Surgical training during the COVID-19 pandemic: Challenges and opportunities for junior trainees

Abstract

The practice of partial mastectomy (PM) in patients with breast cancer has gained momentum over total mastectomy since the results of randomized clinical trials that have provided evidence demonstrating equivalent survival. 1 But in recent years there has been a relative decline in PM compared to bilateral mastectomies, which has been attributed to inadequate esthetic outcomes after PM without reconstruction, which ultimately affects patient satisfaction and their health-related quality of life. 2 On the other hand, PM with immediate reconstruction -what we define as oncoplastic breast surgery (OPBS) -has been proven to be a safe and efficacious means of improving both aesthetics outcomes compared to PM alone without affecting oncological outcomes. 3 Despite the benefits of OPBS, its nationwide utilization has never been precisely quantified. To facilitate future efforts to increase its availability to appropriate candidate patients, this study aims to establish the recent rate and temporal trends of national utilization of OPBS.The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was reviewed for the period 2006-2015 to identify all women 18 years and older who were diagnosed with invasive breast cancer or carcinoma in situ, and underwent PM, as well as identify the subset of women who also underwent any reconstructive procedure during the 30-day postoperative period.The primary outcome was the overall rate of OPBS for the study period, and the temporal trends from 2006 to 2015. The secondary outcome was the annual trend for each OPBS technique: volume displacement (VD), breast reduction (BR), volume reduction (VR), prosthesis, and mastopexy. All statistical tests were two-sided, and p-value of < 0.05 was considered significant. A total 91,129 women underwent PM during the period 2006-2015 of which 4.2% ( n = 3777

Impact of COVID-19 pandemic on plastic surgery training in Europe

“…73.2% of our respondents reported shortening of patients’ stay or changing the type of anesthesia from general to local (40.8%) in the departments, which may be dictated by minimizing the risk of contamination. 4 Testing patients before the admission protects the healthcare workers from COVID-19 exposure and decreases the risk of interpatient transmission. The majority of our respondents indicated that either a PCR test or an antigen test was required before admission (80.3%).…”

“…The following timeframes were taken first wave - 23.01.2020 to 31.05.2020, the interim period - 01.06.2020 to 30.09.2020, the second wave - 01.10.2020 to 28.02.2021. 15 , 16 Visualization was prepared in GraphPad PRISM 9.1, (CA, USA) and Datawrapper (Berlin, Germany). Data on COVID-19 cases number were acquired/retrieved from https://ourworldindata.org/coronavirus.16 Fisher's exact test, and R-spearman correlation were used to analyze the data (GraphPad PRISM 9.1, CA, USA).…”

“…The continuing dilemmas have changed the surgical activities in many countries, including reshaping the work organization in surgical departments, redeployment, change in number and types of procedures performed, restricted access to operating theaters, and changes in treatment protocols. 1 , 2 , 3 , 4 , 5 …”

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

“…This period also brought with it a lack of access to surgical facilities including a limited supply of PPE, decrease in the workforce and a reduced number of skilled anesthetists, all in all contributing to the lack of proper surgical training. 12 The United States, United Kingdom, Canada and New Zealand saw nationwide postponement of surgical board exams and in-training assessment activities were heavily modified. 13 None of these developed countries were successful in implementing proper national guidelines for surgical trainees to operate during the COVID-19 era.…”

The Impact of COVID-19 on Breast Surgery Fellowships

“…The increased use of online didactics and additional time also resulted in additional opportunities for professional and personal development for trainees [33]. We have personally noticed an overall increased time window for literature review and background reading, work on clinical research projects, and manuscript writing time.…”