Impact of the COVID‐19 Pandemic on Surgical Residency Training: Perspective from a Low‐Middle Income Country

Abstract

Background The COVID-19 pandemic has drastically impacted postgraduate training programmes worldwide. This study aims to evaluate the Nigerian situation with respect to surgical training, with a view to identifying gaps and proffering solutions. Methods A cross-sectional survey of surgical residents in Nigeria was conducted between 27 July 2020 and 14 August 2020. A structured questionnaire designed using the free software Google Forms ® was utilised for the study. The questionnaire was electronically distributed randomly to 250 surgical residents via emails and social media platforms including WhatsApp and Telegram. The data obtained was analysed by Google Forms ® . Ethical approval for the study was obtained from the ethics and research unit of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria. Results At the end of the study period, 207 surgical residents completed and submitted the questionnaire, giving a response rate of 82.8%. The majority of respondents reported a reduction (164, 79.2%) or cancellation (11, 5.3%) of postgraduate programmes in their institutions. Of those who had academic programmes, meetings were done using virtual technology in all instances. The majority of respondents reported seeing fewer patients in the outpatient clinics (173, 83.6%), as well as a reduction in the number of emergency and elective operations (58.5% and 90.8%, respectively). About a third of the respondents (70, 33.8%) were contemplating emigrating from the country. Conclusion The COVID-19 pandemic has significantly affected the clinical, research and teaching components of surgical training in Nigeria. It has, however, led to increased adoption of digital technology which should be further explored in the face of current realities.

The impact of COVID-19 on surgical training at a tertiary hospital in Greece: a ‘hidden infectious enemy’ for junior surgeons?

“…The American College of Surgeons and the Royal College of Surgeons of England both recommend that non-emergency procedures be delayed, except operations in cancer patients [ 15 ]. Limiting the performance of elective clinical cases protects patients from in-hospital viral transmission and makes wards and critical care beds available for possible upsurges in the numbers of SARS-CoV‑2 cases.…”

The Impact of COVID-19 on Surgical Training: the Past, the Present and the Future

“…A great number of studies have reported a detrimental effect on surgical training. The majority of them described it ‘severe’ or ‘significant’ and some even ‘catastrophic’ [ 19 , 21 , 22 , 28 , 30 – 43 ]. These reports come both from developed [ 13 , 21 , 22 , 24 , 26 , 31 – 34 , 44 – 52 ] and developing countries [ 28 , 30 , 35 , 53 – 55 ] with very different healthcare systems.…”

“…The majority of them described it ‘severe’ or ‘significant’ and some even ‘catastrophic’ [ 19 , 21 , 22 , 28 , 30 – 43 ]. These reports come both from developed [ 13 , 21 , 22 , 24 , 26 , 31 – 34 , 44 – 52 ] and developing countries [ 28 , 30 , 35 , 53 – 55 ] with very different healthcare systems. Moreover, the results were uniform between a variety of surgical specialties; general surgery [ 13 , 19 , 21 , 30 , 32 , 34 , 37 , 41 , 42 , 44 , 47 , 56 , 57 ], orthopaedics [ 19 , 24 , 58 ], ENT (ear, nose, throat) surgery [ 19 , 31 , 50 ], vascular surgery [ 19 , 22 , 26 ], urology [ 22 , 26 , 53 ], oral and maxillofacial surgery [ 19 , 33 ], and neurosurgery [ 19 , 54 , 59 ].…”

“…Operating theatre exposure was significantly reduced [ 13 , 19 , 30 , 31 , 44 , 53 ], with some authors reporting a reduction of case numbers as great as 50% [ 41 ]. Several factors contributed to this.…”

The higher impact of the COVID‐19 pandemic on resident/fellow training in low‐ and middle‐income countries

“…Dear editors, Among the many detrimental consequences of the COVID-19 pandemic to transplantation, the impact on the training experiences of residents/fellows has not been explored. Trainees in other specialities and medical students have expressed concerns about adequately developing their skills during the pandemic [1,2]. A few re-assignments in a 1-or 2-year transplant training program may lead to significant loss of key training experiences and the ability to meet practice-specific milestones [3].…”