Discrimination of residents during neurosurgical training in Mexico: Results of a survey prior to SARS-CoV-2.

BACKGROUND: Recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic represents an important negative impact on global training of neurosurgery residents. Even before the pandemic, discrimination is a challenge that neurosurgical residents have consistently faced. In the present study, we evaluated discriminatory conditions experienced by residents during their neurosurgical training in Mexico before the SARS-CoV-2 pandemic. METHODS: An electronic survey of 18 questions was sent among residents registered in the Mexican Society of Neurological Surgery (MSNS), between October 2019 and July 2020. Statistical analysis was made in IBM SPSS Statistics 25. The survey focused on demographic characteristics, discrimination, personal satisfaction, and expectations of residents. RESULTS: A response rate of 50% (132 of 264 residents' members of MSNS) was obtained and considered for analysis. Median age was 30.06 ± 2.48 years, 5.3% (n = 7) were female and 16.7% (n = 22) were foreigners undergoing neurosurgical training in Mexico. Approximately 27% of respondents suffered any form of discrimination, mainly by place of origin (9.1%), by gender (8.3%) or by physical appearance (6.1%). About 42.9% (n = 3) of female residents were discriminated by gender versus 6.4% (n = 8) of male residents (P = 0.001); while foreign residents mentioned having suffered 10 times more an event of discrimination by place of origin compared to native Mexican residents (36.4% vs. 3.6%, P < 0.001). CONCLUSION: This manuscript represents the first approximation to determine the impact of discrimination suffered by residents undergoing neurosurgical training in Mexico before the SARS-CoV-2 pandemic.

Burnout, Discrimination, Abuse, and Mistreatment in Latin America Neurosurgical Training During the Coronavirus Disease 2019 Pandemic.

BACKGROUND: Discrimination, abuse, and mistreatment are prevailing problems reported in neurosurgical training programs globally. Moreover, the current coronavirus disease 2019 (COVID-19) pandemic may also show a negative impact on burnout levels in neurosurgery residents. This study aims to evaluate burnout, discrimination, and mistreatment in neurosurgical residents training in Latin America during the severe acute respiratory syndrome coronavirus 2 era. METHODS: A 33-item electronic survey was sent to neurosurgery residents from Latin America from May 10 to 25, 2021. Statistical analysis was performed using SPSS version 25. RESULTS: A total of 111 neurosurgery residents responded to the survey. Mean age was 29.39 ± 2.37 years; 22.5% were female and 36% were training in Mexico. Residents who reported experiencing discrimination for testing positive to COVID-19 had the highest levels of depersonalization (66.7%; P = 0.043) and emotional exhaustion (75%; P = 0.023). Female respondents reported higher rates of gender discrimination (80% vs. 1.2%; P = 0.001), abuse (84% vs. 58.1%; P < 0.005), and sexual harassment (24% vs. 0%; P < 0.001) than did male respondents. Residents training in Mexico reported lower rates of emotional or verbal abuse (59.2% vs. 32.5%; P = 0.007) and bullying (P < 0.005) than did those in other countries in Latin America. Older age was a protective factor for high depersonalization scores (odds ratio [OR], 0.133; 95% confidence interval [CI], 0.035-0.500). Experiencing discrimination represented a risk factor for presenting high emotional exhaustion scores (OR, 3.019; 95% CI, 1.057-8.629). High levels of depersonalization were associated with a 7-fold increased risk of suicidal ideation (OR, 7.869; 95% CI, 1.266-48.88). CONCLUSIONS: The COVID-19 pandemic has been a significant burden on several aspects of health care workers' lives. Our results provide a broad overview of its impact on burnout, discrimination, and mistreatment as experienced by neurosurgery residents training in Latin America, laying the groundwork for future studies and potential interventions.

Burnout, Discrimination, Abuse and Mistreatment in Latin America Neurosurgical Training During the COVID-19 Pandemic

Background Discrimination, abuse and mistreatment are prevailing problems reported in neurosurgical-training programs globally. Moreover, the current COVID-19-pandemic may also display a negative impact on burnout levels in neurosurgery-residents. This study aims to evaluate burnout, discrimination and mistreatment in neurosurgical-residents training in Latin-America during the SARS-CoV-2 era. Methods A 33-item electronic survey was sent to neurosurgery-residents from Latin-America from May-10 to May-25, 2021. Statistical analysis was made using IBM-SPSS-25. Results 111 neurosurgery residents responded the survey. Mean age was 29.39±2.37 years;22.5% were female and 36% were training in Mexico. Residents who reported suffering from discrimination for testing positive to COVID-19 had the highest levels of depersonalization (66.7%, p=0.043) and emotional-exhaustion (75%, p= 0.023). Female respondents presented higher rates of gender discrimination (80%vs.1.2%, p=0.001), abuse (84%vs.58.1%, p<0.005) and sexual-harassment (24%vs.0%, p<0.001) than male respondents. Residents training in Mexico presented lower rates of emotional or verbal abuse (59.2%vs.32.5%, p=0.007) and bullying (p<0.005) than other countries in Latin-America. Older-age was a protective factor for high depersonalization scores (OR 0.133, 95%CI 0.035-0.500). Suffering from discrimination represented a risk factor for presenting high emotional-exhaustion scores (OR 3.019, 95%CI 1.057-8.629). High levels of depersonalization were associated with a 7-fold increased risk of presenting suicidal ideation (OR 7.869, 95%CI 1.266-48.88). Conclusion The COVID-19 pandemic has been a significant burden on several aspects of healthcare workers’ lives. Our results provide a broad overview of its impact on burnout, discrimination and mistreatment as experienced by neurosurgery residents training in Latin-America, laying the groundwork for future studies and potential interventions.

Impact of the Coronavirus Disease 2019 Pandemic on Working and Training Conditions of Neurosurgery Residents in Latin America and Spain.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has exerted a significant impact on health care workers. Recent studies have reported the detrimental effects of the pandemic on neurosurgery residents in North America, Asia, and Italy. However, the impact of the pandemic on neurosurgical training in Latin America and Spain has not yet been reported. In the present report, we describe effects of COVID-19 on training and working conditions of neurosurgery residents in these countries. METHODS: An electronic survey with 33 questions was sent to neurosurgery residents between September 7, 2020 and October 7, 2020. Statistical analysis was made in SPSS version 25. RESULTS: A total of 293 neurosurgery residents responded. The median age was 29.47 ± 2.6 years, and 79% (n = 231) were male. Of respondents, 36.5% (n = 107) were residents training from Mexico; 42% surveyed reported COVID symptoms and 2 (0.7%) received intensive care unit care; 61.4% of residents had been tested for COVID and 21.5% had a positive result; 84% of the respondents mentioned persisted with the same workload (≥70 hours per week) during the pandemic. Most residents from Mexico were assigned to management of patients with COVID compared with the rest of the countries (88% vs. 68.3%; P < 0.001), mainly in medical care (65.4% vs. 40.9%; P < 0.001), mechanical ventilators (16.8% vs. 5.9%; P = 0.003), and neurologic surgeries (94% vs. 83%; P = 0.006). CONCLUSIONS: Our results offer a first glimpse of the changes imposed by the COVID-19 pandemic on neurosurgical work and training in Latin America and Spain, where health systems rely strongly on a resident workforce.