Table 1 Key information of the included articles
From: What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis
No. | First author (Date) | Study specialty | Type of study | Target of the questionnaire | Cases-count of country where study was carried out (cases) | Main findings |
|---|---|---|---|---|---|---|
1 | Abdul Hafiz Oladapo Adesunkanmi (Oct. 2020) [9] | Surgery | Questionnaire | Residents | 50,001–500,000 | The COVID-19 pandemic has significantly affected the clinical, research and teaching components of surgical training in Nigeria. |
2 | Adel Salah Alahmadi (Nov. 2020) [10] | Ophthalmology | Questionnaire | Residents | 50,001–500,000 | COVID-19 pandemic has disrupted residents’ clinical and surgical training and may have a negative impact on residents’ mental health. |
3 | Ahmad K Alhaj (May 2020) [11] | Neurosurgery | Questionnaire | Residents | Multiple countries | Neurosurgery residents have a relatively good knowledge about COVID-19 but most participants did not receive sufficient training about PPE. |
4 | Ahmed M Gabr (Jun. 2020) [12] | Diagnostic and interventional radiology | Non- questionnaire | – | > 1,000,000 | COVID-19 pandemic related decreased case volume and cancellation of conferences had significant impact on diagnostic and interventional radiologist residency training. |
5 | Ameera Balhareth (Jul. 2020) [13] | Multiple specialties | Questionnaire | Residents | 50,001–500,000 | The slowdown of residents’ and fellows’ learning curve is inevitable, so the adoption of smart learning is critical. Anxiety and depression were noticed upon enrolled residents during the pandemic. |
6 | Anne L Cravero (Sep. 2020) [14] | Multiple specialties | Questionnaire | Residents | Multiple countries | Exposure to patients with COVID-19 is significantly associated with higher burnout rates in residents. |
7 | Basil M Kahwash (Sep. 2020) [15] | Allergy and Immunology | Questionnaire | Residents | USA and Canada | Majority of fellows described substantial changes in daily activity such as reassignment to other services. The positive impact of telemedicine on resident education were also reported by enrolled fellows. |
8 | Cesare Zoia (Jun. 2020) [16] | Neurosurgery | Questionnaire | Residents | > 1,000,000 | Most enrolled neurosurgical residents reported significant reduction in clinical surgical activity but increased in educational and scientific activities. |
9 | Christoph Roemmele (May 2020) [17] | Endoscopy | Non-questionnaire | – | > 1,000,000 | COVID-19 outbreak has a negative impact on endoscopy training of gastroenterology fellows in a high-volume center in Germany. |
10 | Davide Pertile (Jun. 2020) [18] | Surgery | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has severely impacted the educational program of surgical residents in Italy. |
11 | Deepak Mishra (May 2020) [19] | Ophthalmology | Questionnaire | Residents | > 1,000,000 | Most participants felt that the COVID-19 lockdown adversely affected their learning, especially surgical training while most found online classes and webinars useful. The residents’ perceived stress levels were higher than normal during the lockdown. |
12 | Devang Odedra (Jun. 2020) [20] | Diagnostic and interventional radiology | Questionnaire | Residents | 500,001–1,000,000 | The COVID-19 pandemic has had a significant impact on various domains of the radiology residency programs, which has been mitigated by several new technology-based strategies. |
13 | Dong-Gune Chang (Jul. 2020) [21] | Orthopedics | Questionnaire | Residents | 5001–50,000 | COVID-19 pandemic had a significant impact on orthopedic residency training on decreased clinical experience and educational activity in South Korea. |
14 | E Christopher Ellison (Aug. 2020) [22] | Surgery | Questionnaire | Residents | > 1,000,000 | The pandemic has forced innovation in clinical experiences and didactic learning to deal with the adverse impact on residency training. |
15 | Edward J Caruana (Oct. 2020) [23] | Cardiothoracic surgery | Questionnaire | Residents | > 1,000,000 | Most of the respond cardiothoracic surgical resident were concerned about their physical and mental health. Redeployment, inadequate PPE, decreased case volume and multi-disciplinary team meetings are major concerns. |
16 | Erin M White (Jul. 2020) [24] | General surgery | Questionnaire | Program directors | > 1,000,000 | Program directors reported dramatically reduced in face-to-face learning opportunities for surgical residents during the COVID-19 pandemic and all programs initiated some strategies to protect resident health. |
17 | Francesco Bandi (Jul. 2020) [25] | Otorhinolaryngology | Questionnaire | Residents | > 1,000,000 | Surgical training has been reported by enrolled residents as the activity perceived to be the most contracted during the pandemic. |
18 | Garrett N Coyan (Aug. 2020) [26] | Thoracic surgery | Questionnaire | Program directors | > 1,000,000 | Thoracic surgery program directors reported several changes in the delivery of training program including decreased operative experience, but most participants are confident that graduating thoracic surgery residents will finish on time. |
