4.5 Article

COVID-19 Pandemic and the Lived Experience of Surgical Residents, Fellows, and Early-Career Surgeons in the American College of Surgeons

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LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.jamcollsurg.2020.09.026

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  1. American College of Surgeons

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A survey of American College of Surgeons members found that the COVID-19 pandemic significantly impacted the lives of surgical trainees and early career surgeons, leading to reduced clinical experiences, compromised personal wellness, and high rates of burnout and depression. Actions to mitigate these effects include increasing access to personal protective equipment and providing wellness programs, particularly targeting high-risk groups.
BACKGROUND: To better understand how the COVID-19 pandemic has affected surgical trainees' and early career surgeons' professional and personal experiences, a survey of the membership of the American College of Surgeons (ACS) Resident and Associate Society (RAS) and Young Fellows Association (YFA) was performed. STUDY DESIGN: An anonymous online survey was disseminated to members of RAS and YFA. Descriptive analyses were performed and factors associated with depression and burnout were examined with univariate and multivariable stepwise logistic regression. RESULTS: Of the RAS/YFA membership of 21,385, there were 1,160 respondents. The majority of respondents (96%) reported the COVID-19 pandemic having a negative impact on their clinical experience, with 84% of residents reporting a > 50% reduction in operative volume and inability to meet minimum case requirements. Respondents also reported negative impacts on personal wellness. Nearly one-third reported inadequate access to personal protective equipment, and depression and burnout were pervasive (>_21% of respondents reported yes to every screening symptom). On multivariable analysis, female sex (odds ratio [OR] 1.54 for depression, OR 1.47 for burnout) and lack of wellness resources (OR 1.55 for depression, OR 1.44 for burnout) predicted depression and burnout. Access to adequate personal protective equipment was protective against burnout (OR 0.52). CONCLUSIONS: These data demonstrate a significant impact of the COVID-19 pandemic on the lives of residents and early-career surgeons. Actionable items from these data include mitigation of burnout and depression through increasing personal protective equipment access and provision of wellness programs, with a particular focus on high-risk groups. (J Am Coll Surg 2021;232:119-137. (c) 2020 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.)

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