Abstract
ABSTRACTObjectives:To evaluate the impact of COVID-19 on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents.Materials and Methods:A web-based survey was sent to 468 Brazilian urology residents from postgraduate years (PGY) 3 to 5 to collect data on clinical practice and training after 4 months of COVID-19. We also assessed health-related and behavior changes, rate of infection by SARS-CoV-2, deployment to the front line of COVID-19, residents’ concerns, and access to personal protective equipment (PPE).Results:Massive reductions in elective and emergency patient consultations, diagnostic procedures and surgeries were reported across the country, affecting PGY 3 to 5 alike. Most in-person educational activities were abolished. The median damage to the urological training expected for 2020 was 6.0 [3.4 – 7.7], on a scale from 0 to 10, with senior residents estimating a greater damage (P< 0.001). Educational interventions developed included online case-based discussions, subspeciality conferences and lectures, and grand rounds. Most senior residents favored extending residency to compensate for training loss and most younger residents favored no additional training (p< 0.001). Modifications in health and lifestyle included weight gain (43.8%), reduced physical activity (68.6%), increased alcoholic intake (44.9%) and cigarette consumption (53.6%), worsening of sexual life (25.2%) and feelings of sadness or depression (48,2%). Almost half were summoned to work on the COVID-19 front-line and 24.4% had COVID-19. Most residents had inadequate training to deal with COVID-19 patients and most reported a shortage of PPE. Residents’ concerns included the risk of contaminating family members, being away from residency program, developing severe COVID-19 and overloading colleagues.Conclusions:COVID-19 had a massive impact in Brazilian urology residents´ training, health and lifestyle behavior, which may reflect what happened in other medical specialties. Studies should confirm these findings to help developing strategies to mitigate residents’ losses.
Highlights
MATERIALS AND METHODSCOVID-19 led to profound changes in the medical scenario worldwide, including a massive reduction of face-to-face medical consultations and suspension or postponement of elective surgical procedures [1, 2]
We investigated alternative educational activities that were implemented by urology residency programs such as web meetings, web conferences and online education programs
The distribution of participants was proportional to the actual distribution of Brazilian urology residents across the country’s five different geographic regions
Summary
COVID-19 led to profound changes in the medical scenario worldwide, including a massive reduction of face-to-face medical consultations and suspension or postponement of elective surgical procedures [1, 2]. It caused a redeployment of health professionals to work at the front line caring for infected patients [3, 4]. Urology residency programs have been facing problems that include the major cutback of residents’ participation in medical visits and surgeries, and the reduction of educational and scientific activities [3, 4, 6, 7]. Residents represent a large component of the workforce at various health facilities and in many hospitals they have become critical at the front line of care for patients with COVID-19 [3, 4]
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