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Impact of COVID-19 on orthopaedic residents-an Indian perspective. OTA Int 2021; 4:e096. [PMID: 34746651 PMCID: PMC8568353 DOI: 10.1097/oi9.0000000000000096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/25/2020] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
Objectives: The COVID-19 pandemic is a public health emergency causing a deleterious effect on the health system. It affected all the specialties and subspecialties in the medical field causing havoc in the health institutions. This pandemic affected both orthopaedic consultants and the residents who are under training. Our purpose was to study the impact of COVID-19 on orthopaedic residents in their professional life. Method: The study design was a computer-based digital online survey of the orthopaedic residents in India. The survey had 15 questions with multiple options related to the effect of COVID-19 on their orthopedic department, effect on teaching, surgical exposure, hands-on surgeries, the effect on workload, effect on mental stress, exposure to arthroplasty, arthroscopic surgeries, spine surgeries, and deformity correction surgeries. Results: Elective surgeries stopped in 91% of the hospitals, academic teaching stopped in 98% of the institutions. Eighty-six percent of the residents are not getting adequate surgical exposure, 73% of the residents are getting negligible hands-on surgical training. Residents are mentally stressed related to academic examinations, academic training, and also because of COVID 19 duties. Residents are getting the least exposure in subspecialties like arthroplasty, arthroscopy, and spine. Conclusion: The COVID-19 pandemic not only affected the orthopaedic consultants but also the orthopaedic residents to a great extent as residents are the backbone of any department/institution. The pandemic affected significantly resident's academic teaching, surgical exposure, hands-on training and mental stress related to COVID duties, academic training disturbance, and also academic examinations.
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Bosco A, Tay HW, Aleem I, Citak M, Uvaraj NR, Park JB, Matsumoto M, Marin-Penna O, Buvanesh J, Khan M, Hey HWD. Challenges to the orthopedic resident workforce during the first wave of COVID-19 pandemic: Lessons learnt from a global cross-sectional survey. J Orthop 2021; 27:103-113. [PMID: 34518748 PMCID: PMC8425745 DOI: 10.1016/j.jor.2021.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/12/2021] [Accepted: 09/01/2021] [Indexed: 01/06/2023] Open
Abstract
Background The COVID-19 pandemic has caused unprecedented concerns on the safety, well-being, quality of life(QOL), and training of the orthopedic resident physician workforce worldwide. Although orthopedic residency programs across the globe have attempted to redefine resident roles, educational priorities, and teaching methods, the global orthopedic residents’ perspective with regards to their safety, well-being, QOL, and training, taking into account regional variances remains unknown. Methods A 56-item-questionnaire-based cross-sectional survey was conducted online during the COVID-19 pandemic involving 1193 orthopedic residents from 29 countries across six geographical regions to investigate the impact of the COVID-19 pandemic on the well-being, safety, and training of orthopedic residents at a global level, as well as to analyze the challenges confronted by orthopedic residency programs around the world to safeguard and train their resident workforce during this period. Results The total response rate was 90.3%(1077/1193). Time spent on residency-training activities decreased by 24.7 h/week (95% CI, −26.5 to −22.9,p < 0.001), with 50.2% (n = 541) residents performing duties outside their residency curriculum. 80.5% (n = 869) residents had no prior experience working in infectious outbreaks. A greater percentage of residents from Middle East, Asia and Europe were redeployed to the COVID-19 frontlines, p < 0.001. Only 46.5% (n = 491) and 58.4% (n = 600) of residents underwent training in critical care or PPE (Personal Protective equipment) usage, respectively; 28.5% (n = 302) residents (majority from Africa, Middle East, South America) reported lack of institutional guidelines to handle infectious outbreaks; 15.4% (n = 160) residents (majority from Africa, Asia, Europe) had concerns regarding availability of PPE and risk of infection. An increase in technology-based virtual teaching modalities was observed. The most significant stressor for residents was the concern for their family's health. Residents' QOL significantly decreased from 80/100 (IQR 70–90) to 65/100 (IQR 50–80) before and during the pandemic, p < 0.001. Conclusions The COVID-19 pandemic has significantly impacted the safety, well-being, QOL, and training of the global orthopedic resident physician workforce to different extents across geographical regions. The findings of this study will aid educators, program leaderships, and policy makers globally in formulating flexible, generalizable, and sustainable strategies to ensure resident safety, well-being, and training, while maintaining patient care.
