ABSTRACT
Background and study aims The COVID-19 pandemic has had a profound impact on gastroenterology training programs. We aimed to objectively evaluate procedural training volume and impact of COVID-19 on gastroenterology fellowship programs in the United States. Methods This was a retrospective, multicenter study. Procedure volume data on upper and lower endoscopies performed by gastroenterology fellows was abstracted directly from the electronic medical record. The study period was stratified into 2 time periods: Study Period 1, SP1 (03/15/2020 to 06/30/2020) and Study Period 2, SP2 (07/01/2020 to 12/15/2020). Procedure volumes during SP1 and SP2 were compared to Historic Period 1 (HP1) (03/15/2019 to 06/30/2019) and Historic Period 2 (HP2) (07/01/2019 to 12/15/2019) as historical reference. Results Data from 23 gastroenterology fellowship programs (total proceduresâ=â127,958) with a median of 284 fellows (range 273-289; representing 17.8â% of all trainees in the United States) were collected. Compared to HP1, fellows performed 53.6â% less procedures in SP1 (total volume: 28,808 vs 13,378; mean 105.52â±â71.94 vs 47.61â±â41.43 per fellow; P â<â0.0001). This reduction was significant across all three training years and for both lower and upper endoscopies ( P â<â0.0001). However, the reduction in volume was more pronounced for lower endoscopy compared to upper endoscopy [59.03â% (95â% CI: 58.2-59.86) vs 48.75â% (95â% CI: 47.96-49.54); P â<â0.0001]. The procedure volume in SP2 returned to near baseline of HP2 (total volume: 42,497 vs 43,275; mean 147.05â±â96.36 vs 150.78â±â99.67; P â=â0.65). Conclusions Although there was a significant reduction in fellows' endoscopy volume in the initial stages of the pandemic, adaptive mechanisms have resulted in a return of procedure volume to near baseline without ongoing impact on endoscopy training.