Shifting the Surgical Residency Match to a 100% Virtual Interview Format During the COVID-19 Pandemic, How has It Affected Placement Into Surgical Training Programs?

INTRODUCTION: The AAMC transitioned to virtual interview formats for the 2020-2021 residency match. This study aims to examine the impact of the 100% virtual interview format for the 2020-2021 residency match on both application and match changes for multiple surgical specialties, including neurosurgery (NS), orthopedic surgery (OS), plastic surgery (PS), general surgery (GS), thoracic surgery (TS), and vascular surgery (VS). METHODS: Cross-sectional study comparing application and match changes between the in-person 2019-2020 and virtual 2020-2021 residency match cycles for different surgical specialties. RESULTS: There was an overall increase in the number of applicants for 5 of the surgery specialties but not VS, and an overall increase in the number of applications per residency program across all specialties. The average number of applications per applicant also increased, except in TS. There were no major match changes except in TS, which saw an increase in number of spots filled by MDs to nearly 100% from 84.2% in the previous cycle. CONCLUSION: The switch to the 100% virtual 2020-2021 residency match interview format was associated with an overall increase in the number of applications per program and number of applications per applicant across multiple surgical specialties. There was a decrease in the number of applicants to VS and an increase in the number of applications per applicant. The switch to a virtual interview format in 2020-2021 was also associated with an increase in TS spots filled by MDs to almost 98%, increasing the already concerning TS match disparity for DO and IMG applicants.

Changing Teaching Trends During Covid-19 And Its Impact On Ent Residency Program In India: A Cross Sectional Study.

Introduction: The COVID-19 pandemic has presented an unmatched challenge to the ENT residency programs to adapt to a form of web-based learning process and stimulation-based training. It also focuses on the mental stress underwent and the viewpoint of the residents to the paradigm shift in clinical care and academics. Methods: An anonymous questionnaire was created in an online survey generator with 22 questions with limited options (yes/no) and was circulated through email and what's app which has been responded to by 240 ENT residents throughout the country. The questionnaire was divided into five sections, demographics, knowledge about COVID-19 and its management, impact on clinical activity, academics and mental well-being section. Results: Out of 240 respondents, 190(79.2%) were junior residents and 50(20.8%) were senior residents. Although many of them knew the necessary precautions to be taken, 94(39.8%) turned out to be positive themselves with the high fear of transmitting to their family members. Three-fourth participants suggested extending the training period after graduation for the loss incurred. However, half of them sought an opportunity to train themselves for the management of communicable disease, 95% of the residents opined that they are having a negative impact on the job performance due to loss of surgical hands-on which has been drastically reduced. Conclusion: The issues mentioned have been addressed through STEPs - Safety of the residents, Time utilisation by research, Education continuation by online web learning and stimulatory programs, psychological support for mental well-being. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03377-7.

Impact of the COVID-19 pandemic on the training of general surgery residents: Surgical training and the COVID-19 pandemic.

Background: The educational process of young doctors should be a topic of high interest, since it is central to preparing the new generations of healthcare providers. The COVID-19 pandemic has affected the medical system on multiple levels, including medical education. Methods: We conducted a descriptive survey study, designed to reflect the impact of the pandemic on the training of general surgery residents. Two questionnaires were delivered to general surgery residents at two different periods: one in the pre-COVID-19 era (December 2019) and one in the COVID-19 era (December 2020). Data were gathered on participants' characteristics, current clinical practice and knowledge, extracurricular activities, and involvement in the management of COVID-19 cases. Results: We registered 33 responses in the pre-COVID-19 era and 45 responses in the COVID-19 era. Most participants felt that the pandemic significantly affected their training in classic and laparoscopic surgery. The number of days per week that the residents were active in the operating room and the possibility of training in laparoscopic surgery outside the hospital decreased significantly in the COVID-19 era. Most participants consider they have not gained sufficient knowledge to practice laparoscopic surgery or to assure their employment in another hospital after finishing their residency program. Conclusion: The pandemic reduced the hands-on activities of general surgery residents, while training in laparoscopy was deficient both before and during the pandemic. New training methods should be sought and used in order to adapt the educational system to the current context.

The impact of the COVID-19 pandemic on surgical education: A survey and narrative review.

