A tale of two cities: Residents’ operative experience in the United Kingdom and Germany during COVID-19

Jayakumar, Nithish; Hellwig, Sönke; Allison, Callum; Stummer, Walter; Holling, Markus; Surash, Surash

Background The COVID-19 pandemic has had a detrimental effect on residents’ operative training. Our aim was to identify the proportion of procedures performed by residents across two neurosurgical centres – one in the United Kingdom (UK) and one in Germany – during the pandemic-affected months of March 2020-May 2020, inclusive, in comparison to March 2019-May 2019, inclusive. Methods All neurosurgical procedures performed at the UK and German institutions, between 01/03/2019-31/05/2019 (pre-COVID months) and 01/03/2020-31/05/2020 (COVID-months), were extracted and operative notes evaluated. Statistical analysis was performed on SPSS v22 (IBM). Results There was a statistically significant reduction in operative volume in the UK centre from the pre-COVID months to the COVID-months (χ2(5)=84.917; p<0.001) but no significant difference in the operative volume in the German centre (p=0.61). Mann-Whitney U test demonstrated a statistically significant difference in the volume of resident operating in the COVID-months compared to pre-COVID months in both UK and German centres (p<0.001). Average number of procedures performed by residents in the UK centre as the primary surgeon fell from 82 to 72 per month (pre-COVID vs COVID-months) whereas German residents’ operating volume increased from 68 to 89 per month (pre-COVID vs COVID-months). Conclusions The COVID-19 pandemic has significantly reduced the volume of operating by neurosurgical residents in the UK centre whereas residents in the German centre performed more procedures compared to 2019. This may reflect variations in national practice on maintaining surgical activities and provision of critical care beds during the first wave of the pandemic.