Optimizing surgical training in the time of COVID-19-Victorian regional teaching hospital experience

Reductions in elective surgery due to the COVID-19 pandemic led to a paralleled reduction in patient based surgical training opportunities.

To quantify the impact of COVID-19 on surgical training, we completed a retrospective audit of the Urology Department activity during Victorian pandemic waves in 2020 at our large regional teaching hospital. Corresponding weeks in the year prior were used as the control. Interviews with department members illustrated the adaptive approach to surgical training used at our institution.

A State of Disaster Surgical Triage Team was assembled and surgical operations were split between one public and two private hospitals. A pandemic triaging protocol was established and 335 Category-2 patients were re-triaged. The first wave saw a 13.8% reduction in clinic reviews, with the second wave having an overall increase of 8.8% with 56% being telehealth. The second wave saw an 11.0% reduction in overall operating, with reduced emergency operating in both the first and second wave of 17.4% and 45.5%, respectively. Reductions impacted surgical technical skill training, resulting in surgical education provided through technology platforms including webinars, podcasts and pre-recorded operative videos. The unique challenges trainees were faced with due to the pandemic encouraged development of non-technical RACS competencies.

The COVID-19 pandemic presented significant challenges for service delivery and training. Reduced direct patient contact and procedures, but opportunities to develop the non-technical skills required to respond to the pandemic. The use of variable educational opportunities and tools ensured our trainees continued to progress through their training.