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Affiliation(s)
- Aju Bosco
- Orthopedic Spine Surgery Division, Institute of Orthopedics and Traumatology, Madras Medical College, EVR Road, Park Town, Chennai, 600003, TamilNadu, India
| | - Hui Wen Tay
- Department of Orthopedics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ilyas Aleem
- Department of Orthopedic Surgery, University of Michigan, 1500 East Medical Center Drive, 2912 Taubman Center, SPC 5328, Ann Arbor, MI, 48109, USA
| | - Mustafa Citak
- Department of Orthopedic Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767, Hamburg, Germany
| | - Nalli Ramanathan Uvaraj
- Orthopedic Spine Surgery Division, Institute of Orthopedics and Traumatology, Madras Medical College, Chennai, 600003, TamilNadu, India
| | - Jong-Beom Park
- Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271 Cheonbo-ro, Uijeongbu-si, Gyeonggi-do, 11765, South Korea
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University, Keio University Hospital, Shinanomachi 35, Shinjyukuku, Tokyo, 160-8582, Japan
| | - Oliver Marin-Penna
- Department of Orthopedic Surgery and Traumatology, Hospital Universitario Infanta Leonor, C/ Gran Via del Este, 80, 28031, Madrid, Spain
| | - Janakiraman Buvanesh
- Institute of Orthopedics and Traumatology, Madras Medical College, Chennai, 600003, TamilNadu, India
| | - Moin Khan
- Division of Sports Medicine & Shoulder Surgery, Department of Orthopedic Surgery, McMaster University, 1280 Main Street West, Michael DeGroote Centre for Learning and Discovery (MDCL), 3104 Hamilton, Hamilton, ON, L8S 4K1, Canada
| | - Hwee Weng Dennis Hey
- University Orthopedics, Hand and Reconstructive Microsurgery Cluster (UOHC), National University Health System, 1E Kent Ridge Road, NUHS Tower Block Level 11, 119228, Singapore
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Wen YX, Wang H, Tie K, Ni QB, Qin J, Tan Y, Pan ZQ, Chen B, He HY, Chen LB. Safety and Effectiveness of Orthopaedic Medical Staff in Providing Support in Combating the COVID-19 Pandemic: A Retrospective Investigation from Wuhan, China. Orthop Surg 2021; 13:778-785. [PMID: 33686801 PMCID: PMC8126947 DOI: 10.1111/os.12898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/19/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022] Open
Abstract
Objective To evaluate whether it is safe and effective for orthopaedic medical staff to provide support to the work against COVID‐19. Methods One hundred and twenty‐two orthopaedic medical staff from the orthopaedic center of Zhongnan Hospital of Wuhan University were included in this retrospective investigation. A total of 43 surgeons and 69 nurses provided medical support in the treatment of COVID‐19 patients from 1 January 2020 to 8 April 2020 in four different hospitals in Wuhan. We collected data on the age, gender, and body temperature of orthopaedic medical staff, as well as the results for their chest CT scans, SARS‐CoV‐2 RNA, SARS‐CoV‐2 IgM and SARS‐CoV‐2 IgG tests, and training and examinations on COVID‐19 knowledge. We also collected data on the time span of work, the number of infected staff during the support period, the number of COVID‐19 patients the surgeons treated and the cure rate, the performance of the surgeons as assessed by the specialists and patients, and the number of infected staff during the pandemic. Results Among the 49 surgeons and 73 nurses, 43 surgeons and 69 nurses provided support against COVID‐19. A total of 12 surgeons and 11 nurses provided support in the fields of respiration, intensive care, and emergency. A total of 34 surgeons and 58 nurses worked in the designated wards restructured for COVID‐19 in the orthopaedic building. The average time span of work for the surgeons and nurses was 14.78 ± 3.64 days and 24.77 ± 7.58 days, respectively. No