The Covid-19 pandemic left a profound mark on medical education and training worldwide, with surgical specialties in developing countries often bearing the brunt of its impact.
This is according to a recent resident survey in Pakistan.
As governments implemented social distancing and lockdowns to combat the pandemic, outpatient services and elective surgeries were cancelled or delayed – a crisis mode adopted by many developing nations.
New research underscores the detrimental effect of these measures on surgical residents’ training. It suggests hospitals in developing countries must now ensure stable internet access for surgical trainees to bridge the gap with virtual learning.
One year after the initial detection of the virus in Pakistan, the study highlights the ongoing impact of the pandemic on surgical education.
More than half of the survey respondents reported a significant reduction in elective surgical procedures, ranging from severe to complete.
Most indicated they saw fewer patients in outpatient clinics, severely limiting their hands-on learning opportunities.
However, the study also revealed increased emergency cases, potentially due to a backlog of outpatient consultations presented as emergencies.
The strain on healthcare systems globally led to hospitals grappling with an overwhelming influx of Covid-19 patients, necessitating the reallocation of resources.
In the surveyed region, 42.1% of surgical residents were reassigned to manage patients with Covid-19, consequently reducing their participation in surgical training programmes.
Only 6.6% of respondents voluntarily took on these new roles, indicating that hospital policies compelled surgical residents to assume these responsibilities.
Recognising the challenges posed by the pandemic, many developed countries adapted by modifying their curricula to include online teaching and virtual learning tools.
These measures included online case discussions, virtual academic sessions and video-based education.
However, a significant number of respondents in the survey reported that their hospitals did not offer any virtual tutoring platform, possibly due to a lack of necessary infrastructure and internet connectivity in public healthcare facilities.
The study suggests hospitals in developing countries should facilitate these new learning modalities by providing surgical trainees with appropriate hardware, equipment, and stable internet access.
The pandemic not only minimised clinical and surgical learning opportunities but also had a substantial impact on the academic and research activities of surgical trainees.
More than half of the respondents reported a severe to complete reduction in academic sessions, with many residents reducing or entirely interrupting their research activities.
This contrasts with reports from other regions where the reduction in surgical cases afforded residents more time for research projects.
In addition, surgical residents in the surveyed area reported increased personal study time during the pandemic, albeit far less than anticipated, considering their heightened workload due to managing Covid-19 patients alongside their regular surgical responsibilities.
The adverse effects were felt across surgical, clinical, academic and research activities, with most respondents believing these disruptions would negatively impact their job performance.
Furthermore, the pandemic’s dramatic changes took a toll on the psychological wellbeing of surgical trainees, with an overwhelming majority reporting increased stress and anxiety, mainly stemming from concerns about contracting the virus at work.
Shortages of personal protective equipment (PPE) were identified as a factor exacerbating trainee anxiety, suggesting the importance of ensuring an adequate PPE supply for all residents to alleviate these concerns, ultimately safeguarding patient care.
Despite its insightful findings, the study has limitations. Being survey-based, it is susceptible to recall bias as respondents were required to compare their training parameters with the pre-pandemic situation.
Additionally, the study was conducted in only three public hospitals affiliated with the same institution, limiting results.
