Assessing the Early Impact of the COVID-19 Pandemic on Spine Surgery Fellowship Education

Abstract

Study Design: This was a cross-sectional study. Objective: The objective of this study is to report the impact of COVID-19 on spine surgery fellow education and readiness for practice. Summary of Background Data: COVID-19 has emerged as one of the most devastating global health crises of our time. To minimize transmission risk and to ensure availability of health resources, many hospitals have cancelled elective surgeries. There may be unintended consequences of this decision on the education and preparedness of current surgical trainees. Materials and Methods: A multidimensional survey was created and distributed to all current AO Spine fellows and fellowship directors across the United States and Canada. Results: Forty-five spine surgery fellows and 25 fellowship directors completed the survey. 62.2% of fellows reported >50% decrease in overall case volume since cancellation of elective surgeries. Mean hours worked per week decreased by 56.2%. Fellows reported completing a mean of 188.4±64.8 cases before the COVID-19 crisis and 84.1% expect at least an 11%–25% reduction in case volume compared with previous spine fellows. In all, 95.5% of fellows did not expect COVID-19 to impact their ability to complete fellowship. Only 2 directors were concerned about their fellows successfully completing fellowship; however, 32% of directors reported hearing concerns regarding preparedness from their fellows and 25% of fellows were concerned about job opportunities. Conclusions: COVID-19 has universally impacted work hours and case volume for spine surgery fellows set to complete fellowship in the middle of 2020. Nevertheless, spine surgery fellows generally feel ready to enter practice and are supported by the confidence of their fellowship directors. The survey highlights a number of opportunities for improvement and innovation in the future training of spine surgeons. Level of Evidence: Level III.

What is The Impact of The COVID-19 Pandemic on Residency Training: A Systematic Review and Analysis

“…The majority of the studies were published in countries severely affected by the pandemic, and therefore, medical education and residency training were substantially affected in these countries. Fewer elective operations because of policies established during the pandemic were noted in some specialties, such as urology, orthopedics, plastic surgery, and diagnostic angiography (11)(12)(13)(14). The policies of lockdown and quarantine reduced patient volume for some diseases, such as trauma and infectious diseases, which induced less clinical exposure (15,16).…”

“…Surgical specialties were the most and rst affected. Elective surgeries were cancelled or postponed during the pandemic, providing less practice and experience for the residents (11,13,14,16). Additionally, residents in surgical specialties were redeployed to manage patients with COVID-19 or perform other work due to medical resource reallocation, disrupting their original surgical training courses.…”

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

“…Surveys of residents from both HMICs and LMICs reported decreased operating volumes, resident participation in operative procedures and time spent in the OR [4,[10][11][12][13][14][15][16][17]. A survey done with trainees in 5 Southeast Asian nations showed a significantly greater reduction in elective cases in Indonesia and the Philippines (P < 0.001), the latter of which also contained the most respondents (76%), reporting closure of outpatient clinics, with the median duration of closure being 8 weeks [18].…”

“…Trainees in the USA, although not reportedly concerned about the completion of their fellowships, manifested a slight concern with regard to their future jobs [17]. Conversely, the general concerns of neurosurgical trainees in Asian LMICs have been revolving around ideas related to career progression, examinations being deferred and to decreased training in terms of the clinical and operative skills required in the operating theatre [13,18].…”

Adult Hip and Knee Reconstruction Education during the COVID-19 Pandemic

“…In multiple subspecialties, there have been concerns that the decrease in the volume of cases caused by the pandemic would prevent trainees from meeting Accreditation Council for Graduate Medical Education (ACGME) case minimums 1 , 2 , 3 , 4 , 5 , 6 . Several orthopaedic surgery fellowships, including adult reconstruction 7 , spine 8 and sports medicine 9 , have noted significant decreases in case volumes.…”