Effects of COVID-19 on Facial Plastic and Reconstructive Surgery Fellowship Training and Director Practices

OBJECTIVES: The objectives of this study include characterizing the practice patterns and testing strategies of facial plastic and reconstructive surgery (FPRS) fellowship directors (FDs) secondary to COVID-19 and to quantify the impact of COVID-19 on FPRS fellowship training. STUDY DESIGN: Cross-sectional survey. SETTING: Online. METHODS: A survey was sent to all American Academy of Facial Plastic and Reconstructive Surgery FDs and co-FDs in September 2020. Descriptive analyses were performed. RESULTS: Of 77 eligible FDs, 45 responded (58.4%) representing a diverse group across the United States. All but 1 FD routinely screened patients for COVID-19 in the preoperative setting. FDs largely believed that universal preoperative testing was cost-effective (66.7%), improved patient safety (80.0%) and health care worker safety (95.6%), and was not burdensome for patients (53.3%). With regard to volume of cosmetic/aesthetic, reconstructive, facial nerve, and trauma surgery, FDs indicated largely no change in volume (34.9%, 71.0%, 68.4%, and 80.0%, respectively) or fellow experience (67.4%, 80.6%, 84.2%, and 80.0%). Half (50.0%) of the FDs reported decreased volume of congenital/craniofacial surgery, but 75.0% did not believe that there was a change in fellow experience. Overall, of the 15 responses indicating “worsened training” across all domains of FPRS, 14 were located in the Northeast (93.33%). CONCLUSIONS: The COVID-19 pandemic has had the least impact on the volume of reconstructive procedures, facial nerve operations, and trauma surgery and a negative impact on congenital/craniofacial surgery volume, and it has accelerated the demand for cosmetic/aesthetic operations. Overall, the majority of FDs did not feel as though their fellows’ trainings would be adversely affected by the ongoing pandemic.