Riding the waves: the ongoing impact of COVID-19 on a national surgical training cohort

Background: The World Health Organisation declared a global pandemic on the 11 March 2020 resulting in implementation of methods to contain viral spread, including curtailment of all elective and non-emergent interventions. Many institutions have experienced changes in rostering practices and redeployment of trainees to non-surgical services. Examinations, study days, courses, and conferences have been cancelled. These changes have the potential to significantly impact the education and training of surgical trainees.Aim: To investigate the impact of the COVID-19 pandemic on training, educational, and operative experiences of Irish surgical trainees.Methods: Surgical trainees were surveyed anonymously regarding changes in working and educational practices since the declaration of the COVID-19 pandemic on 11 March 2020. The survey was circulated in May 2020 to both core and higher RCSI surgical trainees, when restrictions were at level five. Questions included previous and current access to operative sessions as well as operative cases, previous and current educational activities, access to senior-led training, and access to simulation-/practical-based training methods. A repeat survey was carried out in October 2020 when restrictions were at level two.Results: Overall, primary and secondary survey response rates were 29% (n = 98/340) and 19.1% (n = 65/340), respectively. At the time of circulation of the second survey, the number of operative sessions attended and cases performed had significantly improved to numbers experienced pre-pandemic (p Conclusion: Surgical training and education have been significantly impacted in light of COVID-19. This is likely to continue to fluctuate in line with subsequent waves. Significant efforts have to be made to enable trainees to meet educational and operative targets.</div

Pulmonary function testing.

<p>Pulmonary function testing.</p

The effect of emphysema on readmission and survival among smokers with heart failure - Fig 2

<p><b>Emphysema on CT is associated with increased mortality (a) and readmissions (b)</b>. Kaplan-Meier survival curves for mortality (a) and readmission free survival (b) showing that patients with emphysema on CT have decreased event free survival and decreased readmission free survival as compared to patients without emphysema on CT.</p

Cox proportional hazards models for time to readmission.

<p>Cox proportional hazards models for time to readmission.</p

Outcomes.

<p>Outcomes.</p

Patient characteristics by emphysema status.

<p>Patient characteristics by emphysema status.</p

Outcomes by cardiac function.

<p>Outcomes by cardiac function.</p

Cox proportional hazards models for time to mortality.

<p>Cox proportional hazards models for time to mortality.</p

Patient characteristics by HF readmission status.

<p>Patient characteristics by HF readmission status.</p

Flow diagram.

<p>Flow diagram describing the inclusion and exclusion criteria for the study population.</p