(480) The COVID-19 Pandemic’s Impact on Otolaryngology Training: A Systematic Review

Introduction: In response to the COVID-19 pandemic, Oto residencies globally altered curricula on an institutional basis. We present the first systematic review summarizing changes and assessing the implications on residents’ clinical and surgical experience, didactics, and well-being.

Methods: A systematic literature search queried Cochrane, Embase, Google Scholar, Pubmed, Scopus, and Web of Science for English articles from 2019-2023 about Oto residency in the pandemic. The terms (COVID-19 OR Pandemic) +/AND (ENT OR Otolaryngology) +/AND Resident +/AND Residency were used. Two independent reviewers extracted data on country, study type, and impact on training, didactic education, and well-being.

Results: The search yielded 1421 articles; 1341 were excluded after title/abstract screening. 80 articles were reviewed fully and 27 were included from 16 countries and 5 continents. 85.7% were cross-sectional, 10.7% were retrospective, and 3.6% were prospective. 21 articles discussed clinical and/or surgical training, of which 71.4% (N=15) reported decreased surgical hours, 61.9% (N=13) had decreased clinical hours, 66.7% (N=14) had decreased surgical cases, and 4.8% (N=1) had increased clinical hours and cases. 15 articles discussed didactics, of which 25.9% (N=7) reported an increase, 22.2% (N=6) reported a decrease, and 7.4% (N=2) had no change. 14 articles discussed well-being. Residents’ anxiety increased in 71.4% (N=10), burnout, stress, and depression increased in 35.7% (N=5), insomnia increased in 21.4% (N=3), and alcohol/tobacco use increased in 14.3% (N=2). 2 articles reported a negative impact on future employment.

Conclusions: Oto residents experienced reduced training opportunities and worsened well-being during the pandemic. Didactic training varied based on access to technology and may highlight global disparities.