Impact of COVID-19 Pandemic on Ibero-American Urology Residents: Perspective of American Confederation of Urology (CAU)

Abstract

Introduction: Since World Health Organization (WHO) declared COVID-19 as a global pandemic, urology services have developed strategies to prioritize and not to differ urgent and oncological patient's medical attention, in order to optimize resources and decrease infection probability among staff and patients. This unprecedented situation has generated a decrease in assistance and academic activities in most medical residences. The aim of this manuscript is to evaluate the impact of this health crisis on training programs through a survey addressed to urology medical residents. Materials and Methods: Cross sectional designed study, with multiple-choice non validated survey answered online by residents. Questionnaire was developed through the CAU EDUCACION platform. Results: A total of 148 responses from 18 countries coming from Latin America and Spain answering the survey. Of total, 82% answered that the activity of their urology department was significantly reduced, attending only urgent surgical pathologies, 15 % that, the urology activity has been closed completely and the staff was assigned to COVID-19 patients care, 3% continue with the regular clinic activity. Likewise, 75% stated that their surgical training has been completely affected, 93% receive urological information through tools such as Skype, ZOOM meeting, Cisco Webex, being Webinar modality the most used. Despite technological boom, 65% answered their academic training has been partially or completely affected. Most of the surveyed residents consider that period of residence should be extended to retrieve the educational targets. Conclusion: This unprecedented reality is negatively impacting the heterogeneous residency programs that American Confederation of Urology (CAU) nucleates. It is necessary to continue with technological innovation and allocate time and resources to easily generate accessible tools to favor the training of future urologists.

The impact of COVID-19 on surgical training: a systematic review

“…Similarly, 60% of urology program directors in the United States were concerned that trainees will not meet minimum case requirements due to the pandemic [ 26 ]. Echoing this, the main concern expressed by 148 urology trainees throughout Latin America and Spain was the impact of the health crisis on their surgical learning curve, with all stating that their operative activity had been at least partially affected [ 27 ]. Amongst neurosurgery trainees across the United States and Canada, 8.2% (16/197) were concerned that their overall requisite case numbers would be impacted by the pandemic [ 23 ].…”

“…Redeployment rates were variable across studies, ranging from 46% [ 30 ] to 6% [ 27 ]. Redeployment was defined as providing non-surgical care to patients or being transferred to a non-surgical specialty.…”

“…The highest rate was reported by Kapila et al with 46% of Belgian plastic surgery trainees providing non-specialty support to patients with COVID-19 [ 30 ]. The lowest rate was 6%, reported amongst 148 urology trainees across 18 countries [ 27 ]. No studies reported that no trainees had been redeployed.…”

“…In the United States, 3 out of 5 orthopaedic programmes removed trainees from all outpatient activity [ 31 ] and 86% of fellow-led head and neck clinics were cancelled during the pandemic [ 18 ]. However, remote clinical work continued to be performed by trainees in some studies [ 13 , 26 , 27 ]. Fifty-one percent of urology trainees (54/106) based in the United States reported that they had continued to participate in in-person clinical encounters and 65% were still participating in telehealth consultations [ 13 ].…”

“…However, these were only received favourably by 64.6%. Paesano et al reported that 65% (96/148) of urology trainees across Latin America and Spain felt that theoretical training has been negatively affected, this is despite 93% accessing online learning tools [ 27 ]. Similarly, Rosen et al found that 48% (31/65) of urology programme directors in the United States reported that teaching had been negatively impacted by COVID-19 despite all surveyed programs using video-conferencing [ 26 ].…”