Ruth Blanco Colino updates us on what the evolving COVID-19 outbreak means for surgeons in training.
NB: This is an unprecedented situation, and so insights mentioned below have only been taken from the evidence and experiences of countries that have already been affected by Coronavirus, such as China and Italy. [1]
Surgical residents are part of the frontline in the COVID-19 pandemic. COVID-19 has had, or will have, an impact on surgical training in many, if not all, countries affected by the virus.
The impacts, so far, have been widespread. For example, to help us cope with the situation, surgical training programmes have been modified or interrupted so that we can cover for colleagues at surgical units and help with COVID-19 patients where needed. Surgical training has also been affected in that the recruitment of new residents into surgical training programmes, in many countries, has been delayed. In others, however, the fast incorporation of recently graduated medical students is being considered to help ease the strain on healthcare workers as the ratio of patients to professionals grows substantially. [2]
Many centres have already cancelled elective procedures to avoid patients’ risk to COVID-19 exposure and to prevent the shortage of hospital and ICU beds. In the months to come, we will see the real impact of the cancellation of these elective surgeries on residents’ training and workload. [3]
Special considerations will be needed when planning surgery for COVID-19 patients – these are additional learnings which must be covered. We also need to consider the fact that, in a pandemic situation, we might come into contact with asymptomatic patients in the operating theatre who might only present symptoms later on, during the postoperative period. The safety and proper protection of residents caring for patients who are coming into an emergency department, or being admitted to the wards, must be a priority. The fight against COVID-19 can bring about difficult situations for residents and other healthcare workers, such as putting their families at risk or seeing how colleagues become patients themselves.
In addition, in the most affected areas, surgical residents may be required to help with COVID-19 patients. Many associations, such as the Association of Surgeons in Training, or the Asociación Española de Cirugía (AEC) have included special recommendations for surgical residents with regards to this. [4, 5]
We are already seeing the impact that COVID-19 is having on academic careers – several conferences and courses globally have had to be delayed, or cancelled altogether. And, some ongoing research has been cancelled, too, due to the overload of studies needed for COVID-19, or because it’s simply impossible to carry out studies in such demanding and challenging conditions. However, at the same time, research opportunities like COVIDSurg have been launched as part of an international collaborative effort to improve patients’ surgical management in the COVID-19 pandemic.
As residents, it is essential to stay updated. Social media is a fast resource that can contribute to residents’ training. It can be a very helpful platform for sharing worldwide experiences and some of the latest findings. For surgeons and healthcare professionals across the globe, useful hashtags to follow on Twitter in relation to COVID-19 and surgery are #COVIDSurg, #COVID19surgery and #COVID19ESCP.
On a final note, we must remember that only by joining efforts globally and locally at our hospitals we will be able to face and overcome the COVID-19 pandemic.
Ruth is a 2nd year General and Gastrointestinal Surgery resident at Hospital Vall d’Hebron in Barcelona and a Co-lead of the EuroSurg Collaborative. She graduated in Medicine at “Universitat Autònoma de Barcelona” and holds a minor in Clinical Surgery.
- Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: what we know. Int J Infect Dis [Internet]. 2020; Available from: https://www.sciencedirect.com/science/article/pii/S1201971220301235
- Col·legi de Metges de Barcelona. El CoMB posa en marxa diverses mesures urgents per donar suport a metges i metgesses davant l’evolució de l’epidèmia de COVID-19 [Internet]. 2020. Available from: https://www.comb.cat/mobile/actualitat/noticies/noticies_fitxa.aspx?Id=WP5gUipFm%2FMoLuHRv2GfAg%3D%3D
- Gunner CK, Oliphant R, Watson AJ. Crises drive innovation. Color Dis [Internet]. 2020;2–4. Available from: https://doi.org/10.1111/codi.15043
- ASIT. RE: COVID-19. The implications for surgical trainees in the delivery of care and training. Vol. 44. 2020. p. 6–9.
- Asociación Española de Cirujanos. Recomendaciones para los residentes de cirugía general ante la pandemia por SARS COV-2. 2020; Available from: https://www.aecirujanos.es/files/noticias/152/documentos/Recomendaciones_residentes.pdf