The impact of COVID-19 pandemic on surgical residency programmes in Italy: a nationwide analysis on behalf of the Italian Polyspecialistic Young Surgeons Society (SPIGC)

Davide Pertile, Gaetano Gallo, Fabio Barra, Alessandro Pasculli, Paola Batistotti, Marco Sparavigna, Giuseppe Vizzielli, Domenico Soriero, Giusi Graziano, Salomone Di Saverio, Roberto Luca Meniconi, Eleonora Guaitoli, Andrea Mazzarri, SPIGC Working Group, Alessandra Aprile, Vittorio Aprile, Emanuele Botteri, Debora Brascia, Valerio Cozza, Francesco Damarco, Carlo Di Marco, Mariasole Gallazzi, Marco Giovenzana, Mario Giuffrida, Jacopo Lanari, Giovanni Lanza, Pasquale Lo Surdo, Fabio Maglitto, Mattia Manitto, Alessio Minuzzo, Nunzio Montelione, Gerardo Palmieri, Edoardo Pasqui, Federica Perelli, Elisa Piovano, Luca Portigliotti, Marta Ribolla, Angela Romano, Andrea Romboli, Giuseppe Sena, Alberto Settembrini, Alessandro Sturiale, Francesco Velluti, Davide Pertile, Gaetano Gallo, Fabio Barra, Alessandro Pasculli, Paola Batistotti, Marco Sparavigna, Giuseppe Vizzielli, Domenico Soriero, Giusi Graziano, Salomone Di Saverio, Roberto Luca Meniconi, Eleonora Guaitoli, Andrea Mazzarri, SPIGC Working Group, Alessandra Aprile, Vittorio Aprile, Emanuele Botteri, Debora Brascia, Valerio Cozza, Francesco Damarco, Carlo Di Marco, Mariasole Gallazzi, Marco Giovenzana, Mario Giuffrida, Jacopo Lanari, Giovanni Lanza, Pasquale Lo Surdo, Fabio Maglitto, Mattia Manitto, Alessio Minuzzo, Nunzio Montelione, Gerardo Palmieri, Edoardo Pasqui, Federica Perelli, Elisa Piovano, Luca Portigliotti, Marta Ribolla, Angela Romano, Andrea Romboli, Giuseppe Sena, Alberto Settembrini, Alessandro Sturiale, Francesco Velluti

Abstract

Introduction: Recently, Italy has been heavily hit by COVID-19 pandemic and today it is still one of the most affected countries in the world. The subsequent necessary lockdown decreed by the Italian Government had an outstanding impact on the daily life of the entire population, including that of Italian surgical residents' activity. Our survey aims to evaluate the impact of COVID-19 on the training programme of Italian surgical residents.

Materials and methods: We designed a 12-item-electronic anonymous questionnaire on SurveyMonkey© web application. The survey was composed of different sections concerning demographic characteristics and impacts of COVID-19 on the concrete participation in clinical, surgical and research activities. Future perspectives of responders after the pandemic were also investigated.

Results: Eighty hundred responses were collected, and 756 questionnaires were considered eligible to be included in the study analysis. Almost 35 and 27% of respondents experienced, respectively, complete interruption of surgical and clinical activities. A subgroup analysis, comparing the COVID-19 impact on clinical activities with demographics data, showed a statistically significant difference related to specialties (p = 0.0062) and Italian regions (p < 0.0001). Moreover, 112 residents have been moved to non-surgical units dealing with COVID-19 or, in some case, they voluntarily decided to interrupt their residency programme to support the ongoing emergency.

Conclusion: Our survey demonstrated that COVID-19 pandemic has severely impacted the educational programme of Italian surgical residents. Despite many regional differences, this survey highlighted the overall shortage of planning in the re-allocation of resources facing this unexpected health emergency.

