A Continental Survey on the Impact of COVID-19 on Neurosurgical Training in Africa

Abstract

Background Containment measures for COVID-19 have affected surgical training globally. We sought to assess how neurosurgical training has been affected across Africa in April 2020. Methods A cross-sectional survey was distributed to African Neurosurgical trainees seeking to review demographics and effects of COVID on training. Results A total of 123 neurosurgery trainees responded from 23 African countries and a further 6 were abroad. A total of 91.80% were men, and 96.70% were training in public institutions. Only 41% had received training in COVID-19 with 61.79% worried that they would contract COVID-19 while performing their clinical duties. There was a marked reduction in clinical activities including a median reduction of elective surgery (−80%), clinics (−83%), and emergency surgery (−38.50%). A total of 23.58% of residents did not receive a formal salary, with 50% on less than $1000 USD gross per month. Conclusions This is the first continental survey of neurosurgery trainees in Africa. COVID-19 has significantly affected clinical and learning opportunities. There are concerns of the long-term effects on their training activities for an uncertain period of time during this pandemic. Although there has been a global increase in e-learning, there is need to evaluate if this is accessible to all trainees.

The impact of the COVID-19 pandemic on global neurosurgical education: a systematic review

“…Surveys of residents from both HMICs and LMICs reported decreased operating volumes, resident participation in operative procedures and time spent in the OR [4,[10][11][12][13][14][15][16][17]. A survey done with trainees in 5 Southeast Asian nations showed a significantly greater reduction in elective cases in Indonesia and the Philippines (P < 0.001), the latter of which also contained the most respondents (76%), reporting closure of outpatient clinics, with the median duration of closure being 8 weeks [18].…”

“…In almost all neurosurgery departments, teaching, academic meetings, lectures and conferences were converted to an online format during the course of the pandemic. An emphasis was laid upon reducing inter-individual contact at the expense of exposure to the operating room [8][9][10][11][12]. However, reducing such real-world experience has had detrimental effects on resident training.…”

“…In-person teaching activities were cancelled in most neurosurgical departments worldwide [8][9][10][11][12]24]. There has been a greater use of online education initiatives, including webinars, virtual conferences and lecture series [8].…”

“…Some trainees participated multiple times in virtual conferences multiple times each week, suggesting that virtual education could partially substitute in-person sessions [26]. However, several cross-sectional studies, done to assess this shift in education, illustrated a pattern [11,13,15]. In North America, which is considered to have better socioeconomic status, 98.5% of respondents said that their programme was transferred to online platforms [15].…”

The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

“…These reports come both from developed [ 13 , 21 , 22 , 24 , 26 , 31 – 34 , 44 – 52 ] and developing countries [ 28 , 30 , 35 , 53 – 55 ] with very different healthcare systems. Moreover, the results were uniform between a variety of surgical specialties; general surgery [ 13 , 19 , 21 , 30 , 32 , 34 , 37 , 41 , 42 , 44 , 47 , 56 , 57 ], orthopaedics [ 19 , 24 , 58 ], ENT (ear, nose, throat) surgery [ 19 , 31 , 50 ], vascular surgery [ 19 , 22 , 26 ], urology [ 22 , 26 , 53 ], oral and maxillofacial surgery [ 19 , 33 ], and neurosurgery [ 19 , 54 , 59 ].…”