The Impact of the COVID-19 Pandemic on Plastic Surgery Programs
Ronald K. Akiki, BA1, Joseph W. Crozier, MA2, Scott Schmidt, MD, MBA2, Raman Mehrzad, M.D., M.H.L, M.B.A2.
1The Warren Alpert Medical School of Brown University, Providence, RI, USA, 2Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Brown University, Providence, RI, USA.
BACKGROUND: As a result of the COVID-19 pandemic, the US health care infrastructure was heavily affected. Hospitals nationwide announced a temporary cancellation of elective surgical cases to accommodate for the increasing number of COVID-19 patients. The American Society of Plastic Surgeons recommended a complete cessation of all elective and nonessential surgeries. This caused a significant change in the structure of plastic surgery programs. With residents and faculty spending less time in the operating room, both educational challenges and opportunities emerged. The objective of this study was to assess the changes employed by plastic surgery programs in the United States as a result of the COVID-19 pandemic.
METHODS: A 16-question ACAPS-approved survey was distributed on April 29th 2020 to attendings in academic plastic surgery programs in the United States. The Fisher exact test was used to assess for possible differences amongst the four US sub-regions. All variables were controlled for the number of attending responses submitted from the same program.
RESULTS: A total of 111 attendings, including 30 (27.8%) program directors responded to the survey. Respondents represented all four United States subregions, with a majority located in the Northeast (41.4%). The average estimated percentage of elective case volume was 23% of normal. Those who reported a decrease in emergent surgical case volume (55.2%) estimated it to be at an average of 45% of the normal. Almost all attendings (95.6%) in this survey agreed that they were working less hours than usual, and 40.9% of those reported a decrease of more than 20 hours per week of work. A majority of attendings (82.1%) also reported a decrease in their monthly salary. The percentage projected current salary compared to normal was 85%. Almost all attendings confirmed grand rounds at their institution to be virtual (96.8%). A majority of those (65.6%) reported their residency program organizing or participating in joint grand round lectures with other plastic surgery programs. CONCLUSIONS: Our survey data suggest that academic plastic surgery programs have had impactful changes to their operative and educational schedules, teaching, revenue and patient care. The data described in this study could be used as a baseline for future pandemics affecting plastic surgery programs to help strategize their operational and educational structures.
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