DOI: http://dx.doi.org/10.18203/2349-2902.isj20210359

Past, present and future of the national surgical residency program: residents' concerns and post COVID-19 pandemic preparedness

Muhammad Zaeem Khalid, Haroon Javaid Majid, Muhammad Imran Anwar, Junaid Azad

Abstract


Background: The pandemic affected the day-to-day routine of millions of people, with the healthcare sector being at the frontline.  The surgical units have seen a drastic decrease in the amount of patient load, elective surgical procedures, and consequently a decrease in the quality of surgical training.

Methods: A cross-sectional study was conducted using a self-structured questionnaire, containing questions about concerns during COVID-19 Pandemic, availability of PPEs and the effect of surgical training during the pandemic, administered on already enrolled surgical trainees of major tertiary care hospitals of the country. A total of 207 surgical trainees were conveniently enrolled in this descriptive study. 

Results: Out of a total of 207 surgical trainees, 41.7% were first-year residents, 37.9% were second-year, 1.9% were third, 4.4% were forth and 14.1% were fifth-year surgical trainees. 62.6% of doctors reported that their stress levels have increased, most of them were worried about transmitting the infection to their families and vulnerable patients (p<0.01). 56.4% of surgical trainees reported being satisfied with their department’s response to the pandemic, 30.1% doctors said that the testing capacity was insufficient but 60.7% were satisfied with the support of their own hospital. Only 1.9% of doctors were satisfied from their training during the pandemic (p<0.01)

Conclusions: The system needs an urgent improvement in the provision of safety measures, an increase in the use of technology for the purpose of training and an easy provision of psychological support to trainees.


Keywords


COVID-19, Pandemic, Surgery, Training, Personal protective equipment

Full Text:

PDF

References


Blanco-Colino R, Soares AS, Kuiper SZ, Zaffaroni G, Pata F, Pellino G. Surgical Training During and After COVID-19: A Joint Trainee and Trainers Manifesto. Ann Surg. 2020;272(1):e24-6.

Serafini G, Parmigiani B, Amerio A, Aguglia A, Sher L, Amore M. The psychological impact of COVID-19 on the mental health in the general population. QJM, Int J Med. 2020;113(8):531-7.

Rana R-E-S, Ather MH, Enam SA. Change in surgical practice amidst COVID 19; example from a tertiary care centre in Pakistan. Ann Med Surg (Lond). 2020;54:79-81.

Waris A, Atta UK, Ali M, Asmat A, Baset A. COVID-19 outbreak: current scenario of Pakistan. New Microbes and Infections. 2020;35.

APP. Govt warns of another lockdown if people don’t follow SOPs. Pakistan Today. 2020 Jun 3; Available from: https://www.pakistantoday.com.pk/2020/06/03/govt-warns-of-another-lockdown-if-people-dont-follow-sops/. Accessed on 22 Oct 2020.

Nepogodiev D, Bhangu A, Glasbey JC, Li E, Omar OM, Simoes JFF et al. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020;396(10243):27-38.

Khalid, Atiqa, Ali S. COVID-19 and Its Challenges for the Healthcare System in Pakistan. Asian Bioethics Review; 2020: 1–14.

Woloshin S, Patel N, Kesselheim AS. False Negative Tests for SARS-CoV-2 Infection-Challenges and Implications. N Engl J Med. 2020;383(6):e38.

Wan R, Mao Z-Q, He L-Y, Hu Y-C, Wei-Chen. Evidence from two cases of asymptomatic infection with SARS-CoV-2: Are 14 days of isolation sufficient? Int J Infect Dis. 2020;95:174-5.

Osama M, Zaheer F, Saeed H, Anees K, Jawed Q, Syed SH et al. Impact of COVID-19 on surgical residency programs in Pakistan; A residents’ perspective. Do programs need formal restructuring to adjust with the “new normal”? A cross-sectional survey studies. Int J Surg. 2020;79:252-6.

ASIT. ASIT and the 15 Specialty Associations Joint Letter to Surgical Trainees on COVID-19: the implications for surgical trainees in the delivery of care and training, 2020. https://mcusercontent.com/2db94ddc48ad9a433004a8ac7/files/989e84ca-d7af-4c61-a669-a1154437013a/ASiT_The_15_Speciality_Associations_Letter_to_Surgical_Trainees_COVID19.pdf. Accessed June 18, 2020.

De Berker HT, Bressington MJ, Mayo IM, Rose A, Honeyman C. Surgical training during the COVID-19 pandemic: Challenges and opportunities for junior trainees. J Plast Reconstr Aesthet Surg. 2020.

James HK, Pattison GTR. Disruption to Surgical Training during Covid-19 in the United States, United Kingdom, Canada, and Australasia: A Rapid Review of Impact and Mitigation Efforts. J Surg Educ. 2020;S1931-7204(20)30213-0.

Ferrario L, Maffioli A, Bondurri AA, Guerci C, Lazzarin F, Danelli P. COVID-19 and surgical training in Italy: Residents and young consultants’ perspectives from the battlefield [published online ahead of print, 2020 Jun 1]. Am J Surg. 2020;S0002-9610(20)30349-4.

Agrawal V, Sharma D. Surgical training “Before COVID-19 (BC)” to “After COVID-19 (AC)”: Needs-driven approach for the Global South. Br J Surg. England; 2020.

Ayanian JZ. Mental Health Needs of Health Care Workers Providing Frontline COVID-19 Care. JAMA Health Forum. 2020;1(4):e200397.

Shanafelt T, Ripp J, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. JAMA. 2020;323(21):2133-4.

Mental Health Foundation. Looking After Your Mental Health While Working During The Coronavirus Outbreak. Available online at: https://www.mentalhealth.org.uk/publications/looking-after-your-mental-health-during-coronavirus-outbreak/while-working. Accessed March 25, 2020.

Tomlin J, Dalgleish-Warburton B, Lamph G. Psychosocial Support for Healthcare Workers During the COVID-19 Pandemic. Front Psychol. 2020;11:1960.

McKechnie T, Levin M, Zhou K, Freedman B, Palter V, Grantcharov T. Virtual Surgical Training During COVID-19: Operating Room Simulation Platforms Accessible from Home. Ann Surg. 2020;272(2):e153-4.