19 | Gaurav Kumar Upadhyaya (Jul. 2020) [27] | Orthopedics | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has severely disrupted the education and training of the orthopedic residents in India. |
20 | Geoffrey H Rosen (May 2020) [28] | Urology | Questionnaire | Program directors | > 1,000,000 | Residents have more time away from urology related clinical duties including redeployment and wellness is a priority for program directors. |
21 | Giovanna Bitonti (Jul. 2020) [29] | Gynecology | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic had a considerable negative impact on obstetrics and gynecology residency training program and new strategies are necessary to minimize training deficiencies. |
22 | Hassan Aziz (Jul. 2020) [30] | General surgery | Questionnaire | Residents | > 1,000,000 | COVID-19 has significant impact on surgical training and education. Except to negative impact, a positive consequence of the pandemic is increased educational didactics and should be continued after the pandemic. |
23 | Hsiang-Yun Lo (Sep. 2020) [31] | Emergency medicine | Non- questionnaire | – | 1–5000 | The COVID-19 pandemic engendered a reduced emergency department volume and decreased emergency medicine residents’ clinical exposure. All portion of emergency medicine residency training were affected by the pandemic, with pediatric emergency medicine being the most affected. |
24 | Jared Johnson (Jun. 2020) [32] | Pediatric Otorhinolaryngology | Questionnaire | Program directors | > 1,000,000 | Pediatric otolaryngology fellowship directors reported the COVID-19 pandemic has had a significant impact on training program, with the majority feeling that both their fellows surgical and clinical experience have been significantly impacted. |
25 | Jessica B Robbins (Jun. 2020) [33] | Diagnostic and interventional radiology | Questionnaire | Program directors | > 1,000,000 | Enrolled program directors reported COVID-19 pandemic has markedly impacted the perceived well-being and educational missions of radiology residency programs across the U.S. |
26 | Jian Zheng (Jun. 2020) [34] | General surgery | Questionnaire | Residents | > 1,000,000 | Enrolled chief residents were not as concerned with the case requirements for board examination but were more concerned in the potential delay in the date of the examinations and inadequate preparedness for these examinations. |
27 | Johnathan A Khusid (May 2020) [35] | Urology | Questionnaire | Residents | > 1,000,000 | Advocating for adequate PPE, providing support at the residency program and institutional levels, telehealth education programs and fostering a sense of shared responsibility for COVID-19 patients may optimize urology residents’ well-being and education. |
28 | Joshua D Burks (Sep. 2020) [36] | Neurosurgery | Non-questionnaire | – | > 1,000,000 | Impact of the COVID-19 pandemic on neurosurgery residency training is different from levels of residents and areas of the surgery. |
29 | Julia R Coleman (Sep. 2020) [37] | Surgery | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has a significant impact on the lives of surgical residents. Increased PPE access and wellness resources targeting in high-risk groups are actionable items to response for major health crisis during the pandemic. |
30 | Katarzyna M Pawlak (Jun. 2020) [38] | Gastrointestinal Endoscopy | Questionnaire | Residents | Multiple countries | COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy residents worldwide. |
31 | Katherine E Fero (May 2020) [39] | Urology | Questionnaire | Residents and program directors | > 1,000,000 | Enrolled participants reported decreased case volume, increased use of telehealth and educational activities via virtual platforms. Program directors and residents perceive an overall negative impact on surgical training and increased anxiety about competency. |
32 | Khurram Shahzad Khan (Aug. 2020) [40] | Surgery | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. |
33 | Kofi Clarke (Oct. 2020) [41] | Gastrointestinology | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has impacted GI fellowship training in the U.S. in multiple aspects, including endoscopy, inpatient and outpatient activities, and educational conferences. |
34 | Madhusudan Ganigara (Oct. 2020) [42] | Pediatric cardiology | Questionnaire | Residents | > 1,000,000 | Restrictions imposed by the COVID-19 pandemic have greatly increased utilization of online learning platforms. This survey reveals that an online lecture curriculum offers advantages that may mitigate some negative consequences of the pandemic. |
35 | Mariantonia Ferrara (Jun. 2020) [43] | Ophthalmology | Questionnaire | Residents | Multiple countries | The vast majority of residents reported decreased of clinical and surgical activities. Application of new technology-based tools is needed. |
36 | Medalit E Huamanchumo-Suyon (Oct. 2020) [44] | General surgery | Questionnaire | Residents | > 1,000,000 | The impact of COVID-19 has been reflected in a decreased number of elective surgical procedures, daily activities in the surgery department and the suspension of rotations. The majority of residents reported that the impact of COVID-19 in their training was severe. |
