Repurposing a Small Community Hospital Surgical Residency Program in an Epicenter of the COVID-19 Pandemic

Abstract

Background COVID-19 put a stop to the operative experience of surgical residents, leaving reassignment of the team, to the frontlines. Each program has adapted uniquely; we discuss how our surgical education changed in our hospital. Study Design A retrospective review of changes in general surgery cases, bedside procedures, and utilization of residents before and during the pandemic. Procedures were retrieved from electronic medical records. Operating room (OR) cases 1 month before and 5 weeks after the executive order were collected. Triple lumen catheter (TLC), temporary hemodialysis catheter (HDC), and pneumothorax catheter (PC) insertions by surgical residents were recorded for 5 weeks. Results Before the pandemic, an average of 27.9 cases were done in the OR, with an average of 10.1 general surgery cases. From March 23 to April 30, 2020, the average number of cases decreased to 5.1, and general surgery cases decreased to 2.2. Elective, urgent, and emergent cases represented 83%, 14.6%, and 2.4% prior to the order and 66.7%, 15.1%, and 18.2%, respectively, after the order. Bedside procedures over 5 weeks totaled to 153, 93 TLCs, 39 HDCs, and 21 PCs. Conclusion Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. We worked with other departments to allocate our team to areas of need and re-evaluated daily. The strengths of our team to deliver care and perform many bedside procedures allowed us to meet the demands posed by this disease while remaining as a cohesive unit.

What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis

“…The majority of residents reported that the impact of COVID-19 in their training was severe. 37 Melissa K Meghpara (Nov. 2020) [ 45 ] Surgery Non- questionnaire – > 1,000,000 Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. The strengths of the repurposing allowed the team to meet the demands posed by the pandemic.…”

“…However, these questionnaire studies had some limitations, such as subjective questions, voluntary response bias, and heterogeneity of respondents and institutional bias, which may limit their generalizability [ 74 ]. Only nine studies had conducted objective investigations and had “real numbers” comparing the prepandemic and pandemic periods [ 17 , 31 , 36 , 39 , 45 , 49 , 50 , 54 , 61 ]. These studies indicated the severity of the effect and identified domains that were affected.…”

The impact of coronavirus 2019 on general surgery residency: A national survey of program directors

“…In order to preserve personal protective equipment, reallocate resources and staff, and minimize exposure to the patient and hospital employees, surgical interventions were limited to emergent and urgent cases during the initial surge of the pandemic [ 1 ]. Simultaneously, general surgery residents have a unique and broad skillset that encompasses in-depth knowledge of critical care and bedside procedures (e.g., central lines) that make them an invaluable resource during these demanding times [ 8 ]. As seen in the presented data, this led to dramatic changes in clinical assignments, operative experience, and the educational format for general surgery residents.…”