Background: Since the emergence of the COVID-19 pandemic, medical education has been a concerning issue, especially in surgical fields. Due to the postponement of many elective surgeries and even alternations in the pattern of emergent surgeries, concerns have been raised about whether residents of surgical disciplines are experienced enough after graduation or not. We aimed to describe the impact of the COVID-19 pandemic on surgical residency training in different fields. Materials and methods: We conducted a cross-sectional study with a 20-item questionnaire on residents of surgical disciplines from three different educational hospitals of Tehran University of Medical Sciences, Iran in 2020. In addition, we reviewed the current literature regarding the impact of COVID-19 pandemic on surgical education worldwide. Results: Our survey, with a response rate of 56.8% demonstrated significant reduction in the time spent in elective surgeries, surgical clinics and even in emergent surgeries for residents. Besides, it has reported that significant time has been spent in COVID 19 wards which resulted in decreased satisfaction of educational activities. Conclusions: The impacts of COVID 19 pandemic on surgical education are significant and inevitable. Thus, we must integrate novel educational methods in surgical curriculum to optimize training and minimize the adverse effects of the pandemic on surgical education.

Impact of COVID-19 on surgical residency training programs in Mexico City: The third victim of the pandemic. A resident's perspective.

OBJECTIVE: The aim of this study is to assess the perceptions of the impact of health-care disruption due to COVID-19 on the academic training and skills of surgical trainees. MATERIAL AND METHODS: We developed a 32-question survey assessing the clinical and surgical impact of COVID-19 on surgical training programs and proposals to compensate for the decrease in surgical education. We got 453 responses of surgical trainees in Mexico City. RESULTS: Sixty-six percent of the respondents answered that their centers had converted to the exclusive attention of COVID-19 patients. Ninety-five percent reported a decrease in surgical skills learning and 91.8% reported a decrease to clinical exposure. On proposals, 75.6% reported that it is essential to take the necessary measures to recover the clinical and surgical milestones lost. In the binary logistic regression analysis, we found that the postgraduate year (≥ PG-Y3) was statistically significant factor (p ≤ 0.000) related to a favorable opinion to developing an academic contingency plan and postponing the end of the academic residency year. CONCLUSION: More than 90% of the survey respondents reported having been affected by COVID-19 mitigation strategies. Our data calls for urgent training adjustments by hospital and university program leaders to mitigate downstream educational repercussions.

OBJETIVO: Evaluar las percepciones del impacto de la interrupción de la atención médica por COVID-19 en la formación académica y las habilidades de los residentes quirúrgicos. MATERIAL Y MÉTODOS: Realizamos una encuesta de 32 preguntas, evaluando el impacto clínico y quirúrgico del COVID-19 en los programas de entrenamiento quirúrgico y propuestas para compensar la disminución de la educación quirúrgica. Obtuvimos 453 respuestas de residentes quirúrgicos en la Ciudad de México. RESULTADOS: El 66% respondió que sus centros se convirtieron en atención exclusiva de pacientes con COVID-19. El 95% presentó una disminución en el aprendizaje de habilidades quirúrgicas y el 91. 8% presentó una disminución de la exposición clínica. El 75.6% consideró fundamental tomar las medidas necesarias para recuperar las destrezas clínicas perdidas. En el análisis de regresión logística binaria, encontramos que el año de posgrado (> PG-Y3) fue un factor estadísticamente significativo (p <0,000) relacionado con una opinión favorable para desarrollar un plan de contingencia académica y posponer el final del año de residencia académica. CONCLUSIÓN: Más del 90% de los encuestados fueron afectados por las estrategias de mitigación de COVID-19. Nuestros datos exigen ajustes urgentes por parte de los líderes de programas de hospitales y universidades para mitigar las repercusiones educativas posteriores.

Recovery of Surgical Training Through Extended Laparoscopic Simulation Training.