37 | Melissa K Meghpara (Nov. 2020) [45] | Surgery | Non- questionnaire | – | > 1,000,000 | Repurposing the surgical department for the concerns of the pandemic has involved all surgical staff. The strengths of the repurposing allowed the team to meet the demands posed by the pandemic. |
38 | Muhammad Osama (Jun. 2020) [46] | Surgery | Questionnaire | Residents | 500,001–1,000,000 | Reduction in working hours, hands-on and clinical case volume were found during the pandemic in surgical residency training. Psychological burdens of fear of acquiring the infection should be addressed. |
39 | Nahuel Paesano (Jul. 2020) [47] | Urology | Questionnaire | Residents | Multiple countries | COVID-19 pandemic is negatively impacting the residency programs. It is necessary to continue with technological innovation and allocate time and resources to generate accessible tools for future training. |
40 | Natalie A Homer (Oct. 2020) [48] | Oculoplasty | Questionnaire | Residents | > 1,000,000 | During the COVID-19 restrictions most participated in emergent clinical activities and novel telemedicine curriculum. Most residents expressed concern regarding a negative impact on overall subspecialty education and surgical confidence. |
41 | Neo Poyiadji (Sep. 2020) [49] | Diagnostic radiology | Non- questionnaire | – | > 1,000,000 | COVID-19 pandemic caused a marked decrease in radiology resident imaging interpretation volume and has had a tremendous impact on resident education. |
42 | Paloma Del C Monroig-Bosque (Jul. 2020) [50] | Pathology | Non- questionnaire | – | > 1,000,000 | Redeploying pathology residents during the COVID-19 pandemic resulted in optimization of patient care while ensuring residents’ safety and helped to maintain continuous high-quality education through active involvement in unique learning opportunities. |
43 | Panayiotis D Megaloikonomos (Jul. 2020) [51] | Orthopedics | Questionnaire | Residents | Multiple countries | Most respond residents in Europe felt the decrease in clinical, surgical and educational activities would have a great effect on their training in orthopedic and trauma field. |
44 | Panayiotis E Pelargos (Aug. 2020) [52] | Neurosurgery | Questionnaire | Residents | Multiple countries | All enrolled residents have experienced reduced work hours and a reduction in operative case volumes. Adaptions including increased didactic time and using electronic platforms. |
45 | Raphael E Huntley (Aug. 2020) [53] | Oral and Maxillofacial Surgery | Questionnaire | Residents | > 1,000,000 | COVID-19 pandemic has great impact on oral and maxillofacial surgery residency training. Residents’ concerns on availability of PPE, operative experience and completion of graduation requirements. |
46 | Robert J Rothrock (Jul. 2020) [54] | Neurosurgery | Non- questionnaire | – | > 1,000,000 | During the height of the COVID-10 pandemic, 59.4% reduction in daily neurosurgical census over the study period and 83.8% reduction in case volume compared with similar period in 2019. |
47 | S Veerasuri (Jul. 2020) [55] | Diagnostic and interventional radiology | Questionnaire | Residents | > 1,000,000 | During the pandemic, there have been significant changes to departmental workflows, radiology workload, and the nature of daily work thus had a significant impact on training and residents’ well-being. |
48 | Samit Shah (Aug. 2020) [56] | Interventional cardiology | Questionnaire | Residents and program directors | > 1,000,000 | The pandemic affected interventional cardiology fellowship training in the U.S. with many fellows at risk of not satisfying program procedural requirements. |
49 | Tanush Gupta (May 2020) [57] | Interventional cardiology | Questionnaire | Residents and program directors | > 1,000,000 | The pandemic caused a marked volume reduction in cardiac catheterization laboratory and impacted interventional cardiology fellowship training. |
50 | Theresa Guo (Jun. 2020) [58] | Otolaryngology | Questionnaire | Residents | Multiple countries | The majority of respond residents felt that their education and training had been negatively impacted by the pandemic in particular in surgical training. |
51 | Tonya W An (Aug. 2020) [59] | Orthopedics | Questionnaire | Residents | > 1,000,000 | Programs currently use a variety of strategies to provide essential orthopedic care. Continued prioritization of resident safety and necessary training accommodations is needed. |
52 | Virginia K Singla (Nov. 2020) [60] | Cardiovascular Electrophysiology | Questionnaire | Program directors | > 1,000,000 | The COVID-19 pandemic has resulted in a decrease in procedural volume for clinical cardiac electrophysiology procedures, but the majority of the participants do not anticipate major barriers to timely graduation. |
53 | Zaid S Aljuboori (Oct. 2020) [61] | Neurosurgery | Non- questionnaire | – | > 1,000,000 | A significant reduction in operative volume in neurosurgery residency training programs. Increased research-related activities and research productivity were also reported. |