Ophthalmology residency surgical training has been significantly impacted by COVID-19

It has been well documented that the COVID-19 pandemic has affected both office visits to ophthalmologists and ophthalmic surgical procedures. What is less well known is the impact of the pandemic on ophthalmic education, particularly for ophthalmology residents. To look at these changes, researchers from several academic ophthalmology departments across the United States accessed data from the Accreditation Council for Graduate Medical Education (ACGME) on average case logs performed by ophthalmology residents as the primary surgeon, as well as primary surgeon and surgical assistant roles among graduating ophthalmology residents from 2012 to 2020 (before and during the pandemic).

Their findings have been published in the recent issue of BMC Medical Education. The average total cases logged by residents as primary surgeon increased by 3.2% yearly from 2012 to 2019 but decreased by 11.2% from 2019 to 2020. The greatest decreases were seen in cataract, retina, and keratorefractive surgeries.

In addition, the average case logs for some of those procedural categories for which ACGME requires a minimum number for graduation, including keratorefractive and strabismus surgeries, increased each year before 2020 but decreased in 2020 to their lowest numbers since 2012. However, other procedures in 2020 had case log numbers similar to those reported before the pandemic, such as cataract surgery, keratoplasty, vitreoretinal procedures, and globe trauma.

What does this mean for resident training in 2022, 2 years after the pandemic began? The authors conclude that the pandemic focused attention on how vulnerable ophthalmology residency programs are to a significant interruption in surgical volume, and that one way to counteract volatility is to put more emphasis on competency-based assessments. "Developing competency-based rather than volume-based requirements in graduate medical education may be valuable in assessing readiness for practice," the authors note, "particularly during periods with interruptions in surgical volume."