The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC)

Abstract

Introduction Recently, Italy has been heavily hit by COVID-19 pandemic and today it is still one of the most affected countries in the world. The subsequent necessary lockdown decreed by the Italian Government had an outstanding impact on the daily life of the entire population, including that of Italian surgical residents' activity. Our survey aims to evaluate the impact of COVID-19 on the training programme of Italian surgical residents. Materials and methods We designed a 12-item-electronic anonymous questionnaire on SurveyMonkey© web application. The survey was composed of different sections concerning demographic characteristics and impacts of COVID-19 on the concrete participation in clinical, surgical and research activities. Future perspectives of responders after the pandemic were also investigated. Results Eighty hundred responses were collected, and 756 questionnaires were considered eligible to be included in the study analysis. Almost 35 and 27% of respondents experienced, respectively, complete interruption of surgical and clinical activities. A subgroup analysis, comparing the COVID-19 impact on clinical activities with demographics data, showed a statistically significant difference related to specialties (p = 0.0062) and Italian regions (p < 0.0001). Moreover, 112 residents have been moved to non-surgical units dealing with COVID-19 or, in some case, they voluntarily decided to interrupt their residency programme to support the ongoing emergency. Conclusion Our survey demonstrated that COVID-19 pandemic has severely impacted the educational programme of Italian surgical residents. Despite many regional differences, this survey highlighted the overall shortage of planning in the reallocation of resources facing this unexpected health emergency.

Impact of the COVID‐19 Pandemic on Surgical Residency Training: Perspective from a Low‐Middle Income Country

“…Most of them also reported seeing fewer patients in the outpatient clinics, as well as a reduction in the number of and attendance at emergency and elective operations. These findings are similar to the findings of other authors [ 15 , 22 – 24 ]. These findings have potential significant negative impact on surgical training vis-à-vis acquisition of surgical skills and expertise, which are greatly dependent on hands-on experience.…”

“…Sadly, 14 Nigerian doctors have died of COVID-19, the first, an obstetrician, following a Caesarean section [ 25 ]. Shortage of PPE is a major contributing factor to these infections and deaths [ 15 ]. Most (173, 83.6%) of the respondents in our study did not have appropriate/adequate PPE to work with.…”

“…The pandemic and its containment measures also have important ramifications on the training of medical doctors [ 15 ]. The surgical specialties, being largely dependent on patient flow for hands-on experience, stand the greatest risk of being negatively affected.…”

A look at the global impact of SARS CoV-2 on orthopedic services

“…These challenges faced by orthopedic residents is echoed by residents in other surgical specialties, with many surgical residents being unable to keep up with surgical and clinical exposure due to the dwindling elective surgery rate and clinic attendance numbers. 27 , 30 Whilst some governing bodies overseeing the training of residents, such as the Accreditation Council for Graduate Medical Education (ACGME), have adapted their administrative requirements of training, such that the reduced clinical exposure of residents does not impact their ability to receive their eventual specialist accreditation, it remains to be seen whether this reduction in exposure will affect the clinical competency of future specialists trained during this pandemic era. The ACGME system of postgraduate education accreditation originated from the United States of America, and has since expanded internationally, with the system currently being employed in Singapore, Qatar, the UAE, and Saudi Arabia, amongst other countries, with the system replacing previously instituted postgraduate accreditation programs.…”

Doing More with Less: Surgical Training in the COVID-19 Era

“…The COVID-19 pandemic led to cancelation of elective operating with minimal presence of surgical trainees in theatres [32]. Although hands-on training is postponed during the pandemic, simulation training should be expanded.…”