An Evaluation of Neurosurgical Resident Education and Sentiment During the COVID-19 Pandemic: A North American Survey

INTRODUCTION Restrictions in elective surgery and large group gatherings as well as changes in faculty and resident schedules during the COVID-19 pandemic has led to rapid evolvement of the training curriculum for neurosurgical trainees. While necessary, these changes may have significant impact on the training of neurosurgery residents. METHODS A survey assessing changes to resident clinical and educational workload and their sentiment about how these changes may affect their careers was distributed electronically to neurosurgery residents in the United States and Canada. RESULTS One hundred ninety-seven resident responses were collected between April 17, 2020 and April 30, 2020. The survey respondents were spread over 29 states and Canada and were evenly spread across all residency levels (P = .619). Nearly 82% reported that the inpatient and outpatient volumes were either greatly (44.0%) or moderately (37.8%) reduced. Greater than 91% reported a significant reduction in work hours and a significant increase in resident didactics (P < .001). Nearly all residents surveyed (98.5%) reported that their program had converted to electronic platforms for their didactic lectures, and there was a significant increase in the time residents spent in didactic lectures. Residents reported converting the majority of their time outside of neurosurgery clinical responsibilities into watching remote didactic lectures, conducting research, and preparing for board examinations, while nearly 14% of trainees spent at least a portion of that time providing COVID-19 medical care. Senior residents were more likely to express concern about their educational experience as well as their future career prospects. CONCLUSION Universally, residents have experienced reduced work hours and operative case volumes. Programs have adapted by increasing didactic time and using electronic platforms. The findings suggest that senior residents may feel the effects more than their junior counterparts. This may require more acute attention from faculty with respect to preparing senior residents for moving on to fellowship or ultimate job. It is possible that this remarkable time period will prompt a critical re-appraisal of the pre-COVID-19 adequacy of educational content in our training programs, and that enhanced educational efforts driven by this pandemic may be lasting.

An Evaluation of Neurosurgical Practices During the Coronavirus Disease 2019 Pandemic.

OBJECTIVE: We sought to understand how the coronavirus disease 2019 pandemic has affected the neurosurgical workforce. METHODS: We created a survey consisting of 22 questions to assess the respondent's operative experience, location, type of practice, subspecialty, changes in clinic and operative volumes, changes to staff, and changes to income since the pandemic began. The survey was distributed electronically to neurosurgeons throughout the United States and Puerto Rico. RESULTS: Of the 724 who opened the survey link, 457 completed the survey. The respondents were from throughout the United States and Puerto Rico and represented all practices types and subspecialties. Nearly all respondents reported hospital restrictions on elective surgeries. Most reported a decline in clinic and operative volume. Nearly 70% of respondents saw a decrease in the work hours of their ancillary providers, and almost one half (49.1%) of the respondents had had to downsize their practice staff, office assistants, nurses, schedulers, and other personnel. Overall, 43.6% of survey respondents had experienced a decline in income, and 27.4% expected a decline in income in the upcoming billing cycle. More senior neurosurgeons and those with a private practice, whether solo or as part of a group, were more likely to experience a decline in income as a result of the pandemic compared with their colleagues. CONCLUSION: The coronavirus disease 2019 pandemic will likely have a lasting effect on the practice of medicine. Our survey results have described the early effects on the neurosurgical workforce. Nearly all neurosurgeons experienced a significant decline in clinical volume, which led to many downstream effects. Ultimately, analysis of the effects of such a pervasive pandemic will allow the neurosurgical workforce to be better prepared for similar events in the future.

An Evaluation of Neurosurgical Resident Education and Sentiment During the Coronavirus Disease 2019 Pandemic: A North American Survey.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous impact on the healthcare system. Owing to restrictions in elective surgery and social distancing guidelines, the training curriculum for neurosurgical trainees has been rapidly evolving. This evolution could have significant long-term effects on the training of neurosurgery residents. The objective of the present study was to assess the effects of COVID-19 on neurosurgical training programs and residents. METHODS: A survey consisting of 31 questions assessing changes to resident clinical and educational workload and their sentiment regarding how these changes might affect their careers was distributed electronically to neurosurgery residents in the United States and Canada. RESULTS: The survey respondents were from 29 states and Canada and were relatively evenly spread across all levels of residency. Nearly 82% reported that the inpatient and outpatient volumes had been either greatly (44.0%) or moderately (37.8%) reduced. Greater than 91% reported that their work responsibilities or access to the hospital had been reduced, with a significant reduction in work hours and a significant increase in resident didactics (P < 0.001). Senior residents expressed concern about their educational experience and their future career prospects as a result of the pandemic. CONCLUSION: Universally, residents have experienced reduced work hours and a reduction in their operative case volumes. Programs have adapted by increasing didactic time and using electronic platforms. It is quite possible that this remarkable period will prompt a critical reappraisal of the pre-COVID-19 adequacy of educational content in our training programs and that the enhanced educational efforts driven by this pandemic could be lasting.