A quantitative approach to understanding the effect of the COVID-19 pandemic on training opportunities for neurosurgical trainees in England.

INTRODUCTION: The literature speaks to the impact of the COVID-19 pandemic having a profound effect on surgical training. Our objective in this study was to quantify the effect of the COVID-19 pandemic on neurosurgical training and to test whether an effect on the quality of neurosurgical training can be inferred from a quantitative methodology. METHODS: Surgical training episodes logged by neurosurgical trainees with a National Training Number were provided by e-logbook for the period January 2019 to December 2023. This was crosslinked with trainee data provided by the Intercollegiate Surgical Curriculum Programme and compared with data from the Capse Healthcare Knowledge System, which records operative spells in English neurosurgical units, over the same period. RESULTS: Some 24,416 surgical training episodes were logged by trainees in 2023 compared with 32,033 in 2019. The ratio of surgical training episodes logged to operative spells recorded increased from 0.74 to 0.84 between 2019 and 2021, but fell to 0.72 by 2023. When filtered for elective cranial surgical training episodes logged compared with operative spells, the data show a significant drop from 67% to 60%. However, spinal surgical training episodes logged have risen from 58% to 70% of operative spells, although the number of surgical training episodes logged has declined by 1,118. The average number of surgical training episodes logged per year per trainee in 2019-2020 was 132, and this has risen every year and stands at 173 in 2022-2023. CONCLUSIONS: The primary findings of this study are that the recording of training events is below pre-pandemic levels. In total, 4,617 fewer cases were logged in 2023 than in 2019 and the proportion of elective cranial cases logged compared with operative spells fell from 67% in 2019 to 60% in 2023. This study suggests further efforts are needed to safeguard training opportunities and maintain a high quality of training.