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UPJ INSIGHT Impact and Implications of the COVID-19 Pandemic on Urological Training

By: Michael Callegari, MD, MBA; John Maclean; Stephen Rhodes, PhD; Brandon Piyevsky; Megan Prunty, MD; Erin Jesse, MD; Kim Tay, MD; Ramy Abou-Ghayda, MD, MPH; Michael Zell, MD; Kyle Scarberry, MD; | Posted on: 01 Sep 2022

Callegari M, Maclean J, Rhodes S et al. Impact and implications of the covid-19 pandemic on urological training. Urol Pract. 2022;9(5)474-480.

Study Need and Importance

COVID-19 has forever impacted health care in the U.S. Changes to health and hospital policies led to disruptions to both patient care and medical training. There has been and continues to be limited understanding of the impact on urology resident training across the U.S. Our aim within this article was to examine the trends in urology procedures before, during and within the early COVID pandemic through the lens of resident case logs captured and reported by the ACGME (Accreditation Council for Graduate Medical Education). Retrospective review of the only publicly available urology resident case logs was performed spanning July 2015 and June 2021.

What We Found

Analysis of the procedures performed indicated an average upward trend of urological cases nationally over the 5 years reviewed, even when COVID-19-impacted 2020 was included. This trend (and dip) can be observed within the Figure. Deeper review illustrates an average annual increase of 26 procedures between 2016 and 2021, except for 2020, which saw an average drop of approximately 67 cases. However, in 2021 case volume dramatically increased to the same rate as projected had there not been a disruption in 2020.

“Analysis of the procedures performed indicated an average upward trend of urological cases nationally over the 5 years reviewed, even when COVID-19-impacted 2020 was included.”

Figure. Number of procedures split by category and fit of model 3B (+ 95% confidence intervals).

Limitations

Some limitations toward these findings stem from the fact that resident case logs are products of self-reporting across all accredited programs within the U.S. and fail to capture how regional or institutional policies may have impacted case slowdowns or overall volume, and ultimately each resident’s experience.

Interpretations for Patient Care

“Urological care is essential and in high demand, as evidenced by the uptick in volume across the U.S.”

While the number of logged cases decreased during 2020, a return to pre-pandemic volume was noted by 2021. Despite widespread pandemic-related disruptions in surgical care, urological volume appeared to not only have rebounded, but continued to increase, likely having minimal detriment to urological training over time. Urological care is essential and in high demand, as evidenced by the uptick in volume across the U.S.