Gender disparity and the impact of COVID-19 on surgical training in New Zealand ophthalmology.

To evaluate the impact of the COVID-19 pandemic on New Zealand ophthalmology surgical training, focusing on surgical volume, case-mix, trainee involvement and gender disparities. Analysis of logbook data for New Zealand based trainees of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) from 1 January 2017 to 31 December 2022 was conducted comparing trainee-involved and trainee-performed case volumes between pre-pandemic (2017-2019) and pandemic (2020-2022) years, normalised by full-time equivalents (FTE). Analysis of 41,370 trainee-involved surgeries revealed that while the total number of trainee-involved procedures remained stable during the pandemic, trainee-performed surgeries decreased significantly by 11.8%. This was driven by a significant gender disparity (p=0.045), with a 24.9% decline for female trainees, concentrated among those in urban centres, while male trainee numbers remained stable (+0.74%). Provincial trainees performed twice as many surgeries as urban counterparts. A significant case-mix shift also occurred, with greater glaucoma (+27.6%) and fewer oculoplastic (-20.8%) surgeries. The pandemic was associated with a significant gender disparity in surgical training, driven by a reduction in procedures performed by female trainees predominantly in urban centres. The findings underscore the need to ensure equitable access to surgical training.