The perspective of surgical residents on current and future training in light of the COVID-19 pandemic

Editor

The COVID-19 pandemic has led to a significant reorganization of hospitals and postponement of nearly all elective procedures^1–5. This has challenged surgical training like never before. The perspective and experience of residents during this pandemic is essential in understanding ways to preserve ongoing surgical training. A nationwide survey of residents was carried out to explore views on the impact of COVID-19 on surgical activity and training. One hundred and twenty three residents answered, with an equal spread in specialty and year of training. Sixteen per cent saw a complete halt to their activity, 29 per cent saw activity decline by 90 per cent, 39 per cent by 75 per cent, and 9 per cent by 50 per cent; 36·5 per cent had completely stopped consultations. Fifty-seven per cent of surgical residents had been recruited to work in COVID-related departments. Twenty per cent reported having been infected by COVID-19; 67 per cent of whom had been working in COVID-19 units when this happened. Belgium had not yet adopted a generalized policy of testing for COVID-19 among healthcare staff when this survey was performed. Therefore, this number does not include those residents who are asymptomatic carriers.

In terms of surgical training, 36 per cent of respondents were provided continuous education; for 70 per cent of them this was in terms of virtual learning by webinars, online case presentations and journal clubs. Sixty-five per cent reported that they had been able to perform increased research during this time, and 81 per cent felt they were able to widen their theoretical knowledge regarding their specialty. Sixty per cent of residents felt that their surgical skills training had suffered but were able to spend more time on research and study; 33 per cent felt training had suffered globally; 60 per cent felt training should be prolonged if measures continue; and 56 per cent felt psychological strain as a result of the pandemic.

With the possibility of a second wave, and the likelihood of fundamental changes in society, it is clear that COVID-19 will impact training in the foreseeable future. As such, it is crucial we structure a clear strategy to ensure residents are able to continue to attain essential surgical skills. In broad terms, one main focus is virtual learning⁶, which was exemplified in our study by 70 per cent of residents who were provided with continuous education by participating in webinars, online journal clubs and online case presentations. This further underlines the emergence of online learning and virtual knowledge sharing. Another focus during this time is the use of skills-based learning using simulation models⁷. Deliberate practice and skills-based learning help residents in focusing on key skills to achieve the highest level of competence when next in the operating theatre^8,9.

The COVID-19 pandemic has had a significant impact on resident surgical activity and training. A clear strategy to ensure continued surgical education is required. This will require a concerted effort from trainers and trainees to ensure surgical education is safeguarded and future patients can consult skilled, well-trained and able surgeons in times to come.