An Evaluation of Neurosurgical Resident Education and Sentiment During the Coronavirus Disease 2019 Pandemic: A North American Survey

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a tremendous impact on the healthcare system. Owing to restrictions in elective surgery and social distancing guidelines, the training curriculum for neurosurgical trainees has been rapidly evolving. This evolution could have significant long-term effects on the training of neurosurgery residents. The objective of the present study was to assess the effects of COVID-19 on neurosurgical training programs and residents.

Methods: A survey consisting of 31 questions assessing changes to resident clinical and educational workload and their sentiment regarding how these changes might affect their careers was distributed electronically to neurosurgery residents in the United States and Canada.

Results: The survey respondents were from 29 states and Canada and were relatively evenly spread across all levels of residency. Nearly 82% reported that the inpatient and outpatient volumes had been either greatly (44.0%) or moderately (37.8%) reduced. Greater than 91% reported that their work responsibilities or access to the hospital had been reduced, with a significant reduction in work hours and a significant increase in resident didactics (P < 0.001). Senior residents expressed concern about their educational experience and their future career prospects as a result of the pandemic.

Conclusion: Universally, residents have experienced reduced work hours and a reduction in their operative case volumes. Programs have adapted by increasing didactic time and using electronic platforms. It is quite possible that this remarkable period will prompt a critical reappraisal of the pre-COVID-19 adequacy of educational content in our training programs and that the enhanced educational efforts driven by this pandemic could be lasting.

Keywords: COVID-19; Education; Neurosurgery; Pandemic; Residency; Survey.

Copyright © 2020 Elsevier Inc. All rights reserved.

Figures

Figure 1

Graph showing the number of survey respondents stratified by residency year. The respondents were equally distributed across the residency years (P = 0.619). PGY, postgraduate year.

Figure 2

Graph showing the resident work hours per week before and after the pandemic. Before the pandemic, 97.9% of residents were working >60 hours per week. During the pandemic, once elective cases had been stopped and distancing measures had been implemented, 66% were working P < 0.0001).

Figure 3

Graph showing the weekly resident didactic lecture time before and after the pandemic. Before the pandemic, 72.8% of residents spent ≤4 hours per week in didactic lectures offered by their programs. During the pandemic, after the decline in elective cases and implementation of distancing measures, more than one half of the residents (58.7%) reported spending >4 hours per week in didactic lectures offered by their programs, a statistically significant difference (P < 0.0001).

Figure 4

Pie chart showing where residents have been spending increased time during the coronavirus disease 2019 pandemic. These were not mutually exclusive categories (e.g., a respondent could have selected having spent increased time conducting clinical research and watching remote didactic lectures and spending time in the anatomy laboratory).