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Trainee Surgeons in the COVID-19 Era: Combatting Suboptimal Conditions
30 October 2020
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While the Confederation of British Surgery continue to be impressed with the tireless dedication of surgeons and those in the surgical training pathway as all of us in the medical profession work above and beyond to meet the myriad challenges posed by COVID-19, we do recognise that the effects – including burnout and illness – are very real, and that many surgeons feel frustrated, rather than encouraged by what has arguably been ‘empty’ applause.
We would therefore encourage Surgeons to prioritise and practice self-care in addition to performing their duties. It may be helpful to those who have not yet read our June blog, Mutual Support and Limiting Moral Distress in the Time of C-19 to review it, along with the paper from which it was derived.
Last month in our blog Trainee Surgeons in the Covid-19 Era: In Their Own Words, we discussed some of the many issues affecting trainees, and presented some of their proposals to ameliorate the training process. This month, we continue to examine some factors affecting surgical training in the current climate.
As we saw thousands of nurses and NHS staff demonstrating this August to demand planned pay rises be brought forward in the wake of their service on the front lines of the pandemic – protests that were unequivocally supported by the Confederation – we reflect that this chaotic backdrop poses unique circumstances for all medics, and certainly for aspiring surgeons, as well as those already in the surgical training pathway.
In 2017, a study* conducted on behalf of the Council of the Association of Surgeons in Training demonstrated that applications for surgical training had declined over the previous decade, and recognised that trainees were achieving educational requirements at substantial personal expenditure. The study’s conclusions indicated that in order to encourage graduates to pursue and remain in surgical training, urgent action was required;
- To fund the mandatory requirements and annual training costs for completion of training; and,
- To provide greater transparency to inform doctors of what postgraduate training costs would be.
These measures were seen by researchers as fundamental to increase diversity in surgery, reduce the debt load on trainees, and to ensure surgery remained a popular career choice – all aspects the Confederation deems essential to advance the profession.
Three years on, whilst significant efforts have been undertaken – chiefly innovated from within the surgical community - to improve education and training, conditions remain suboptimal. With prohibitive factors around the financial costs continuing to affect those in the training pathway, it is perhaps unsurprising that issues like the global pandemic, economic uncertainty and concerns about the devastating impact of a no-deal Brexit on the NHS** have given aspiring surgeons pause.
— Simon Fleming 🔨 (@OrthopodReg) May 5, 2019
Add to this the psychological, social and physical costs of surgical training, and factor in a culture that can often leave trainees feeling demoralised, and it’s obvious the status quo must be urgently addressed to ensure the profession continues to attract the next generation of surgeons.
Attesting to these valid concerns, the recent results of our pioneering research (a summary of which can be viewed in our September blog CBS’ Groundbreaking Research Makes Headlines Across the Nation, with the full results available in the CBS News section of the website), shone a light on disturbing practices within the healthcare service, and a culture of abusive treatment against surgeons by their NHS employers – a sentiment which has been echoed and amplified across social media over the last several years.
Despite the many challenges faced by aspiring surgeons, CBS, the trade union established for surgeons, by surgeons, are continually seeking to empower trainees and improve the current situation. We firmly believe that surgeons are natural innovators, as our profession routinely demands in-depth analysis to generate solutions to complex problems – so we know that surgeons are well-placed to identify areas of improvement, and equipped with the steadfastness needed to implement solutions.
Recently, the Confederation have been keen to support the Future Surgery show, which explored disruptive technology, connectivity, human factors training and research. The potential for new technology to improve efficiency in theatre, drive down costs and enhance patient outcomes is incredibly exciting, and we strongly believe in supporting UK surgical teams' ongoing education regarding new tech initiatives, equipment, and procedures.
Additionally, the Confederation have launched a new study to take the temperature of trainees about their perceptions regarding surgical training during COVID-19, which can be completed here. This has been sent to members as well as forwarded on to surgical associations and promoted on social media, and consultants have been encouraged to distribute the survey to their trainees, in order to build a robust dataset and obtain the views of trainees across the UK.
As we outlined last month, CBS recognises we must act together to meet the challenges of the second wave and the colder months, and while we acknowledge that current circumstances make it difficult to have answers where additional information remains vague, we are nevertheless encouraged by the innovative and resolute spirit of the surgical community.
CBS is keen to hear from those involved in training at all levels, so that we can best support the education and training of our future surgeons. As always, we welcome your views and comments, please engage with us via @UKsurgeons across social media platforms.
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*https://bmjopen.bmj.com/content/bmjopen/7/11/e018086.full.pdf
** https://www.bma.org.uk/news-and-opinion/demand-to-avoid-no-deal-brexit
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