EDITORIAL COMMENT

The COVID-19 pandemic has been an unprecedented event in the modern world with ramifications felt throughout healthcare, economies, global relations, and society in general. The effect on healthcare cannot be understated. Within our relatively small world of urology resident education the anxiety was palpable as many hospitals reduced the number of operations, sometimes completely stopping all elective surgeries. In some hard-hit areas, urology residents were pulled to cover other services in need of help.

Thankfully, Daily et al have demonstrated that in adult urology there was no significant difference in surgical volume for graduating urology residents before vs during the COVID-19 pandemic. This was done by analyzing the case logs of 1866 US graduating residents from academic year (AY) 2015-2016 through AY 2020-2021. Logs were aggregated as “pre-COVID” (AY 2015-16 through AY 2018-19) and “COVID affected” (AY 2019-20 and 2020-21) and compared. While there was no significant difference in the number of adult index cases logged, there was a statistically significant decrease in pediatric cases.

Whether this statistically significant decrease in both pediatric major and minor cases is clinically significant (with an absolute difference of about 6 minor cases and 5 major cases between the groups) is open for debate. As mentioned by the authors, a decline in pediatric cases has been described previously before the pandemic by Silvestre et al.¹ Even with these case reductions the graduating residents are averaging well above the ACGME minimums for graduation (though this data is in aggregate).

I commend the authors on a well-written paper. It tackles a subject that has been in the minds of many in surgical resident training. Despite no significant difference in the number of cases done it remains to be seen how graduating residents feel subjectively about their training and how it was affected by COVID.