Abstract

IntroductionVicissitudes including re-deployment, elective cancellations, and remote educational events have restricted training opportunities during the COVID pandemic. This study aimed to analyse COVID's impact on global Higher Surgical Trainee (HST) performance metrics including hospital adaptability and variance.Materials and MethodIntercollegiate Surgical Curriculum Programme (ISCP) portfolios of 50 HSTs (median age 36 (range 29–46) yr., female 15, male 35), including 191 six-month rotational placements, were analysed over two years (March 2019 to 2021). Primary effect measures were: operative logbook numbers, index procedures validated against curriculum requirements and Work Based Assessments (WBA).ResultsDuring COVID-19, operative experience per placement declined 26.1% (median 211 vs. 156, p<0.010), with a 32.1% decline in trainee primary surgeon experience (162 vs. 110, p<0.010). Regarding index procedures: cholecystectomy declined 45.5% (11 vs. 6, p=0.027) and inguinal hernia 62.5% (8 vs. 3, p<0.010). WBAs were similar (17 vs. 13, p=0.364). Despite relative equivalence before COVID, median total number of operative procedures performed in District General Hospitals (DGH, n=65) were 40.9% fewer than Tertiary Hospitals (TH, n=110, p<0.010). Radar plots of composite metrics ranged from 11.1 to 75.6% coverage before (p=0.011) vs. 13.3 to 68.9% after COVID (p=0.015).DiscussionHospital training metrics varied over five-fold, a difference likely amplified by COVID, with THs more adaptable to existential shared lessons.

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