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. 2022 Mar 4;22(1):142.
doi: 10.1186/s12909-022-03205-0.

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

Hursuong Vongsachang  1 , Michael J Fliotsos  2   3 , Alice C Lorch  4 , Eric L Singman  5 , Fasika A Woreta  2 , Grant A Justin  6   7
Affiliations

The impact of COVID-19 on ophthalmology resident surgical experience: a retrospective cross-sectional analysis

Hursuong Vongsachang et al. BMC Med Educ. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic caused significant disruption to in-office and surgical procedures in the field of ophthalmology. The magnitude of the impact of the pandemic on surgical training among ophthalmology residents is not known. This study aims to quantify changes in average case logs among United States (U.S.) ophthalmology residency graduates prior to and during the COVID-19 pandemic.

Methods: Retrospective, cross-sectional analysis of aggregate, national data on case logs of U.S. ophthalmology residency graduates from 2012 to 2020. The yearly percent change in the average number of procedures performed in the Accreditation Council for Graduate Medical Education (ACGME) ophthalmology resident case logs were analyzed using linear regression on log-transformed dependent variables. The average percent change from 2019 to 2020 was compared to the average yearly percent change from 2012 to 2019 for procedures performed as the primary surgeon, and primary surgeon and surgical assistant (S + A), as well as procedures for which there are ACGME minimum graduating numbers.

Results: Across all procedures and roles, average case logs in 2020 were lower than the averages in 2019. While average total cases logged as primary surgeon increased yearly by 3.2% (95% CI: 2.7, 3.8%, p < 0.001) from 2012 to 2019, total primary surgeon case logs decreased by 11.2% from 2019 to 2020. Cataract (-22.0%) and keratorefractive (-21.1%) surgery experienced the greatest percent decrease in average primary surgeon cases logged from 2019 to 2020. Average total cases logged as S + A experienced an average yearly increase by 1.2% (95% CI: 0.9,1.6%, p < 0.001) prior to 2020, but decreased by 9.6% from 2019 to 2020. For ACGME minimum requirements, similar changes were observed. Specifically, the average case logs in YAG, SLT, filtering (glaucoma), and intravitreal injections had been increasing significantly prior to 2020 (p < 0.05 for all) but decreased in 2020.

Conclusions: These findings demonstrate the vulnerability of ophthalmology residency programs to a significant interruption in surgical volume. There is a critical need for development of competency-based, rather than volume-based, requirements to evaluate readiness for independent practice.

Keywords: COVID-19; Clinical competence; Graduate medical education; Ophthalmologic surgical procedures.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of the percent change in average case logs among U.S. ophthalmology residency graduates from 2019–2020 to the average yearly percent change from 2012–2019 for cases logged as A primary surgeon, B surgeon and assistant, and C procedures listed as minimum graduation requirements
See this image and copyright information in PMC

References

    1. James Chodosh. Important coronavirus updates for ophthalmologists. [Internet]. American Academy of Ophthalmology. 2020 [cited 2021 Jan 5]. Available from: https://www.aao.org/headline/alert-important-coronavirus-context
    1. Recommendations for urgent and nonurgent patient care [Internet]. American Academy of Ophthalmology. 2020 [cited 2021 Apr 19]. Available from: https://www.aao.org/headline/new-recommendations-urgent-nonurgent-patien...
    1. NATIONAL PATIENT AND PROCEDURE VOLUME TRACKER [Internet]. Strata Decision Technology; 2020 Jun [cited 2020 Apr 19]. Available from: https://www.stratadecision.com/wp-content/uploads/2020/06/National-Patie...
    1. Mishra K, Boland MV, Woreta FA. Incorporating a virtual curriculum into ophthalmology education in the coronavirus disease-2019 era. Curr Opin Ophthalmol. 2020;31(5):380–5. doi: 10.1097/ICU.0000000000000681. - DOI - PubMed
    1. Reed DS, Hill MD, Justin GA, Giles GB, Santamaria JA, Hobbs SD, et al. Finding Focus in Crisis: Resident-Driven Graduate Medical Education at a Military Training Facility during the COVID-19 Pandemic. Mil Med. 2020;30(11–12):469–71. doi: 10.1093/milmed/usaa193. - DOI - PMC - PubMed