Abstract
Introduction Drastic restructuring of the UK’s National Health Service was undertaken in response to the COVID-19 pandemic with alterations to service delivery introduced from March 2020. This has affected surgical training programmes. This study quantifies the impact of the pandemic on postgraduate orthopaedic training. Methods A prospective study was undertaken between 16 March and 3 May 2020 to capture alterations to training activity. Data were collected regionally by all trauma and orthopaedic specialty registrars in the West sector of the North West School of Surgery using a live online proforma. Results A total of 1,018 entries were analysed from 10 hospitals with a median of 21 entries per trainee (interquartile range: 17.5–26). Overall, 382 elective and 169 trauma lists were cancelled during the study period in addition to 155 elective and 132 fracture clinics. Seven trainees self-isolated during this period, losing 39 sessions. All nine candidates who were due to sit their FRCS exit examinations had them cancelled. Trainees were redeployed to other specialties in 231 entries (22.7%), with altered duties undertaken in intensive care (24.4%), accident and emergency (25.1%), and general medicine (50.3%). Trainees had no assigned alternative duties in 192 sessions (18.9%), and provided 90 extra fracture clinics and 70 extra trauma lists. Teaching and administration were logged for the remaining eight entries. Conclusions The COVID-19 pandemic has resulted in an overall 43% reduction in training opportunities, which must be addressed in order for trainees to achieve their Certificate of Completion of Training competences.
Highlights
The World Health Organization declared COVID-19 a pandemic on 11 March 2020, causing a substantial social and medical impact globally.[1,2] The severity and magnitude of the COVID-19 crisis has resulted in a tremendous burden across healthcare services worldwide, with systems that had no previous experience of a disease process of such extent having to respond urgently and reorganise services in order to minimise fatalities.[3]
The aim of this study was to illustrate the regional impact of the COVID-19 pandemic on trauma and orthopaedic training in the West sector of the North West School of Surgery
There was no significant difference (p=0.190) between submissions for junior trainees and senior trainees. Trainees in their last year of training (n=14) applying for their Certificate of Completion of Training (CCT) submitted a median of 17 entries (IQR: 17–20)
Summary
The World Health Organization declared COVID-19 a pandemic on 11 March 2020, causing a substantial social and medical impact globally.[1,2] The severity and magnitude of the COVID-19 crisis has resulted in a tremendous burden across healthcare services worldwide, with systems that had no previous experience of a disease process of such extent having to respond urgently and reorganise services in order to minimise fatalities.[3]. In the UK, the ongoing disease progression has created an unprecedented challenge for the National Health Service (NHS), which like many other global such as clubfoot and developmental dysplasia of the hip in children.[9] Throughout these guidelines, re-evaluation of current clinical practice has been recommended to reduce patient and healthcare provider exposure. An example can be seen in the guidance on the surgical treatment of common upper limb fractures: ‘Most upper limb fractures, including clavicle, humeral and wrist fractures, have high rates of union and may be managed non-operatively, recognising that some patients may require late reconstruction.’[8] It advises that (where possible) non-operative measures are encouraged training of specialty registrars in trauma and orthopaedics. The aim of this study was to illustrate the regional impact of the COVID-19 pandemic on trauma and orthopaedic training in the West sector of the North West School of Surgery
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