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Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort
Orla Hennessy1, Amy Lee Fowler2, Conor Hennessy3
1Department of General Surgery, University Hospital Galway, Galway, Ireland. o.hennessy95@gmail.com.
Insights
The COVID-19 pandemic initially disrupted surgical training, but operative experiences and education improved by October 2020. However, many cancelled courses remain unrescheduled, impacting surgical trainees.
Area of Science:
- Medical Education
- Surgical Training
- Public Health Crises
Background:
- The COVID-19 pandemic led to widespread cancellations of elective procedures and redeployment of surgical staff.
- Educational activities, including examinations, courses, and conferences, were significantly disrupted.
- These changes posed a substantial threat to the continuity and quality of surgical trainee education.
Purpose of the Study:
- To assess the impact of the COVID-19 pandemic on the training and educational experiences of surgical trainees in Ireland.
- To compare the experiences of trainees during different phases of pandemic-related restrictions.
- To identify specific areas of disruption and recovery in surgical education.
Main Methods:
- An anonymous survey was distributed to core and higher surgical trainees affiliated with RCSI (Royal College of Surgeons in Ireland).
- The survey captured data on operative session attendance, case exposure, educational activities, and access to training methods.
- Two survey waves were conducted: May 2020 (Level 5 restrictions) and October 2020 (Level 2 restrictions).
Main Results:
- Survey response rates were 29% (initial) and 19.1% (follow-up).
- By October 2020, attendance at operative sessions and case numbers significantly recovered to pre-pandemic levels.
- Exposure to formal teaching returned to pre-COVID levels, though 97% of cancelled courses were not rescheduled.
Conclusions:
- The COVID-19 pandemic profoundly affected surgical training and education.
- While operative and educational activities showed recovery, the long-term impact of cancelled courses requires attention.
- Sustained efforts are crucial to ensure surgical trainees meet their educational and operative benchmarks amidst ongoing pandemic waves.
Background:
The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees.
Aim:
To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees.
Methods:
Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two.
Results:
Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p < 0.0001). Exposure to formal teaching and education sessions returned to pre-COVID levels (p < 0.0001). Initially, 23% of trainees had an examination cancelled; 53% of these trainees have subsequently sat these examinations. Of note 27.7% had courses cancelled, and 97% of these had not been rescheduled.
Conclusion:
Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.
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