Keywords: COVID-19; Clinical activity; Italian surgical residents; Research activity; Surgical activity; Survey.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a Graphical representation of 112 respondents who left their surgical training divided according to the attended year of residency; b graphical representation of 112 respondents who left their surgical training according to the region where they are employed; c graphical representation of 112 respondents who left their surgical training according to surgical activity; d training and research activities in the field of COVID-19 among the 112 residents who left their surgical training; e impact on clinical training programme among 112 residents who left their surgical training; f direct involvement in COVID-19 emergency activities divided according to surgical specialty among 112 residents who left their surgical training
Fig. 1
Fig. 1
a Graphical representation of 112 respondents who left their surgical training divided according to the attended year of residency; b graphical representation of 112 respondents who left their surgical training according to the region where they are employed; c graphical representation of 112 respondents who left their surgical training according to surgical activity; d training and research activities in the field of COVID-19 among the 112 residents who left their surgical training; e impact on clinical training programme among 112 residents who left their surgical training; f direct involvement in COVID-19 emergency activities divided according to surgical specialty among 112 residents who left their surgical training
Fig. 2
Fig. 2
a Impact of COVID-19 pandemic on residents’ active participation to clinics divided according to surgical specialty. b Impact of COVID-19 pandemic on residents’ active participation to clinics, divided according to the region where they are employed. c Impact of COVID-19 emergency on active participation to clinics divided according to the attended year of residency
Fig. 3
Fig. 3
Impact of pandemic COVID-19 on training and research activities divided according to the attended year of residency
Fig. 4
Fig. 4
a Impact on clinical training programme divided according to surgical specialty. b Impact on clinical training programme divided according to regions where respondents are employed
Fig. 5
Fig. 5
a Impact of COVID-19 emergency on residents’ future career. b Impact on residents’ future career divided according to surgical specialty
Fig. 6
Fig. 6
Training and research activities in the field of COVID-19

References

    1. Gallo G, Trompetto M. The effects of COVID-19 on academic activities and surgical education in Italy [published online ahead of print, 2020 Apr 5] J Investig Surg. 2020 doi: 10.1080/08941939.2020.1748147.
    1. Rosenbaum L. Facing covid-19 in Italy—ethics, logistics, and therapeutics on the epidemic’s front line. N Engl J Med. 2020 doi: 10.1056/NEJMp2005492.32187459.
    1. Giulio M, Maggioni D, Montroni I, et al. Being a doctor will never be the same after the COVID-19 pandemic [published online ahead of print, 2020 Mar 30] Am J Med. 2020 doi: 10.1016/j.amjmed.2020.03.003.
    1. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (covid-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 doi: 10.1001/jama.2020.2648.32091533.
    1. Bianco F, Incollingo P, Grossi U, Gallo G. Preventing transmission among operating room staff during COVID-19 pandemic: the role of the Aerosol Box and other personal protective equipment. Updates Surg. 2020;12:13. doi: 10.1007/s13304-020-00818-2.
    1. Wu A, Huang X, Li C, Li L. Novel coronavirus (2019-nCov) pneumonia in medical institutions: problems in prevention and control. Chin J Infect Control. 2020;19:1–6.
    1. Ives J, Huxtable R. Surgical ethics during a pandemic: moving into the unknown? [published online ahead of print, 2020 Mar 30] Br J Surg. 2020 doi: 10.1002/bjs.11638.
    1. Eysenbach G. Improving the quality of web surveys: the checklist for reporting results of internet e-surveys (CHERRIES) [published correction appears in doi:10.2196/jmir.2042] J Med Internet Res. 2004;6(3):e34. doi: 10.2196/jmir.6.3.e34.
    1. Elsey EJ, Griffiths G, Humes DJ, West J. Meta-analysis of operative experiences of general surgery trainees during training. Br J Surg. 2017;104(1):22–33. doi: 10.1002/bjs.10396.
    1. Chung RS. How much time do surgical residents need to learn operative surgery? Am J Surg. 2005;190(3):351–353. doi: 10.1016/j.amjsurg.2005.06.035.
    1. Pellino G, Moggia E, Novelli E, et al. An update of the aims and achievements during the first year of the Young Group of the Italian Society of Colorectal Surgery (Y-SICCR) Tech Coloproctol. 2019;23(3):291–298. doi: 10.1007/s10151-019-01966-3.
    1. Stokes DC. Senior medical students in the COVID-19 response: an opportunity to be proactive [published online ahead of print, 2020 Mar 25] Acad Emerg Med. 2020 doi: 10.1111/acem.13972.
    1. Graham LA, Maldonado YA, Tompkins LS, Wald SH, Chawla A, Hawn MT (2020) Asymptomatic SARS-CoV-2 transmission from community contacts in Healthcare Workers. Ann Surg (In press)
    1. COVIDSurg Collaborative Global guidance for surgical care during the COVID-19 pandemic. Br J Surg. 2020 doi: 10.1002/bjs.11646.
    1. Porpiglia F, Checcucci E, Amparore D, et al. Slowdown of urology residents’ learning curve during COVID-19 emergency. BJU Int. 2020 doi: 10.1111/bju.15076.
    1. Colombo A, Bassani G. Carenza di medici: ma per quale SSN? Dati, riflessioni e proposte dalla formazione [Lack of doctors, but for what System? Shortage of clinicians in Italy and Lombardy and reflections on structural constrains in training] Ig Sanita Pubbl. 2019;75(5):385–402.

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