Study examines the impact of the COVID-19 pandemic on ophthalmology residency and fellowship training

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A team of researchers in Saudi Arabia set out to study the impact of the COVID-19 pandemic on residency and fellowship training in terms of clinical load, surgical exposure, medical education, and research opportunities.¹

The researchers, in the Ophthalmology Department at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, maintained in the study COVID-19 pandemic has negatively affected many aspects of the healthcare system. The team included Abdulmalik Alyahya, a Fellow physician, Abdulrahman Alyahya, MD, Abdulrahman Alammar, MD, SBP, and Sami AlShahwan, MD.

“Many meta-analysis studies showed that surgical training and medical education have faced the most negative effects,” they wrote.

The retrospective study was conducted at King Khaled Eye Specialist Hospital (KKESH), in Riyadh, Saudi Arabia, to review the impact of the COVID-19 pandemic on the training program by comparing the years 2018 and 2019 before the pandemic to 2020 and 2021 after the pandemic.

“Our hospital has been affected by the COVID-19 pandemic, as have many other healthcare sectors,” the researchers wrote. “The most negative effect was during March 2020 and May 2020, when the hospital announced that outpatient clinic visits and surgery would be limited to emergency cases only.”

Afterward, the hospital implemented strict infection control in the hospital and resumed routine outpatient clinic visits and elective surgery as usual.

“However, a number of no-shows during the clinic, surgery cancellations, and absent infected physicians and healthcare staff were unpredictably playing a role in the healthcare and education process,” the researchers noted.

According to the study, the study’s sample included 117 KKESH graduates (residents and fellows in the surgical subspecialties) from 2018 to 2021. All of the sample populations were included.¹

The researchers collected the data in a specifically designed form. All participants were ensured to have a full surgical logbook with no missing data in the documentation.

“Outpatient visits were collected through electronic records in the hospital registry,” the researchers wrote. “The teaching activities and grand rounds were collected through the residency and fellowship program.”

According to the study, from 2018 to 2021, 18,669 surgeries were performed. The total number of surgeries performed was 3,980, 4,898, 4,813, and 4,978 in 2018, 2019, 2020, and 2021, respectively. There was a 23.1% (N = 918) increase in the number of surgeries done by trainees from 2018 to 2019, then a 1.7% (N = 85) reduction from 2019 to 2020, followed by an increase of 3.4% (N = 165) from 2020 to 2021.¹

The mean number of surgeries performed by fellows showed a 25.2% (N = 1,042) increase from 2018 to 2019, a 7.3% (N = 107) reduction from 2019 to 2020, and a 15.1% (N = 550) increase (p = 0.018). In the case of residents, there was a 10.7% (N = 136) reduction from 2018 to 2019, a 2.1% (N = 24) increase from 2019 to 2020, and a 40% (N = 783) reduction in the total number of phacoemulsification surgeries (p < 0.001).¹

In total, there was a 25.1% (N = 8,215) increase in the number of patients seen in outpatient clinics from 2019 to 2020. All activities were on-site during 2018 and 2019.

“A gradual shift occurred from on-site to virtual over 2020 and 2021 without any effect on the number,” the researchers wrote in the study. “From 2019 to 2020, there was an increase in the number of papers submitted by the trainees.”

There was an increase of 25% (N = 10), 20% (N = 2), and 6.3% (N = 3) in the retrospective research, prospective research, and case reports, respectively.¹

According to the researchers, the surgical exposure has not affected the fellows and residents of the hospital. However, the number of surgeries for the residents has been affected due to the stoppage of overseas surgical courses during the pandemic.

“The volume of the outpatient clinic has increased after the pandemic, which could be caused by the increased number of referrals to our tertiary hospital, mainly after the pandemic effect on other hospitals in the kingdom and the implementation of the virtual clinic and telephone call. Interestingly, research activity has also increased after the pandemic,” they concluded.

Reference:

1. Alyahya A, Alyahya A, Alammar A, et al. (July 27, 2024) The Impact of the COVID-19 Pandemic on Ophthalmology Residency and Fellowship Training: A Retrospective Study. Cureus 16(7): e65531. doi:10.7759/cureus.65531