The Effects of COVID-19 on General Surgery Residency Programs in the United States

Kansas Journal of Medicine (09/25/23) Vol. 2023, No. 16, P. 228 Foerster, Katherine; Fischer, Karl; Nguyen, Michael; et al.

A recent survey explored how the COVID-19 pandemic affected U.S. general surgery residency programs. In the survey, residency program directors and coordinators were asked to evaluate COVID's impact in the early months of the pandemic. In total, 132 of 303 contacted programs completed the survey. According to the data, residents in nearly 30% of the responding programs were asked to work in fields outside of their specialty. Twenty-nine programs placed residents in a critical care unit; nine assigned them to internal medicine; four put them in the emergency department; two placed them in pulmonary units; and one program each placed them in trauma, nephrology, specially-created wards and the line team. One or more residents within 96 programs tested positive for COVID during the study period, while 81.8% of the responding programs said residents routinely cared for COVID-positive patients. Programs whose residents provided such care said they did so because of staffing needs, resident redeployment strategies and consultations to perform procedures. Meanwhile, programs in which residents were not involved in COVID-positive patient care cited little need, residency policy and preservation of personal protective equipment as reasons. Roughly one-third of the responding programs said the pandemic led to curricular changes in areas including conference frequency and format, educational content, systems and schedules and coping assistance. Approximately a quarter of the respondents said they had already incorporated epidemiologic training into their curriculum, with 26.5% planning to embed additional material. Although 63.6% of the programs reported no curricular changes, 76.5% acknowledged changes to their Morbidity and Mortality conference or other academic conferences. Resident schedule changes were reported by 81.1% of the respondents, mainly to limit resident-patient exposure, boost intensive care unit coverage or enhance resident utilization. The study authors learned the pandemic also challenged residents' ability to meet graduation requirements. Most programs reported a pandemic-fueled decline in surgical caseloads, while just 31.8% said the pandemic impacted residents accommodation of required caseloads. The researchers suggest residency programs could use the survey's conclusions to inform planning for future pandemics.

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