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Highlights • U.S. neurosurgery residents report moderate burnout during the COVID-19 pandemic. • Neurosurgery residents report uncertainty about future healthcare reform & earnings. • The COVID-19 pandemic may impair residents’ achievement of surgical milestones. • Burnout is associated with altered rotation or vacation schedules and lower PGY. • Career satisfaction is associated with delivery of neurosurgical patient care., The coronavirus disease 2019 (COVID-19) pandemic has posed significant changes to resident education and workflow. However, the impact of the pandemic on U.S. neurosurgery residents has not been well characterized. We investigated the impact of the COVID-19 pandemic on U.S. neurosurgery resident workflow, burnout, and career satisfaction. In 2020, a survey evaluating factors related to career satisfaction and burnout was emailed to 1,374 American Association of Neurological Surgeons (AANS) residents. Bivariate and multivariate (logistic) analyses were performed to characterize predictors of burnout and career satisfaction. 167 survey responses were received, with a response rate (12.2%) comparable to that of similar studies. Exclusion of incomplete responses yielded 111 complete responses. Most respondents were male (65.8%) and White (75.7%). Residents reported fewer work hours (67.6%) and concern that COVID-19 would impair their achievement of surgical milestones (65.8%). Burnout was identified in 29 (26.1%) respondents and career satisfaction in 82 (73.9%) respondents. In multivariate analysis, burnout was significantly associated with alterations in elective rotation/vacation schedules (p = .013) and the decision to not pursue neurosurgery again if given the choice (p

Background “Interpersonal and Communication Skills” (ICS) is a core competency set forth by the ACGME. No structured curriculum exists to train orthopedics residents in ICS. Methods Twenty-four out of thirty-five orthopedics residents completed the survey (69%). The survey had the following domains: [1] Demographics, [2] Communication Needs/Goals, and [3] Communication Barriers. Results Eighty-three percent of respondents wanted to improve their communication skills and their patient's experience. Interns-PGY4s wanted to improve on similar specific communication skills. All residents desired training in conflict management. Conclusion There is a need among orthopedics residents for a communication skills curriculum early in residency training, specifically in conflict management., Highlights • In procedural training programs (including Orthopedics), there is less focus on non-technical skills acquisition. • When surveyed, 83% of orthopedic trainees perceived a need to improve their communication skills. • All orthopedic trainees wanted training in conflict management.

Introduction The 2019 coronavirus disease (Covid-19) pandemic has led to sweeping changes in residency programs across the world, including cancellation of elective cases. The impact of safety measures on neurosurgical training remains unclear. To understand how neurosurgical residents have been affected, the authors analyze operative experience in months leading up to and during the pandemic. Materials and Methods Resident and institutional case totals were tallied for a single residency program in Miami-Dade County, USA from January 01, 2019 to June 30, 2020. Matched cohort analysis was performed before and during the pandemic to assess effect on resident surgical training. Results Case totals for all levels of training were lower when restrictions were placed on elective surgeries. An average of 11 cases were logged in April 2020, down from 26 in April 2019 (mean 8.7 – 22, 95% CI; p

Background The severe acute respiratory syndrome coronavirus 2 pandemic has created challenges to neurosurgical patient care. Despite editorials evaluating neurosurgery responses to 2019 novel coronavirus disease (COVID-19), data reporting effects of COVID-19 on neurosurgical case volume, census, and resident illness are lacking. The aim of this study was to present a real-world analysis of neurosurgical volumes, resident deployment, and unique challenges encountered during the severe acute respiratory syndrome coronavirus 2 outbreak peak in New York City. Methods Daily census and case volume data were prospectively collected throughout the severe acute respiratory syndrome coronavirus 2 outbreak in spring 2020. Neurosurgical census was compared against COVID-19 system-wide data. Neurosurgical cases during the crisis were analyzed and compared with 7-week periods from 2019 and early 2020. Resident deployment and illness were reviewed. Results From March 16, 2020, to May 5, 2020, residents participated in 72 operations and 69 endovascular procedures compared with 448 operations and 253 endovascular procedures from January 2020 to February 2020 and 530 operations and 340 endovascular procedures from March 2019 to May 2019. There was a 59% reduction in neurosurgical census during the outbreak (median 24 patients, 2.75 average total cases daily). COVID-19 neurosurgical admissions peaked in concert with the system-wide pandemic. Three residents demonstrated COVID-19 symptoms (no hospitalizations occurred) for a total 24 workdays lost (median 7 workdays). Conclusions These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-19 outbreak. While redeployment to support the COVID-19 response was required, a significant need remained to continue to provide critical neurosurgical service.