The Impact of COVID-19 on Surgical Training and Education

Cutting Ties: General Surgery Residents Have Higher Attrition Rates Than Residents in Other Surgical Training Programs

OBJECTIVE

Attrition rates among general surgery residents are notoriously high relative to other specialties. The aim of this study was to compare annual resident attrition rates between general surgery and other surgical subspecialties and to examine these trends in recent years.

DESIGN

This was a retrospective study performed using Accreditation Council for Graduate Medical Education (ACGME) Data Resource Books from 2012-2022. Annual attrition rate and average ten-year attrition rate were calculated for general surgery and surgical specialties. Differences were assessed by Pearson chi-square test.

SETTING

All ACGME accredited residency programs in the United States were included.

RESULTS

General surgery residencies had a significantly higher average annual attrition rate (3.3%) than all other surgical specialties studied except thoracic surgery. Most attrition among general surgery residents was voluntary and these rates did not appear to be affected by the COVID-19 pandemic.

CONCLUSIONS

Attrition among general surgery residents is higher than in other surgical specialties, suggesting that early specialization may be protective against resident attrition.

Impact of COVID-19 on surgical exposure and training for general surgery trainees in Australia: a national audit

PURPOSE

The COVID-19 pandemic has caused a major disruption in operative volumes over the last few years, which has directly impacted on surgical training. This study aims to quantify the impact of COVID-19 and the relevant restrictions on General Surgery trainees in Australia.

METHODS

Logbook data of General Surgery trainees from 2019 to 2021 was analysed and compared to assess the impact of COVID-19 on operative numbers and supervision levels during major operations.

RESULTS

There was a statistically significant reduction in overall operative numbers in Australia, with a decrease of 2.0% in 2020 (IRR 0.980, 95% CI 0.973-0.986, P < 0.001) and 6.8% in 2021 (IRR 0.932, 95% CI 0.926-0.938, P < 0.001). Elective operations reduced by 6.6% in 2020 (IRR 0.934, 95% CI 0.927-0.942, P < 0.001) and 10.3% in 2021 (IRR 0.934, 95% CI 0.927-0.942, P < 0.001). Victoria and NT were the most affected jurisdictions; while hepatobiliary, trauma and surgical oncology were the most affected subspecialties. The proportion of overall primary operating has significantly decreased (41.8% vs. 40.2%, P < 0.001) between 2019 and 2020, and decreased further to 39.7% in 2021.

CONCLUSION

The COVID-19 pandemic has had an overall negative impact on surgical training in General Surgery. Efforts should be directed at minimizing detraining of trainees and further disruptions to their training.