].…”

Adult Hip and Knee Reconstruction Education during the COVID-19 Pandemic

“…Multiple survey studies were conducted evaluating resident and fellowship education during COVID-19. In general surgery, surveys of residents showed they received more didactic teaching during the pandemic than prior to the pandemic, as the majority (80.6%) went to completely online platforms 19 . In a survey of hematology and oncology fellows at a single institution, 100% of individuals appreciated the flexibility of online didactics, but only 63% felt that they learned the same amount online as in-person 20 .…”