Introduction The coronavirus disease 2019 (COVID-19) pandemic has adversely affected surgical training internationally. Laparoscopic surgery has a steep learning curve necessitating repetitive procedural practice. We evaluate the efficacy of short- and long-duration simulation training on participant skill acquisition to support the recovery of surgical training.  Methods A prospective, observational study involving 18 novice medical students enrolled in a five-week course. Nodal timed assessments involved three tasks: hoop placement, stacking of sugar cubes and surgical cutting. One month post-completion, we compared the ability of six novice course participants to that of six surgical trainees who completed a smaller portion of the course curriculum. Results Course participants (n=18) completed tasks 111% faster on their third and last course attempt. The surgical trainee group (n=6) took 46% longer to complete tasks compared to the six re-invited course participants, whose ability continued to advance on their fourth effort with a combined 154% earlier completion time compared to try one. Conclusions This study supports the adoption of a structured, extended, regular and spaced-out simulation course or curriculum to cultivate greater skill acquisition and retention amongst surgical trainees, and improve patient care.

Effects of pandemic on training programs in surgery: problems and solutions / Efectos de la pandemia en los programas de formación en cirugía: problemas y soluciones

Resumen La pandemia por el virus SARS-CoV-2 ha afectado fuertemente los programas de educación quirúrgica. El Capítulo Chileno del American College of Surgeons realizó un webinar para evaluar y discutir los efectos de la pandemia en la educación quirúrgica. Este evento contó con la asistencia de 450 personas de 17 países, incluyendo la participación de destacados docentes del área quirúrgica. Las principales conclusiones de este webinar fueron que la pandemia alteró considerablemente los programas de educación quirúrgica. Un 26% de los residentes se contagiaron, pero la mayoría no precisó cuidados especiales. Las intervenciones quirúrgicas disminuyeron hasta en un 90% en algunos programas. Los residentes debieron asumir el cuidado de pacientes COVID-19. Se han implementado sistemas de enseñanza virtual, como seminarios en línea o webinars, discusión de casos clínicos, videos y simulación. Dichas actividades teóricas, al igual que la simulación quirúrgica fueron evaluadas, mayoritariamente, vía web. Las sociedades científicas han tenido un importante rol en estas actividades. En el futuro, los programas universitarios enfrentarán escenarios con menos pacientes y una reducción de las oportunidades de enseñanza para residentes. Las actividades en línea y simulación adquirirán mayor relevancia. Es posible superar esta crisis como lo han hecho los países desarrollados, comparados con ellos, carecemos de un plan nacional de emergencia en salud, en el que los estudiantes y personal sanitario tengan un rol definido en áreas específicas, con metas concretas. El retorno a la "nueva normalidad" estará lleno de desafíos.

The SARS-CoV-2 pandemic has had an impact in surgical residency programs. The Chilean chapter of the American College of Surgeons organized a webinar to discuss and address the effects of this pandemic on surgical education. This meeting had a virtual attendance of 450 people from 17 countries, including the participation of surgical educators. Conclusions of this webinar were that COVID-19 has strongly affected surgical education programs. Twenty six per cent of residents were infected. Most of them did not need special care. Surgical opportunities have decreased up to 90% in some programs. Residents have had to be involved in managing COVID-19 patients. Changes in surgical education, led to a virtual instruction which includes seminars, webinars, case discussion, videos and simulation. Assessment has been performed of theoretical activities, via web. Simulation tasks also have been evaluated. Scientific societies had a very important role in these activities. In the near future, university programs will face different scenarios in hospitals and clinical centers, with fewer patients and reduced clinical instruction for residents. Online activities and simulation will increase in relevance in years to come. It is possible to overcome this crisis, as some developed countries have already done, compared to them, we lack a national emergency health plan in which medical students, residents, doctors, and all health care providers have a designated role in specific areas with clear goals. The return to "the new normal" will be filled with challenges.

Surgical Education and Training during the COVID-19 Pandemic: Strategies and Solutions for Pakistan.

The coronovirus disease-2019 pandemic has severely impacted surgical education and training in Pakistan and worldwide, causing problems, such as risk of infection, limited hands-on training, examination delays, and trainee redeployment to non-surgical specialties. The current review was planned to describe innovative strategies adopted by surgical training programmes worldwide in order to suggest comprehensive recommendations at the level of the College of Physicians and Surgeons Pakistan and individual institutions to counter the challenges presented by the pandemic in Pakistan. The innovative use of technology, including open-access online educational portals, virtual educational activities and simulation-based learning, can help reform education delivery during the pandemic. Hospitals' implementation of "shift schedules" for rotations helps continue training while minimising risks. Moreover, examination boards and residency programmes must appropriately tailor their eligibility criteria and assessment processes to the current situation. Lastly, it is vital to safeguard trainees' mental wellness during the pandemic and after by ensuring readily available professional psychological support when needed.

