Effect of the COVID‐19 Pandemic on Otolaryngology Trainee Surgical Case Numbers: A Multi‐institutional Review

Mann, Scott E.; Duffy, James; Muffly, Tyler M.; Tilva, Keval; Gray, Stacey T.; Hetzler, Laura; Kraft, Shannon; Malekzadeh, Sonya; Pletcher, Steven D.; Cabrera‐Muffly, Cristina

doi:10.1177/01945998221083845

Cited by 4 publications

(5 citation statements)

References 8 publications

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“…This is similar to stable case volumes noted in trainee case logs including urology residents, Society of Urologic Oncology fellows, and general surgery residents 10–12 . However, for some surgical specialties, there were significant decreases in volume including ophthalmology and otolaryngology 13,14 . This may reflect differences in the proportion of elective cases as well as the relative risk of COVID‐19 transmission during the procedures.…”

Section: Discussionsupporting

confidence: 62%

“…[10][11][12] However, for some surgical specialties, there were significant decreases in volume including ophthalmology and otolaryngology. 13,14 This may reflect differences in the proportion of elective cases as well as the relative risk of COVID-19 transmission during the procedures. For urology FPMRS fellows, there was a statistically significant decrease among two COVID-affected cohorts: GI procedures decreased for AY 2020−2021 from AY 2019−2020 (4.2 vs. 8.9, p = 0.04).…”

Section: Discussionmentioning

confidence: 99%

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Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

Daily,

Popat,

Koenig

et al. 2023

Neurourology and Urodynamics

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IntroductionDuring the COVID‐19 pandemic and subsequent staffing shortages there was concern about the case volume, and thus competency, of graduating trainees due to reduced surgical volumes. Elective procedures were particularly affected, which includes Female Pelvic Medicine and Reconstructive Surgery (FPMRS) cases. To understand whether FPMRS fellows were affected, we assessed their case logs for changes during the pandemic.MethodsThe nationally aggregated case logs of graduating FPMRS fellows, both urology and obstetrics and gynecology (OBGYN), were obtained from the Accreditation Council for Graduate Medical Education. The available academic years (AYs) included 2018−2019, 2019−2020, and 2020−2021. Standard deviation for each index category was derived from the average and 90th percentile data. One‐way analysis of variance was used to compare differences in case volumes for tracked index categories between AYs.ResultsGraduating fellows logged an average of 517.4 (standard deviation [SD] 28.6) and 818.0 (SD 37.9) cases, for urology and OBGYN respectively, over their fellowship training during the examined period. No significant differences in total surgical procedures were found for either specialty between pre‐COVID AY 2018−2019 and COVID‐affected AYs 2019−2020 and 2020‐2021. For urology fellows, gastrointestinal (GI) procedures was the only index case category with a significant difference, and it was a decrease between the two COVID‐affected AYs: 2020‐2021 compared to 2019−2020 (8.9 vs. 4.2, p = 0.04). For both urology and OBGYN fellows, there was a statistically significant decrease in graft/mesh augmentation procedures from COVID‐affected AY 2019−2020 to AY 2020−2021. This may be attributed to the reclassification of mesh removal cases from graft/mesh augmentation procedures to genital procedures in 2020−2021. There was not a significant decrease in these procedures from pre‐COVID AY 2018‐2019 to the COVID‐affected AYs. There were no other statistically significant differences between AYs for OBGYN fellows.ConclusionsSurgical case volumes for FPMRS urology and OBGYN fellows who trained during the COVID‐19 pandemic were comparable to those of their pre‐pandemic peers. No significant differences between pre‐COVID and COVID‐affected years were found for either total surgical procedures or index case categories. Despite disruptions in health care nationwide, FPMRS trainee case volumes were largely unaffected.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

Daily,

Popat,

Koenig

et al. 2023

Neurourology and Urodynamics

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“…Case reduction and surgical skill perceived by both residents and staffs were similar to previous studies that measure the case numbers reduction, 17 , 18 and also similar to the previous study that revealed a significant decrease in surgical case volumes. 19 The hospital’s policy of reducing surgical cases might cause their lack of confidence. The more difficult and complicated the procedures were, the more the residents felt unconfident ( Table 5 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on the otolaryngology residency training program in a university-based hospital in Bangkok, Thailand

