Seattle, Washington, is an epicenter of the coronavirus disease 2019 epidemic in the United States. In response, the Division of General Surgery at the University of Washington Department of Surgery in Seattle has designed and implemented an emergency restructuring of the facility’s general surgery resident care teams in an attempt to optimize workforce well-being, comply with physical distancing requirements, and continue excellent patient care. This article introduces a unique approach to general surgery resident allocation by dividing patient care into separate inpatient care, operating care, and clinic care teams. Separate teams made up of all resident levels will work in each setting for a 1-week period. By creating this emergency structure, we have limited the number of surgery residents with direct patient contact and have created teams working in isolation from one another to optimize physical distancing while still performing required work. This also provides a resident reserve without exposure to the virus, theoretically flattening the curve among our general surgery resident cohort. Surgical resident team restructuring is critical during a pandemic to optimize patient care and ensure the well-being and vitality of the resident workforce while ensuring the entire workforce is not compromised.

Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. As of March 31, 2020, there have been more than 850 000 confirmed cases and an estimated 42 000 deaths worldwide.¹ The number of COVID-19–associated fatalities in the US now exceeds 3800, and 210 deaths have occurred in the Seattle, Washington, area,² making it an epicenter of the outbreak in the US.

For health care professionals on the front lines of care, it is only a matter of time before the workforce is affected by illness. At the University of Washington, in Seattle, we anticipate that some of the surgery resident house staff and faculty will eventually contract the virus. The current recommendation from the Centers for Disease Control and Prevention is 14 days of self-isolation for any confirmed COVID-19 infection that does not require hospitalization.³ The Washington State Department of Health mandates that anyone who had close contact with a patient with confirmed COVID-19 while not wearing proper personal protection equipment self-isolate at home for 14 days.⁴ This has the potential to put incredible strain on the health care system by limiting the number of clinicians available for patient care.

In an attempt to mitigate this scenario, the Division of General Surgery at the University of Washington Department of Surgery has implemented an emergency restructuring of our general surgery resident clinical teams. Our goal has been to minimize exposure to COVID-19 and protect our surgical resident workforce. To do this, we have limited the number of surgery residents with direct patient contact and have created independent resident physician teams that are isolated from one another, to create physical distancing in case of contagion among residents (Box).