A Multicenter Analysis of the Early Impact of COVID-19 on Junior Resident Operative Case Volume
Institutions have reported decreases in operative volume due to COVID-19. Junior residents have fewer opportunities for operative experience and COVID-19 further jeopardizes their operative exposure. This study quantifies the impact of the COVID-19 pandemic on resident operative exposure using resident case logs focusing on junior residents and categorizes the response of surgical residency programs to the COVID-19 pandemic.
Materials and methods
A retrospective multicenter cohort study was conducted; 276,481 case logs were collected from 407 general surgery residents of 18 participating institutions, spanning 2016-2020. Characteristics of each institution and program changes in response to COVID-19 were collected via surveys.
Senior residents performed 117 more cases than junior residents each year (P < 0.001). Prior to the pandemic, senior resident case volume increased each year (38 per year, 95% confidence interval 2.9-74.9) while junior resident case volume remained stagnant (95% confidence interval 13.7-22.0). Early in the COVID-19 pandemic, junior residents reported on average 11% fewer cases when compared to the three prior academic years (P = 0.001). The largest decreases in cases were those with higher resident autonomy (Surgeon Jr, P = 0.03). The greatest impact of COVID-19 on junior resident case volume was in community-based medical centers (246 prepandemic versus 216 during pandemic, P = 0.009) and institutions which reached Stage 3 Program Pandemic Status (P = 0.01).
Residents reported a significant decrease in operative volume during the 2019 academic year, disproportionately impacting junior residents. The long-term consequences of COVID-19 on junior surgical trainee competence and ability to reach cases requirements are yet unknown but are unlikely to be negligible.
Kramer, B., Plitt, G., French, J. C., Nygaard, R. M., Cassaro, S., Edelman, D. A., Lees, J. S., Meier, A. H., Joshi, A., Johnson, M. P., Chavez, J., Hope, W. W., Morrissey, S., Gauvin, J. M., Puri, R., LaFemina, J., Kang, H. S., Harzman, A. E., Jaafar, S., Chandramouli, M. A., … Lipman, J. M. (2022). A Multicenter Analysis of the Early Impact of COVID-19 on Junior Resident Operative Case Volume. The Journal of surgical research, 279, 208–217. Advance online publication. https://doi.org/10.1016/j.jss.2022.06.015
J Surg Res