Abstract

Background: The first wave of the COVID-19 pandemic caused a rapid and significant restructuring of surgical services worldwide. Inadvertently, infection control and prevention measures, both within and outside hospitals, have caused a negative impact on training. The aim of this narrative review is to give an overview of this impact and the measures employed for the recovery of training.

Methodology: A Medline search was conducted with the purpose of identifying relevant papers using the terms ‘COVID’, ‘ SARS-CoV-2’ ‘ surg*’ and ‘training’.

Results: Most of the evidence provided is extracted from surveys and editorials. This is not without methodological and other limitations. All areas of surgical training were negatively impacted. Theatre exposure was significantly reduced (up to 50%). Most centres refrained from minimally invasive surgery and imposed a ‘minimal staff’/ ‘consultant only’ policy which reduced training opportunities even further. Outpatient clinics were either cancelled or converted to consultant led virtual clinics. Training courses, examinations, conferences, and training rotations were postponed or cancelled. Endoscopy sessions were also discontinued during the first wave of the pandemic. 

A survey by our group demonstrated that trainees had concerns about the lack of guidance from training stakeholders and would like to see their mentors and trainers prioritising training at every opportunity. A four step framework was proposed. 
In attempts to mitigate these adverse impacts of the pandemic there has been a rise in the evolution of new technologies, like telemedicine and platforms for webinars. Surgical simulation and immersive technologies such as virtual reality (VR), augmented reality (AR), and mixed reality had a role to play in the recovery of training.

Conclusion: There is little doubt that COVID-19 has significantly decreased training opportunities for surgeons. The recovery effort needs to be coordinated by training authorities nationally, with the involvement of trainees in decision-making. Alternative teaching methods should be used, not to replace, but to enhance the current training opportunities.

Additional Information

This presentation was given at the SES 2022 online conference, January 2022.