Impact of COVID-19 on Neurosurgical Training in Southeast Asia

Abstract

Objective Neurosurgery departments worldwide have been forced to restructure their training programs because of the coronavirus disease 2019 (COVID-19) pandemic. In this study, we describe the impact of COVID-19 on neurosurgical training in Southeast Asia. Methods We conducted an online survey among neurosurgery residents in Indonesia, Malaysia, Philippines, Singapore, and Thailand from May 22 to 31, 2020 using Google Forms. The 33-item questionnaire collected data on elective and emergency neurosurgical operations, ongoing learning activities, and health worker safety. Results A total of 298 of 470 neurosurgery residents completed the survey, equivalent to a 63% response rate. The decrease in elective neurosurgical operations in Indonesia and in the Philippines (median, 100% for both) was significantly greater compared with other countries ( P < 0.001). For emergency operations, trainees in Indonesia and Malaysia had a significantly greater reduction in their caseload (median, 80% and 70%, respectively) compared with trainees in Singapore and Thailand (median, 20% and 50%, respectively; P < 0.001). Neurosurgery residents were most concerned about the decrease in their hands-on surgical experience, uncertainty in their career advancement, and occupational safety in the workplace. Most of the residents ( n = 221, 74%) believed that the COVID-19 crisis will have a negative impact on their neurosurgical training overall. Conclusions An effective national strategy to control COVID-19 is crucial to sustain neurosurgical training and to provide essential neurosurgical services. Training programs in Southeast Asia should consider developing online learning modules and setting up simulation laboratories to allow trainees to systematically acquire knowledge and develop practical skills during these challenging times.

Letter to the Editor Regarding “Impact of COVID-19 on Neurosurgical Training in Southeast Asia”

“…Academic activities, too, have taken a hit, with almost three-fourths of our respondents reporting hampering of their research/thesis, 4 compared with one-third as reported by Wittayanakorn et al. 1 The number of academic sessions conducted by neurosurgery departments in India have decreased by 32.60%, from a median of 5 per week to 2 per week ( P = 0.000). More than 60% of our respondents reported that their departments in India have transitioned from physical classroom teaching to video conferencing platforms to conduct academic sessions, as in Southeast Asia.…”

“…More than 60% of our respondents reported that their departments in India have transitioned from physical classroom teaching to video conferencing platforms to conduct academic sessions, as in Southeast Asia. 1 Eighty-six of our respondents (72.88%) replied that a conference that they had planned to attend had been cancelled due to the current situation. Because of the decreased time spent in clinical and surgical activities, almost 90% of residents were worried about the pandemic impacting their operative and clinical skills adversely.…”

“…We read with great interest the article by Wittayanakorn et al. 1 They conducted an online survey among neurosurgery residents from Indonesia, Malaysia, Philippines, Singapore, and Thailand between 22 and 31 May 2020 and have described the ongoing challenges faced by neurosurgery residents in their training due to the COVID-19 pandemic. Out of 298 respondents in the survey, the majority (160) were from Indonesia.…”

“… 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 Reduction in the operative volumes has reduced surgical experience for residents. 1 4 , 32 , 33 , 34 Rationing of resources such as PPE has left residents either unscrubbed or debarred from the operation theater.…”

Letter to the Editor Regarding “Early Changes to Neurosurgery Resident Training During the COVID-19 Pandemic at a Large United States Academic Medical Center”

“…Other authors from across the world have voiced their concerns regarding neurosurgery training during the COVID-19 pandemic. 30 , 31 , 32 , 33 , 34 Zoia et al. 30 from Italy reported that surgical exposure during the pandemic decreased for 78.6% of residents, while 16.1% did not operate at all.…”