Neurosurgery training in India during the COVID-19 pandemic: straight from the horse’s mouth

Abstract

OBJECTIVEThe COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic.METHODSBetween May 7, 2020, and May 16, 2020, a validated questionnaire was circulated among neurosurgical residents across India by social media, regarding changes in the department’s functioning, patient interaction, surgical exposure, changes in academics, and fears and apprehensions associated with the pandemic. The responses were kept anonymous and were analyzed for changes during the COVID-19 pandemic compared to before the pandemic.RESULTSA total of 118 residents from 29 neurosurgical training programs across 17 states/union territories of the country gave their responses to the survey questionnaire. The survey revealed that the surgical exposure of neurosurgical residents has drastically reduced since the onset of the COVID-19 pandemic, from an average of 39.86 surgeries performed/assisted per month (median 30) to 12.31 per month (median 10), representing a decrease of 67.50%. The number of academic sessions has fallen from a median of 5 per week to 2 per week. The survey uncovered the lack of universal guidelines and homogeneity regarding preoperative COVID-19 testing. The survey also reveals reluctance toward detailed patient examinations since the COVID-19 outbreak. The majority of respondents felt that the COVID-19 pandemic will hamper their operative and clinical skills. Fear of rescheduling or deferring of licensing examinations was significantly higher among those closest to the examination (p = 0.002).CONCLUSIONSThe adverse impact of the pandemic on neurosurgical training needs to be addressed. While ensuring the safety of the residents, institutes and neurosurgical societies/bodies must take it upon themselves to ensure that their residents continue to learn and develop neurosurgical skills during these difficult times.

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

“…3 We conducted a nationwide survey of neurosurgical residents in India, from 7 to 16 May 2020, with 118 respondents from various phases of training, spanning the length and breadth of the country. 4 We found results very similar to those of Wittayanakorn et al., though a few key differences are apparent. Most respondents (88.1%) in our study worked in institutions that dealt with both COVID-19 and non-COVID-19 patients.…”

“…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).…”

“… 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”

“…They reported that their residents logged in an average of 15 (58%) and 5 (20%) fewer cases in April 2020 and May 2020, respectively, and this result was statistically significant. In a nationwide survey conducted among 118 neurosurgery residents from India from May 7, 2020, to May 16, 2020, 28 we observed a significant decline of 67.5% in the surgical exposure of residents since the onset of the pandemic, with the average number of surgeries performed by a resident decreasing from 39.9 to 12.3 per month ( P = 0.000). In addition, three fourths of respondents reported hampering of research activities, and the number of academic sessions had decreased by 32.6% from a median of 5 per week to 2 per week ( P = 0.000).…”

Letter to the Editor Regarding “Neurosurgical Referral Patterns During the COVID-19 Pandemic: A United Kingdom Experience”

“…We must rise above the challenge and again attempt to resume work with the necessary precautions. 15 Proper evidence-based protocols, creation of adequate COVID-19 testing facilities, and the provision of ample personal protective equipment have been instrumental in restarting nonemergent surgeries in our experience.…”