staff were infected during the support period. Over 1000 patients were received in the fever clinic by orthopaedic surgeons. The overall number of the treated hospitalized patients was 622. Among these patients, 226 cases were mild, 318 were mild to moderate, and 58 were severe or critical. The cure rate was 96.01%, 99.37%, and 52.00% respectively. The performance of the surgeons was scored 87.02 ± 3.17 and 90.69 ± 3.58 by the specialists and the patients, respectively. During the whole pandemic, 3 surgeons and 3 nurses who did not participate in the support work were infected in the early stages. The morbidity of all the orthopaedic staff was 4.92% during the whole pandemic, while no one was infected during the support work. Conclusion Our investigation indicated that although they worked outside their specialty, it was safe and effective for the orthopaedic staff to provide medical support in the work against COVID‐19 with adequate precautions and proper training.
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Affiliation(s)
- Yin-Xian Wen
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hua Wang
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kai Tie
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qu-Bo Ni
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jun Qin
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yang Tan
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zheng-Qi Pan
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Biao Chen
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hang-Yuan He
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Liao-Bin Chen
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
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Rawal M, Kathayet TS, Rokaya PK, Thakur AK, Mahat S, Acharya BD, Karki DB, Ojha S. Orthopaedics Practice in a Rural Hospital During the COVID-19 Pandemic: A Descriptive Cross-Sectional Study. JNMA J Nepal Med Assoc 2020; 58:847-850. [PMID: 34506407 PMCID: PMC7775012 DOI: 10.31729/jnma.5543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The coronavirus disease 2019 pandemic is one of the biggest public health challenges that we have faced, and has had a significant impact on the delivery of essential healthcare worldwide. Trauma and orthopaedic surgery was one of the most severely affected specialties as all non-emergency surgical cases were cancelled. With the possibility of future peak of corona virus, knowing the impact of Covid on orthopaedics would enable us to manage trauma patient in an effective manner and will help us to resume normal schedule of the trauma care. METHODS This is a descriptive cross-sectional study. We studied the details of total number of patient at Orthopaedic and trauma outpatient, inpatient and operation theatre of Karnali Academy of Health Sciences from 14th March 2020 to 16 September 2020 as compared with the patient data from the same time period in 2019. RESULTS There were 2288 patients during the non-Covid period who visited to the orthopaedic outpatient in comparison to 1618 during Covid period. Only 5 implant removals were performed in comparison to 50 removals (90% reduction) in elective cases. But the number of surgical cases was almost similar (204 vs 207 respectively). Total number of hospital stay had significantly reduced in the non-COVID period (average 4 days vs 6 days).There were 181 in-patient admissions during the COVID period while 241 admission during the non-COVID period. CONCLUSIONS There is reduction in number of orthopaedic and trauma cases during COVID 19 with marked reduction in number of elective cases. Alternative methods of treatment like telemedicine and small scale health camps at peripheral districts should be conducted to treat non-urgent orthopaedic conditions during lockdown.
