The Early Effects of COVID-19 on Plastic Surgery Residency Training: The University of Washington Experience

Abstract

Summary: Plastic surgeons have the unique perspective of working with all types of patients and care teams from almost all specialties in surgery and medicine, which creates unique challenges in times of distress. As the initial epicenter of coronavirus disease 2019 cases in the United States, the University of Washington program was required to rapidly develop strategies to deal with the escalating crisis. All aspects of the program were affected, including the need to triage the urgency of plastic surgery care, safe staffing of plastic surgery teams, and the role of plastic surgery in the greater hospital community. In addition, as a residency training program, limiting the impact of resident education and maintaining a sense of community and connection among members of the program developed into important considerations. The authors hope that the narrative of their experience will provide insight into the decisions made in the University of Washington health care system but also remind others that they are not alone in dealing with the challenges of this pandemic.

The early response of plastic and reconstructive surgery services to the COVID-19 pandemic: A systematic review

“…Following duplicate removal and article screening, 20 studies were included in the final data synthesis. [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The main characteristics of the included studies are outlined in Table 1 . We identified 5 letters to the editor, 12 expert opinions, 1 review, 1 survey and 1 case report.…”

“…22 , 33 , 41 The evidence base behind distance-learning is well established, and the benefits of accessibility and cost-effectiveness indicates the likely post-pandemic persistence of online education in medical training. 25 To directly limit intra-hospital transmission of the virus, judicious screening for COVID-19 before undergoing an operation or attending hospital visits was highly recommended. At Shanghai Ninth People's Hospital, patients underwent thorough epidemic history surveys, temperature detection, a coronavirus blood test and chest CT scan within 24 h; subsequently a two-week quarantine was enforced for suspected cases.…”

“…25 , 33 , 40 , 41 These studies recommend using HIPPAcompliant video-conferencing application to conduct online webinars, didactic teaching, grand rounds, virtual conferences or even wards rounds, clinic visits or live streaming operations with the patient's consent. 25 Additionally, three studies highlight that some examinations and interviews have been conducted online during the pandemic. 22 , 33 , 41…”

Plastic Surgery and COVID-19 in the GCC: Fears, Lessons Learned, and the Plan for the Future

“… 13 Many institutes created guidelines encouraging program directors to utilize online education and to organize schedules to minimize the presence and unnecessary exposure to suspected COVID- 19 patients without compromising patient care. 30 , 31 Another area for innovation was the focus of surgeons on patient education, telemedicine, and publicity via social media. Telemedicine existed before the COVID-19 pandemic.…”

The Race for a COVID-19 Vaccine: Current Trials, Novel Technologies, and Future Directions

“… 5 As a result, the fight against COVID-19 has required extensive interventions such as quarantine, social distancing, isolation of infected populations, border closures, school shutdowns, and extensive lockdowns to contain the virus, “flatten the curve,” and save lives. 6 The COVID-19 pandemic has changed the landscape of plastic surgery, 7 restructured the daily experience of plastic surgery practices, 7 – 11 altered the way residents and fellows are trained, 12 , 13 substantially impacted research, 14 , 15 and revolutionized patient care. The implications of the current COVID-19 pandemic on plastic surgery are summarized in Table 1 .…”