This Covid-19 pandemic and it's effect are going to stay for a while.
We have surgical residents with limited duration of training left,
Surgery numbers have been reduced to a greater extent, whatever limited numbers are there, the Operation room team wants faster surgeries in order to minimize the risk to the patients and HCW, hence to be done by experts/ consultant.
My worry is with each passing day the limited time is getting over for the poor surgical resident.
Request suggestions/ opinions
Is the virtual training an answer and is it sufficient?? Like surgical lab etc
As we know that cutting is not the only mandate in surgical training, we can be rest assured that inputs on indications / contraindications for surgery, surgical anatomy, procedural steps, postop care can go a long way in establishing the first principles. Adjuncts like recorded videos, animal lab, dry lab with focus on skills training (instrument handling, sutures / knots, staples) would add value.
In fact, Cadavers (Dept of Anatomy) can pitch in to fill the void of certain complex procedures. Probably Covid has taught more respect towards approaching surgical patients !
Agree with you on this, that the things AROUND a surgical procedure can be learned by all the means.
I am also of the opinion that they are very important for a surgical resident.
But the hands on surgical training in OR can never be replaced by the adjuncts else robots and computers and anatomists would have replaced most of us long ago both as surgeons and as a trainer.
I support the views expressed by Dr.Krishna Kumar Govindarajan on the issue of imparting training to the surgical residents during COVID-19 pandemic.
Agree with you on this, that the things AROUND a surgical procedure can be learned by all the means.
I am also of the opinion that they are very important for a surgical resident.
But the hands on surgical training in OR can never be replaced by the adjuncts else robots and computers and anatomists would have replaced most of us long ago both as surgeons and as a trainer.
Thank you @Ayush K Kapila
Very relevant concern raised in your article.
Any suggestions to improve or improvise training in these young surgeons.
The following manuscript offers valuable information to answer your question. Greetings
Article Educación médica en tiempo de Pandemia: el caso de la Enferm...
A valid question... In today's time when everyone is afraid from doctors to patients, it becomes all more imperative to set a timeline ... Are we ready to let it go as a zero year??? Or are we going to do something about it?? In all the medical colleges I guess the focus is on number of doctors rather than on type of doctors. All the residents are being rotated in the SARI wards. They are the ones who are running the college's basically. And we all have forgotten about them. That they are students is nowhere in anybody's mind. They are facing the brunt of it. Will this time be compensated in extended training period beyond three years tenure?? Or will they be let off without completing their tenures after this pandemic is over is a question of great concern. Sad state of affairs it is that surgery has been totally shut down and the students will bear the brunt for it. We already are dealing with the decking standards in medical education and this pandemic has added to the woes. All the residents and interns passing out the medical college during these tes will always lack in training what they have lost to this pandemic. We have to live with it. Like we all have moved back to normalcy in day to day life , surgery should resume in colleges and teachers should think of students . They are the future. What sense of self confidence are we imparting in them. Surgery needs to get back to its feet now. We can't run out of our duties in the name of COVID anymore. Think of the future. These are the people who will be treating is when we get old. So invest , despite the risk. We all planned to become a doctor and serve the community. We have to do that. Rise above your fears and start surgery.
Valid question at a time as this. While it becomes imperative for surgical residents to be trained in a form of clinical apprenticeship, it is obviously going to be a little difficult in this period of COVID-19. The best method of on-the-job training still remains surgical patients; however, in the face of difficulties with general screening of COVID-19 patients, we might need to activate and re-energize the use of mannequins-based simulations in the demonstration of surgical procedures for the time being. Thank you!
Thanks D. K. Gupta , a very pertinent challenge of the times.
Nothing can replace the actual hands -on workplace based experience. However, I suppose we need to take this opportunity to put in place a simulation (both low and high fidelity) trainings. Innovations in teaching and learning are needed to also train on decision making skills in a structured way which often are learnt 'on the job' otherwise.
Some possible wetlab training tools suggested by this paper
http://www.jcmrp.eg.net/article.asp?issn=2357-0121;year=2020;volume=5;issue=4;spage=375;epage=378;aulast=L.
In ophthalmology, we have developed a surgical skills laboratory with simulated, artificial, and animal eyes. The residents have a specific schedule and time spent in the lab, where a surgical instructor (teacher) supervises different surgical steps or whole procedures. We are now evaluating systematically skill acquisition, development, and ability. So far, has helped us to have them using their hands under the microscope field and less anxious about not been able to perform as many surgeries as they would like to fulfill their competencies.