Impact of SARS-CoV-2 on training and mental wellbeing of surgical gynaecological oncology trainees

ABSTRACT

Introduction/Background*The SARS-CoV-2 global-pandemic has caused a crisis disrupting health systems worldwide. Whilst efforts are afoot to determine the extent of disruption, impact on gynaecological oncology trainees/training has not been explored. We present data from an international survey on impact of SARS-CoV-2 on clinical practice, medical education, and mental wellbeing of surgical gynaecological oncology trainees.MethodologyIn our prospective cohort study, a customised web-based-survey was circulated to surgical gynaecological oncology trainees from national/international organisations (May-November 2020). Validated questionnaires assessed mental wellbeing. Wilcoxon rank sum test and Fisher’s exact test tested hypothesis about differences in means and proportions. Multiple linear regression evaluated effect of variables on psychological/mental wellbeing outcomes. Outcomes included clinical practice, medical education, anxiety & depression, distress, mental wellbeingResult(s)*127 trainees from 34 countries responded. 52% (66/127) were from countries with national training programmes (UK/USA/Netherlands/Canada/Australia) and 48% (61/127) from non-national training programme countries. 28% had suspected/confirmed COVID19;28% experienced drop in household income;20% self-isolated from households;45% had to re-use personal protective equipment and 22% purchased their own. 32.3% (41/127) trainees (national training programme trainees=16.6% (11/66);non national training programme trainees=49.1% (30/61), p=0.02) require additional time to complete their training fellowship. The additional training time anticipated did not differ between trainees from countries with/without national training programmes (p=0.11). Surgical training was detrimentally impacted for 50% trainees, with more national training programme trainees (62.3% (38/61) than non national training programme trainees (38.5% (25/65), p=0.01) reporting a detrimental impact despite a greater reduction in mean surgical exposure reported by non national training programme trainees. Departmental teaching continued throughout the pandemic for 69% (87/126) trainees, albeit at reduced frequency for 16.1% (14/87), and virtually for 88.5% (77/87). Trainees reporting adequate pastoral support had better mental wellbeing with lower-levels of anxiety/depression (p=0.02) and distress (p<0.001). National training programme trainees experienced higher levels of distress (p=0.01). Mean mental wellbeing scores were significantly higher pre-pandemic (8.3 (SD=1.6) versus post-pandemic (7 (SD=1.8);p=<0.01).Conclusion*SARS-CoV-2 has negatively impacted surgical training, household income and psychological/mental wellbeing of surgical gynaecological oncology trainees. Overall clinical impact was worse for non national training programme versus national training programme-trainees, though national-training-programme-trainees reported greater distress. COVID19-sickness increased anxiety/depression. The recovery-phase must focus on improving mental-wellbeing and addressing lost training opportunities.