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01 april 2020

COVID-19 – Considerations and Implications for Surgical Learners - Annals of Surgery

In press; https://journals.lww.com/annalsofsurgery/Documents/COVID-19%20%E2%80%93%20Considerations%20and%20Implications%20for%20Surgical%20Learners.pdf
By: Oluwatomilayo Daodu et al. 

Aim
Describe the impact of covid-19 on surgical traineeships. 

Keys

  • Surgical training should be maintained by:
    • Trainee wellness and safety must remain priority.
    • Harness the opportunities to learn from the COVID-19 pandemic.
    • Restructure surgical learning.
    • Adapt current educational milestones.
    • Prepare for post-COVID-19.

Summary

  • Almost all elective surgery has been cancelled and surgical trainees are needed side-by-side with all members of the health-care system to treat covid-19. Therefore, normal surgical resident training is not possible. 
  • How do we maintain integrity of surgical training in the current era?
    • Trainee wellness and safety must remain priority.Eliminate unnecessary transmission risk
      • Face-to-face educational activities should be adapted to remote learning
      •  Appropriate personal protective equipment instructions
      • Restrict trainees from non-essential clinical activities and limit the number of residents rounding on 1 day
      • Also focus on psychological health of residents
    • Harness the opportunities to learn from the COVID-19 pandemic
      • There lies opportunity in learning and cultivating processings skills with the rapid availability of new guidelines, data and considerations on covid. 
      • Develop critical care expertise through deployment to the ICU. 
      • Other administrative tasks (scheduling) in crisis response.
      • Develop leadership skills. 
    • Restructure surgical learning
      • Despite the public health crisis, a formal educational curriculum for residents should not be abandoned .
      • Quarantined surgeons should engage in remote surgical training 
        • Remote learning can be shared by several training facilities / hospitals
    • Adapt current educational milestones
      • Surgical certification and qualifying examinations have been postponed globally.
        • The demoralizing impact of this decision on senior trainees is evident: for many residents, the satisfaction of completing years of training and personal sacrifice has been indefinitely delayed.
    • Prepare for post-COVID-19
      • Surgical systems will face backlogs of operations providing considerable increase in potential experiences for trainees. 
        • This might happen before the rest of society returns to normal (e.g. schools) therefore remain flexible for residents
      • The importance of providing wellness support and resources for trainees, even after the peak of the pandemic has passed, cannot be overstated.