The perceived global impact of the COVID-19 pandemic on doctors' medical and surgical training: An international survey.

INTRODUCTION: The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to the medical and surgical training of doctors globally. AIMS AND OBJECTIVES: This is the first international survey assessing the perceived impact of the COVID-19 pandemic on the training of doctors of all grades and specialties. METHODS: An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data were collated anonymously with informed consent and analysed using univariate and adjusted multivariable analyses. RESULTS: Seven hundred and forty-three doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n = 422) being male. Two-thirds of doctors were in a training post (66.5%, n = 494), 52.9% (n = 393) in a surgical specialty and 53.0% (n = 394) in low- and middle-income countries. Sixty-nine point two percent (n = 514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted amongst non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (P ≤ .05). Low or middle-income country doctors' training was associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (P ≤ .05). CONCLUSION: In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, this international survey reports a widespread perceived overall negative impact on medical and surgical doctors' training globally. Ongoing adaptation and innovation will be required to enhance the approach to doctors' training and learning in order to ultimately improve patient care.

Health Inequalities During COVID-19 and Their Effects on Morbidity and Mortality.

Inequalities in health have existed for many decades and have led to unjust consequences in morbidity and mortality. These have become even more apparent during the COVID-19 pandemic with individuals from black and minority ethnic groups, poorer socioeconomic backgrounds, urban and rurally deprived locations, and vulnerable groups of society suffering the full force of its effects. This review is highlighting the current disparities that exist within different societies, that subsequently demonstrate COVID-19, does in fact, discriminate against disadvantaged individuals. Also explored in detail are the measures that can and should be taken to improve equality and provide equitable distribution of healthcare resources amongst underprivileged communities.

The role of computed tomography scan in the diagnosis of COVID-19 pneumonia.

PURPOSE OF REVIEW: To summarize current literature evidence on the role of computed tomography (CT) scan in the diagnosis and assessment of coronavirus disease 2019 (COVID-19) pneumonia. RECENT FINDINGS: Recent guidelines on the use of CT scans in COVID-19 vary between countries. However, the consensus is that it should not be used as the first line; a notion supported by the WHO. Currently, several investigations are being used including reverse transcription PCR testing, chest radiographs, and ultrasound scans, and CT scans. They are ideally performed later during the disease process as the sensitivity and specificity are highest by that time. Typical COVID-19 features on CT scans vary but include vascular enlargement, ground-glass opacities, and ground glass opacification together with consolidation. SUMMARY: Since COVID-19 was declared as a global pandemic, there was a push towards identifying appropriate diagnostic tests that are both reliable and effective. There is a general agreement that CT scans have a high sensitivity but low specificity in diagnosing COVID-19. However, the quality of available studies is not optimal, so this must always be interpreted with the clinical context in mind. Clinicians must aim to weigh up the practicalities and drawbacks of CT scans when considering their use for a patient. The ease and speed of use of CT scans must be balanced with their high radiation doses, and infection control considerations.