Dacey Sydney, Albright J Alex, Testa Edward J, Cruz Aristides I, Eberson Craig P
Brown University Warren Alpert Medical School, Providence, RI.
Brown University Warren Alpert Medical School, Department of Orthopaedic Surgery, Providence, RI.
J Pediatr Soc North Am. 2024 Feb 12;5(2):614. doi: 10.55275/JPOSNA-2023-614. eCollection 2023 May.
In the early months of the coronavirus disease 2019 (COVID-19) pandemic, elective procedures were suspended to reallocate resources, notably impacting 1-year surgical fellowship programs. The purpose of this study is to compare the case volume of pediatric orthopaedic surgery fellows during the pandemic's peak year to the years before and after. Accreditation Council for Graduate Medical Education (ACGME) case log reports of key procedures in pediatric orthopaedic surgery were compared between the fellowship classes of 2018-2019 (pre-pandemic), 2019-2020 (peak pandemic), and 2020-2021 (post-peak pandemic). Both overall case volume and individual key procedures were analyzed for significant differences between each of the three class years. There was a significant decrease (-43.7 cases, -15.5%) in the overall number of key procedures completed by the fellowship class of 2020 compared to 2019 (p=0.014), with similar significant decreases in various individual key procedures (foot and ankle deformity, limb deformity, and soft tissue: transfer, lengthening, and release). In the subsequent year, there was a significant increase (+98.8 cases, +41.5%) in the average case volume for the class of 2021 (p<0.001), with significant increases in procedures for foot and ankle deformity, clubfoot, limb deformity, hip, and soft tissue: transfer, lengthening, and release. Additionally, the rebound in overall case volume for the class of 2021 surpassed the pre-pandemic caseload completed by the class of 2019 (p=0.008). During the peak of the pandemic when elective cases were suspended, pediatric orthopaedic surgery fellows logged fewer surgical cases compared to the pre-pandemic class of 2019. While the case volume rebounded in the subsequent year, further research is needed to quantify the overall impact of the decreased caseload for the pediatric orthopaedic fellowship class of 2020. Level IV •With the onset of the unprecedented COVID-19 pandemic, the ensuing shutdowns' effects on the training and case volumes of pediatric orthopaedic fellows remain unclear.•This study quantified the change in case volume of pediatric orthopaedic fellows during the first year of the COVID-19 pandemic and identified a significant decrease of nearly 44 total cases (15.5%) performed by fellows of the graduating class of 2020 when compared to those who graduated in 2019.•This study quantified the rebound in case volume for the fellows of the 2021 graduating class when compared to the graduates of the 2020 fellowship class.
在2019冠状病毒病（COVID-19）大流行的最初几个月，为了重新分配资源，择期手术被暂停，这对为期1年的外科住院医师培训项目产生了显著影响。本研究的目的是比较在大流行高峰年份小儿骨科住院医师的病例数量与前后年份的病例数量。对2018 - 2019年（大流行前）、2019 - 2020年（大流行高峰）和2020 - 2021年（大流行高峰后）这几届住院医师培训学员的美国毕业后医学教育认证委员会（ACGME）小儿骨科关键手术病例记录报告进行了比较。分析了这三个年级中每一年之间的总体病例数量和各个关键手术的显著差异。与2019年相比，2020年这一届住院医师培训学员完成的关键手术总数显著减少（减少43.7例，-15.5%）（p = 0.014），各种个别关键手术（足踝畸形、肢体畸形以及软组织：转移、延长和松解）也有类似的显著减少。在随后的一年里，2021年这一届学员的平均病例数量显著增加（增加98.8例，+41.5%）（p < 0.001），足踝畸形、马蹄内翻足、肢体畸形、髋关节以及软组织：转移、延长和松解等手术的病例数量都有显著增加。此外，2021年这一届学员总体病例数量的反弹超过了2019年这一届学员在大流行前完成的病例量（p = 0.008）。在大流行高峰期间，当择期手术暂停时，小儿骨科住院医师培训学员记录的手术病例比2019年大流行前的那一届学员少。虽然病例数量在随后的一年里有所反弹，但需要进一步研究来量化2020年小儿骨科住院医师培训学员病例量减少的总体影响。四级证据 •随着前所未有的COVID-19大流行的爆发，随之而来的停工对小儿骨科住院医师培训和病例数量的影响仍不清楚。•本研究量化了COVID-19大流行第一年小儿骨科住院医师病例数量的变化，并确定与2019年毕业的学员相比，2020年毕业的学员完成的病例总数显著减少了近44例（15.5%）。•本研究量化了2021年毕业的住院医师学员与2020年毕业的学员相比病例数量的反弹情况。
