ABSTRACT
Background: The aim of this study was to quantify trainees' operative volume and assess the effect of the first wave of COVID-19 on general surgery residents' training at a Canadian academic centre. An observational study was performed, focusing on objective operative volumes, hands-on experience, and subjective perceived impact of the pandemic by trainees. Methods: All residents enrolled in our program were included. Quantitative data were collected from anonymized residents' case logs and annual departmental statistics. Qualitative data on residents' perception of the impact of the pandemic was provided by a resident-led focus group. The period of interest, the first wave of the COVID-19 pandemic (January-June 2020), was compared with a reference period (January-June 2019). Case logs of all 21 residents were reviewed. Results: During the first wave of the COVID-19 pandemic, residents logged a total of 475 cases, compared with 914 cases before the pandemic. This represents a decrease of 48% in operative volume;junior residents saw a decrease of 50% and senior residents saw a decrease of 46%. Postgraduate year (PGY)-1 residents were most affected, with a reduction of 58% in operative volume. PGY-4 was the group least affected with a reduction of 37%. When looking at key procedures, junior residents performed 71% fewer laparoscopic appendectomies and 49% fewer laparoscopic cholecystectomies during the pandemic. Senior residents saw a reduction of 55% in lower anterior resections and a reduction of 58% in right hemicolectomies compared with reference period. The resident focus group discussion revealed that 92% of residents think the pandemic had significant drawbacks on their surgical skills and they unanimously reported an overall negative perceived effect on their training. Conclusion: The data provided by this study demonstrate how much the pandemic compromised hands-on exposure of all residents. The reduction in operative volume affected all years of training, especially junior years. This raises concern about the short- and long-term effects on trainees' technical skills. The insights brought by this study will help create personalized mitigating measures and guide future curricula to be more resilient in the face of a next sanitary crisis.