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Affiliation(s)
- Mangal Rawal
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Tufan Singh Kathayet
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Poojan Kumar Rokaya
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Abhishek Kumar Thakur
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Smritee Mahat
- Department of Pathology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Bishnu Dutta Acharya
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Dhan Bahadur Karki
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
| | - Sujata Ojha
- Department of Orthopedic and Trauma, Karnali Academy of Health Sciences, Jumla, Nepal
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Sheridan GA, Hughes AJ, Quinlan JF, Sheehan E, O'Byrne JM. Quantifying the impact of the COVID-19 pandemic on orthopaedic trainees: a national perspective. Bone Jt Open 2020; 1:645-652. [PMID: 33215097 PMCID: PMC7659703 DOI: 10.1302/2633-1462.110.bjo-2020-0149.r1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aims We aim to objectively assess the impact of COVID-19 on mean total operative cases for all indicative procedures (as outlined by the Joint Committee on Surgical Training (JCST)) experienced by orthopaedic trainees in the deanery of the Republic of Ireland. Subjective experiences were reported for each trainee using questionnaires. Methods During the first four weeks of the nationwide lockdown due to COVID-19, the objective impact of the pandemic on each trainee's surgical caseload exposure was assessed using data from individual trainee logbook profiles in the deanery of the Republic of Ireland. Independent predictor variables included the trainee grade (ST 3 to 8), the individual trainee, the unit that the logbook was reported from, and the year in which the logbook was recorded. We used the analysis of variance (ANOVA) test to assess for any statistically significant predictor variables. The subjective experience of each trainee was captured using an electronic questionnaire. Results The mean number of total procedures per trainee over four weeks was 36.8 (7 to 99; standard deviation (SD) 19.67) in 2018, 40.6 (6 to 81; SD 17.90) in 2019, and 18.3 (3 to 65; SD 11.70) during the pandemic of 2020 (p = 0.043). Significant reductions were noted for all elective indicative procedures, including arthroplasty (p = 0.019), osteotomy (p = 0.045), nerve decompression (p = 0.024) and arthroscopy (p = 0.024). In contrast, none of the nine indicative procedures for trauma were reduced. There was a significant inter-unit difference in the mean number of total cases (p = 0.029) and indicative cases (p = 0.0005) per trainee. We noted that 7.69% (n = 3) of trainees contracted COVID-19. Conclusion During the COVID-19 pandemic, the mean number of operative cases per trainee has been significantly reduced for four of the 13 indicative procedures, as outlined by the JCST. Reassignment of trainees to high-volume institutions in the future may be a plausible approach to mitigate significant training deficits in those trainees worst impacted by the reduction in operative exposure.
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Affiliation(s)
- Gerard A Sheridan
- Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrew J Hughes
- Department of Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John F Quinlan
- Department of Orthopaedic Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Eoin Sheehan
- Department of Orthopaedic Surgery, Midlands Regional Hospital, Tullamore, Ireland
| | - John M O'Byrne
- Orthopaedic Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
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Wallace CN, Kontoghiorghe C, Kayani B, Chang JS, Haddad FS. The impact of COVID-19 on trauma and orthopaedic surgery in the United Kingdom. Bone Jt Open 2020; 1:420-423. [PMID: 33215133 PMCID: PMC7659697 DOI: 10.1302/2633-1462.17.bjo-2020-0102] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The coronavirus 2019 (COVID-19) global pandemic has had a significant impact on trauma and orthopaedic (T&O) departments worldwide. To manage the peak of the epidemic, orthopaedic staff were redeployed to frontline medical care; these roles included managing minor injury units, forming a "proning" team, and assisting in the intensive care unit (ICU). In addition, outpatient clinics were restructured to facilitate virtual consultations, elective procedures were cancelled, and inpatient hospital admissions minimized to reduce nosocomial COVID-19 infections. Urgent operations for fractures, infection and tumours went ahead but required strict planning to ensure patient safety. Orthopaedic training has also been significantly impacted during this period. This article discusses the impact of COVID-19 on T&O in the UK and highlights key lessons learned that may help to proactively prepare for the next global pandemic. Cite this article: Bone Joint Open 2020;1-7:420-423.
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Affiliation(s)
- Charles N. Wallace
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Christina Kontoghiorghe
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Barbar Kayani
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Justin S. Chang
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
| | - Fares S. Haddad
- Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
- Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK
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