Covid-19 has had a tremendous impact on lives; it has also significantly affected delivery of healthcare. An online survey of general surgery residents was conducted in the United States to examine the effect of Covid-19 on training and education of residents and its impact on burnout. The anonymous survey had 23 multiple choice questions, which dealt with resident demographics, training program type and location, plans for fellowship training, operative and clinic duties before and during the COVID-19 pandemic and effects on resident wellbeing and burnout. A change in the volume of surgical cases performed by residents in comparison to before the pandemic was taken as the primary outcome measure. Changes in the educational curricula, what was the effect of the pandemic on the preparedness for further advancement in their career and impact on wellness and burnout were the secondary outcome measures.

A total of 1102 general surgery residents participated in the survey; of these, surgical interns constituted 20% of the residents surveyed; 38.1% were senior residents (PGY 4 and PGY 5) and 41% were mid-level residents (PGY 2 and 3); 83% expressed their wish to take up a fellowship after residency. 

The survey revealed that very few cases per week were performed by the surgical residents during the pandemic. This may have been on account of elective surgeries not being taken up during the pandemic. They were also not allowed in the operating room (OR) for cases considered high-risk for Covid-19 transmission; in contrast, interns and junior residents were not even allowed to enter the OR. The overall effect of this was a further reduction of surgical experience for the residents. Almost 80% of residents reported not attending any clinic during the pandemic. Consequently, more than 40% of residents were apprehensive about not meeting the traditional Accredited Council for Graduate Medical Education (ACGME) case requirements for graduation with the current changes. Since their education had mainly shifted to online mode during the pandemic, they were also spending more time on educational didactics than before the pandemic; 80.6% of the residents surveyed had transitioned to a completely online platform for their education. 

The residents had more (≥5) days off per month, but 33.1% residents still reported more burnout than usual during the pandemic. The fear of getting the infection and transmitting it their family was revealed to be a major stressor (72.7%) for the residents.

This survey showed that the pandemic had had a major impact on the surgical training and education of residents. However, the survey did throw up a positive outcome with regard to the teaching methods adopted during the pandemic. The researchers suggest that online didactics should continue to be a part of surgical education in the post-COVID-19 era. Telemedicine has come up in a big way and will play a significant role in the post-Covid era. They also recommended that the focus should on nontechnical clinical training and professional development in terms of team work, crisis management, leadership, research, career planning, and financial literacy, so that the residents are sufficiently ready for fellowship and independent practice even with the decrease in case volumes.

Source: Aziz H, et al. J Surg Educ. Mar-Apr 2021;78(2):431-439.