COVID-19 and jeopardy of a trainee in the era of minimally invasive surgery.

COVID-19 pandemic had a global impact on residency training and surgical training had seen the worst hit. In the current era, the minimal invasive surgery has become inherent component of any surgical speciality training and the COVID-19 crisis has affected the various components of this training including acquisition of knowledge, clinical judgement and technical competency. This impact, coupled with uncertainty in future training and job opportunities have jeopardized the current surgical trainees.

Promoting Access of Osteopathic Medical Students to Surgical Residency Training Programs.

The COVID-19 pandemic has uncovered disparities for allopathic and osteopathic surgical applicants for the upcoming 2021 residency application cycle. It has provided an opportunity for change to the current paradigm in surgical resident selection. This study seeks to quantify the disproportionality of opportunities between allopathic and osteopathic students and provides solutions to level the playing field for all applicants.

Surgical Residents in the Battle Against COVID-19.

PERSPECTIVES: In times of public health crises, medical residency program leaders are responsible to maintain the wellbeing of their residents and ensure uninterrupted training. COVID-19 caused significant impact on healthcare industry, depleting resources and manpower, which led to disruption to graduate medical education and residency training. Surgical residents were affected by the pandemic both by reduced operative opportunities in most training centers and inducing stress and concerns about safety and wellbeing among residents. Spread of the SARS-Cov-2 was naturally accompanied with a gradual decrease in numbers of healthcare personnel which consequently increased the burden on residents. During these times of crisis and uncertainty, it is crucial that residency programs find alternative learning opportunities and deploy pre-designed, dynamic operational strategies to ensure high quality surgical services while optimizing resident safety and wellbeing. The COVID-19 crisis was a natural call for the essential need to add another dimension to residency competencies, which is Crisis-based learning and practice. Times of public health crisis are opportunities to reflect on the medical practice from an interdisciplinary and interprofessional perspective and train the residents to function as part of a larger, globally responsible team. It also calls upon adopting innovative instructional and learning strategies such as utilizing digital and online learning tools to complement learning. A holistic approach to the crisis was taken by the surgical residency program at the University of Illinois in Chicago, which addressed the issue from a resident, hospital, and public health standpoints. An operational strategy was introduced to optimize resident safety, maximize learning opportunities, support other non-surgical services, and promote online teaching and learning. This strategy is meant to serve as a dynamic reference for surgical residency programs and as an infrastructure for dealing with this and any upcoming healthcare crises in an efficient and resident-centered way.

Impact of COVID-19 on surgical residency programs in Pakistan; A residents' perspective. Do programs need formal restructuring to adjust with the "new normal"? A cross-sectional survey study.

BACKGROUND: Due to high-risk exposure of surgical residents to coronavirus, surgical residency programs have changed their training methods and working hours drastically. The purpose of this study is to find out the positive and negative impacts of the pandemic on surgical residency programs and on the lives of surgical residents. MATERIALS AND METHODS: A cross-sectional study was conducted on 112 surgical residents of a tertiary care hospital in Pakistan, with a mean age of 30.5 years from all the departments of surgery using a self-made, validated 40-point questionnaire comprising three sections. The last section also included modified Maslach Burnout inventory. RESULTS: Of all the residents, 97 (86.6%) stated that their surgical hands-on duration is adversely affected by the pandemic. As for clinical exposure, 92 (82.1%) trainees responded that their clinical exposure is affected too. Among all the subjects, 69 (61%) were concerned about transmitting it to their family members and 43 (38.4%) affirmed on being afraid of dying because of their direct exposure. On the brighter side, the average number of working hours per week for surgical residents were reduced from 81.10 ± 6.21 to 49.16 ± 6.25 (p < 0.001) due to the outbreak. Modified Maslach Burnout inventory score was 8.33 ± 2.34 after the outbreak, showing statistically significant reduction in burnout among the surgical residents (p < 0.001). CONCLUSION: The changes in the surgical residency programs amidst the pandemic has reduced the working hours, hands-on and clinical exposure of the surgical residents. Moreover, the situation has provided an opportunity to explore efficient methods of learning that can lead to lesser burnout. However, psychological burdens of surgical residents like fear of acquiring the infection should be appropriately addressed.