COVID-19 Elective Surgery Shutdown and Operative Experience for Graduating Plastic Surgery Independent Residents

Abstract

Introduction The initial wave of the COVID-19 pandemic led to a temporary shutdown of elective procedures. The purpose of this study is to evaluate how the elective surgery shutdown impacted case log numbers for graduating plastic surgery independent residents. Methods The Accreditation Council of Graduate Medical Education graduate self-reported case logs were retrospectively compiled for graduating independent track plastic surgery residents for the year before the pandemic (2019), 4 months into the pandemic (2020) and 16 months into the pandemic (2021). Procedures were grouped into resident review committee area and totals for each area were used for analysis. Average number of cases and standard deviations were compiled. Percent change was calculated comparing each year to the prepandemic baseline. Statistical significance was determined with Student t tests comparing average number of cases. Coefficients of variation were calculated to assess for changes in interprogram variation. Average case numbers were then compared with minimum case requirements necessary for graduation. Results The Accreditation Council of Graduate Medical Education graduation case log statistics were available for 238 independent residents. There were no statistically significant differences in average case number for graduating independent residents for total reconstructive breast, trunk, hand and upper extremity, or total reconstructive procedures between graduation years. The average case number of total lower extremity reconstruction increased from 2019 to 2020 (average = 83–97.4, P = 0.02). The average total number of breast aesthetic cases increased between all years (average = 92, 98, 114), with the average increase from 2019 to 2021 being statistically significant (P = 0.02). Differences in head and neck aesthetic deformities and trunk and extremity deformities between years were not statistically significant. The average case number for all graduating plastic surgery independent residents exceeded the minimum case log requirements. Conclusions The temporary hold on elective procedures during the pandemic decreased the opportunity for plastic surgery trainees to meet minimum case log requirements. Case log data for graduating plastic surgery independent residents demonstrate that despite the temporary suspension, the pandemic did not greatly impact the average resident case numbers.

Shifts in Reduction Mammaplasty Surgical Volumes With the Emergence of a Global Pandemic

“…However, the findings in our study highlight that even with no significant change in case volume for those initial months, there was still an increase in cases after the peak of the pandemic. These findings were reflected in the procedure logs among plastic surgery residents, which demonstrate that despite the halt on surgeries, the pandemic did not impact the average resident case numbers, which continued on an upward trajectory, unlike what was observed for other specialties 36,37 . In fact, operative volume for plastic surgery residents remained higher than for orthopedic, neurosurgery, and general surgery, especially in the 2 years after March 2020 38 .…”

“…These findings were reflected in the procedure logs among plastic surgery residents, which demonstrate that despite the halt on surgeries, the pandemic did not impact the average resident case numbers, which continued on an upward trajectory, unlike what was observed for other specialties. 36,37 In fact, operative volume for plastic surgery residents remained higher than for orthopedic, neurosurgery, and general surgery, especially in the 2 years after March 2020. 38 This evidence, along with what our data present, shows that institutions performing plastic surgery with and without residency programs have experienced a wave in plastic surgery procedures leading researchers to target the potential factors that may be driving this growth.…”

The Influence of Training Pathway, Institution Type, Gender, and a Global Pandemic on Post Graduation Career Plans in Plastic Surgery

“…Previous studies have examined the effects of the pandemic on plastic surgery trainees' education; programs have had to shift to virtual learning, and residents performed fewer cases during the initial part of the pandemic. [9][10][11]15 The pandemic also affected resident wellness negatively. [12][13][14][15][16] However, despite the shutdown of elective and limitation of semielective cases, one study found that graduating independent residents in 2020 did not have significantly different case numbers than residents graduating before or after.…”

“…Additionally, although studies have been done on the effect of the COVID-19 pandemic on plastic surgery trainees, few, (if any) have looked at the impact of a global pandemic on career choices of plastic surgery residents. 9–16…”

“…Additionally, although studies have been done on the effect of the COVID-19 pandemic on plastic surgery trainees, few, (if any) have looked at the impact of a global pandemic on career choices of plastic surgery residents. [9][10][11][12][13][14][15][16] The goal of this study was to investigate immediate postgraduation career choices of plastic surgery residents from 2018 to 2022 and to see if factors such as training pathway, institution type (public versus private), or institution rank had any impact on postgraduation plans. A secondary goal was to determine if the COVID-19 pandemic had any measurable impact on postgraduation career plans, dividing trainees into pre-COVID- 19 (2018-2019) and post-COVID-19 (2020-2022) cohorts.…”