Early changes to neurosurgery resident training during the Covid-19 pandemic at a large United States academic medical center

Burks, Joshua D.; Luther, Evan M.; Govindarajan, Vaidya; Shah, Ashish H.; Levi, Allan D.; Komotar, Ricardo J.

Introduction The 2019 coronavirus disease (Covid-19) pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The impact of safety measures on neurosurgical training remains unclear. To understand how neurosurgical residents have been affected, the authors analyze operative experience in months leading up to and during the pandemic. Materials and Methods Resident and institutional case totals were tallied for a single residency program in Miami-Dade County, USA from January 01, 2019 to June 30, 2020. Matched cohort analysis was performed before and during the pandemic to assess effect on resident surgical training. Results Case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases were logged in April 2020, down from 26 in April 2019 (mean 8.7 – 22, 95% CI; p <0.01), and an average of 20 cases was logged in May 2020, down from 25 in May 2019 (mean 1.2 – 8.8, 95% CI; p = 0.01). In April 2020 there were 299 (66%) fewer cases performed at our institution compared to the year prior, and in May 2020 there were 148 (50%) fewer cases. Conclusions Operative experience was reduced for residents during months when elective cases were restricted. Our data suggests experience in some areas of neurosurgery are more impacted than others, and residents at different levels of training are affected differently. However, the extent of the Covid-19 Pandemic on neurosurgical training is unlikely to be understood in the short-term