Study limitations
Due to the fluid nature of the current COVID-19 crisis, many aspects of clinical care and education vary from day to day and also regionally within the North American AHNS training programs. In addition, due to the nature of survey collection, reporting bias is possible and operative log data may be inaccurate due to delays in entry or omissions by the current and past fellows. Efforts were made to interpret the best available data and to proactively make educational changes thought to enhance the current experience. Follow-up assessment will be needed to evaluate the effectiveness of these interventions.