Effects of COVID‐19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices

Abstract

Objectives The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training. Study Design Cross-sectional survey. Setting Online. Methods A survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed. Results Of 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating “worsened training” across all domains of FPRS, 14 were located in the Northeast (93.33%). Conclusions The COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows’ trainings would be adversely affected by the ongoing pandemic.

Reflecting on Plastic Surgery Training During Early COVID-19 Pandemic: Resident Exposure and Telemedicine

“…Despite the high-risk burden of craniofacial procedures, facial plastic and reconstructive surgery residents were able to continue training thanks to the addition of safety precautions such as preoperative COVID-19 testing. 2 This reflects diverse role that plastic surgeons undertook without compromising the integrity of specialized training. With the influx of COVID-19 patients, plastic surgeons shared burdens of increasing cases.…”

“…This supports the assertion made by most fellowship directors that despite the unique challenges, facial plastic surgery resident training was not adversely affected. 2 …”

“…Cross-sectional survey of facial plastic and reconstructive surgery fellowship directors indicated a direct negative impact on craniofacial surgery volume and 50% reported less patient willingness to undergo congenital/craniofacial surgery. 2 Many plastic surgery residency programs had to drastically modify call schedules, restructure inpatient teams, triage operative cases, and ramp up telemedicine to adjust to these changing demands.…”

Trends in Residency Applicant Volume in Otolaryngology-Head and Neck Surgery and Peer Specialties

“…Trends in OHNS residency applications, however, may be altered by the introduction of innovations such as signaling systems 10 or disruptions from the COVID-19 pandemic. 12 -18 Additionally, greater COVID-19 exposure in OHNS introduced concerns that prospective medical students might be deterred from applying into the field. 12 -15…”

“…12 -18 Additionally, greater COVID-19 exposure in OHNS introduced concerns that prospective medical students might be deterred from applying into the field. 12 -15…”