et al. 2022

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Objective: This study aimed to evaluate the impact of the COVID-19 pandemic on the otolaryngology residency training program in Vajira Hospital, Navamindradhiraj University. Methods: Conducted from October 2021 to January 2022, this cross-sectional survey included all residents, residents who graduated in 2021, and the attending staff. One form was sent to both resident groups for self-assessment and another form to the attending staff for resident assessment. The survey questions were about attitude toward COVID-19 service, knowledge, outpatient department service, surgical skills, and burnout assessment using the Maslach Burnout Inventory. Results: This study included 17 residents and 9 attending staff members. COVID-19 indeed had affected the clinical and surgical training. Regarding the attitude toward COVID-19 services, the residents were moderately satisfied. They were concerned about work suspension resulting from infection and also death from COVID-19. N95 masks and other protective gears were scarce. Compared with those during the prepandemic era, residents had fewer academic activities, and they preferred hybrid teaching. The inpatient department, outpatient department, and surgical training opportunities, as well as elective and urgent surgeries, were also reduced. The attending staff considered 1-year extension of the training program, but the residents disapproved. The residents became less confident both in outpatient department service and surgical skill, and they felt emotional exhaustion, depersonalization, and decreased sense of personal accomplishment. Conclusion: COVID-19 pandemic had significant impact on otolaryngology residency training programs. It did not only affect burnout among residents but also caused a perception of skill and knowledge reduction.

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“…The postponement and cessation of elective surgeries caused by the COVID-19 pandemic resulted in a significant reduction in operative volume for residency programs. 7,[10][11][12][13] In a survey study of head and neck program directors in the US, 70% (26/37) reported 50% to 90% reduction in elective cases performed by fellows and significant curtailing of didactics in March and April of 2020. 14 Izreig et al determined that the surgical volume across all subspecialties except head and neck cancer surgeries experienced higher rates of procedure cancellations leading to reduction in performed cases in 2020 compared to 2019.…”

Section: Introductionmentioning

confidence: 99%

“…5 These changes may have lasting repercussions such as substantial surgical backlog, 16 financial losses of up to $323 billion in 2020 projected by the American Hospital Association, 17 and perhaps most strikingly, decreased surgical case experience among trainees. 7,[10][11][12][13] We sought to examine the impact of COVID-19 on otolaryngology surgical training through and after the height of the pandemic by examining key indicator case trends in an academic tertiary care center.…”

Section: Introductionmentioning

confidence: 99%

The Lasting Impact of the COVID-19 Pandemic on Surgical Key Indicator Cases for Otolaryngology Residency Education

Krishnan

Daggumati

Widmeyer

et al. 2022

Ann Otol Rhinol Laryngol

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Objectives: Early on during the COVID-19 pandemic, the US Centers for Medicare & Medicaid Services (CMS) and other government as well as medical institutions recommended that surgeons postpone nonessential surgeries. The aim of our study is to examine the impact of the COVID-19 pandemic on otolaryngology surgical training by evaluating changes in surgical volumes through various time points relative to the height of the pandemic. Methods: We performed a retrospective review of all surgical cases performed by the Otolaryngology-Head and Neck Surgery department at a tertiary care academic center from 3 time periods: July 1st, 2018, to June 30th, 2019; July 1st, 2019, to June 30th, 2020; and July 1st, 2020, to June 30th, 2021. Results: From the 2018-19 period to the 2020-21 period, the total number of overall cases decreased by 9.9%, from 2386 to 2148 cases. During this same time duration, the number of key indicator cases decreased by 13.4%, from 1715 to 1486 cases. Relative to other cases, ethmoidectomy, rhinoplasty, and stapes/OCR cases decreased the most during the 2019-20 period by 41.9%, 41.8%, and 29.5%, respectively. From the 2018-19 period to the 2020-21 period, thyroid/parathyroid cases decreased the most by 35.4%. Only ethmoidectomy and oral cavity cases showed increases during this period at 9.7% and 24.4%, respectively. Conclusions: Although case volumes have stayed relatively constant, key indicator case volumes at the present tertiary care academic center have not yet fully recovered from the COVID-19 pandemic. Efforts must be made to determine how this has impacted residency surgical education.

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Effect of the COVID‐19 Pandemic on Otolaryngology Trainee Surgical Case Numbers: A Multi‐institutional Review

Cited by 4 publications

References 8 publications

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

Female pelvic medicine and reconstructive surgery fellows' case logs remained stable during the COVID‐19 pandemic

Impact of the COVID-19 pandemic on the otolaryngology residency training program in a university-based hospital in Bangkok, Thailand

The Lasting Impact of the COVID-19 Pandemic on Surgical Key Indicator Cases for Otolaryngology Residency Education

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