A Multicenter Analysis of the Early Impact of COVID-19 on Junior Resident Operative Case Volume.

Autor: Kramer B; Department of General Surgery, Cleveland Clinic, Cleveland, Ohio. Electronic address: kramerb2@ccf.org., Plitt G; Department of General Surgery, Cleveland Clinic, Cleveland, Ohio., French JC; Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio., Nygaard RM; Department of General Surgery, Hennepin Healthcare, Minneapolis, Minnesota., Cassaro S; Department of General Surgery, Kaweah Delta Medical Center, Visalia, California., Edelman DA; Department of General Surgery, Wayne State University School of Medicine, Detroit, Michigan., Lees JS; Department of General Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma., Meier AH; Department of General Surgery, State University of New York, Upstate Medical University, Syracuse, New York., Joshi ART; Department of General Surgery, Einstein Healthcare Network, Philadelphia, Pennsylvania., Johnson MP; Department of General Surgery, Virginia Mason Hospital, Seattle, Washington., Chavez J; Department of General Surgery, Doctor's Hospital at Renaissance at University of Texas Rio Grande Valley, Mission, Texas., Hope WW; Department of General Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina., Morrissey S; Department of General Surgery, Conemaugh Memorial Medical Center, Johnstown, Pennsylvania., Gauvin JM; Department of General Surgery, Cottage Hospital, Santa Barbara, California., Puri R; Department of General Surgery, University of Florida at Jacksonville, Jacksonville, Florida., LaFemina J; Department of General Surgery, University of Massachusetts Memorial Medical Center, Worchester, Massachusetts., Kang HS; Department of Surgery, Virginia Commonwealth University Health, Richmond, Virginia., Harzman AE; Department of General Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio., Jaafar S; Department of General Surgery, Brandon Regional Hospital, Brandon, Florida., Chandramouli MA; Department of General Surgery, Brookdale University Hospital and Medical Center, Brownsville, New York., Lipman JM; Department of General Surgery, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
Jazyk: angličtina
Zdroj: The Journal of surgical research [J Surg Res] 2022 Nov; Vol. 279, pp. 208-217. Date of Electronic Publication: 2022 Jun 17.
DOI: 10.1016/j.jss.2022.06.015
Abstrakt: Introduction: 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.
Results: 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).
Conclusions: 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.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: