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Gaba F, Blyuss O, Rodriguez I, et al. Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees. Int J Gynecol Cancer. 2021;31(9):1268-1277doi: 10.1136/ijgc-2021-002803.
Gaba, F., Blyuss, O., Rodriguez, I., Dilley, J., Wan, Y. L., Saiz, A., Razumova, Z., Zalewski, K., Nikolova, T., Selcuk, I., Bizzarri, N., Theofanakis, C., Lanner, M., Pletnev, A., Gurumurthy, M., & Manchanda, R. (2021). Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees. International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, 31(9), 1268-1277. https://doi.org/10.1136/ijgc-2021-002803
Gaba, Faiza, et al. "Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees." International journal of gynecological cancer : official journal of the International Gynecological Cancer Society vol. 31,9 (2021): 1268-1277. doi: https://doi.org/10.1136/ijgc-2021-002803
Gaba F, Blyuss O, Rodriguez I, Dilley J, Wan YL, Saiz A, Razumova Z, Zalewski K, Nikolova T, Selcuk I, Bizzarri N, Theofanakis C, Lanner M, Pletnev A, Gurumurthy M, Manchanda R. Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees. Int J Gynecol Cancer. 2021 Sep;31(9):1268-1277. doi: 10.1136/ijgc-2021-002803. Epub 2021 Jul 29. PMID: 34326158.
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Int J Gynecol Cancer. 2021 Sep;31(9):1268-1277. doi: 10.1136/ijgc-2021-002803. Epub 2021 Jul 29.

Impact of SARS-CoV-2 on training and mental well-being of surgical gynecological oncology trainees.

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

Faiza Gaba, Oleg Blyuss, Isabel Rodriguez, James Dilley, Yee-Loi Louise Wan, Allison Saiz, Zoia Razumova, Kamil Zalewski, Tanja Nikolova, Ilker Selcuk, Nicolò Bizzarri, Charalampos Theofanakis, Maximilian Lanner, Andrei Pletnev, Mahalakshmi Gurumurthy, Ranjit Manchanda

Affiliations

  1. Department of Gynaecological Oncology, NHS Grampian, Aberdeen, UK [email protected] [email protected].
  2. Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
  3. Department of Physics, Astronomy and Mathematics, University of Hertfordshire, Hatfield, UK.
  4. Department of Pediatrics and Pediatric Infectious Diseases, Institute of Child's Health, Sechenov University, Moskva, Russian Federation.
  5. Department of Gynecologic Oncology, University of Washington, Seattle, Washington, USA.
  6. Department of Gynaecological Oncology, Barts and The London NHS Trust, London, UK.
  7. Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
  8. Department of Gynecologic Oncology, Northwestern University in Chicago, Chicago, Illinois, USA.
  9. Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
  10. Department of Gynecologic Oncology, ?wi?tokrzyskie Cancer Centre, Kielce, Poland.
  11. Department of Gynecologic Oncology, Academic Teaching Hospital of Heidelberg University, Baden-Baden, Germany.
  12. Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey.
  13. UOC Ginecologia Oncologica, Dipartimento per la salute della Donna e del Bambino e della Salute Pubblica, Policlinico Agostino Gemelli IRCCS, Rome, Italy.
  14. Department of Gynaecological Oncology, General Hospital of Athens Alexandra, Athens, Attica, Greece.
  15. Department of Obstetrics/Gynaecology, Kardinal Schwarzenberg'sches Krankenhaus, Schwarzach, Steiermark, Austria.
  16. Department of Gynecology and Obstetrics, University of Zielona Góra, Zielona Góra, Poland.
  17. Department of Gynaecological Oncology, NHS Grampian, Aberdeen, UK.
  18. Department of Gynaecological Oncology, Barts and The London NHS Trust, London, UK [email protected] [email protected].
  19. Wolfson Institute of Preventive Medicine, Barts CRUK Cancer Centre, Queen Mary University of London, London, UK.

PMID: 34326158 DOI: 10.1136/ijgc-2021-002803

Abstract

INTRODUCTION: The SARS-CoV-2 global pandemic has caused a crisis disrupting health systems worldwide. While efforts are being made to determine the extent of the disruption, the impact on gynecological oncology trainees/training has not been explored. We conducted an international survey of the impact of SARS-CoV-2 on clinical practice, medical education, and mental well-being of surgical gynecological oncology trainees.

METHODS: In our cross-sectional study, a customized web-based survey was circulated to surgical gynecological oncology trainees from national/international organizations from May to November 2020. Validated questionnaires assessed mental well-being. The Wilcoxon rank-sum test and Fisher's exact test were used to analyse differences in means and proportions. Multiple linear regression was used to evaluate the effect of variables on psychological/mental well-being outcomes. Outcomes included clinical practice, medical education, anxiety and depression, distress, and mental well-being.

RESULTS: A total of 127 trainees from 34 countries responded. Of these, 52% (66/127) were from countries with national training programs (UK/USA/Netherlands/Canada/Australia) and 48% (61/127) from countries with no national training programs. Altogether, 28% (35/125) had suspected/confirmed COVID-19, 28% (35/125) experienced a fall in household income, 20% (18/90) were self-isolated from households, 45% (57/126) had to re-use personal protective equipment, and 22% (28/126) purchased their own. In total, 32.3% (41/127) of trainees (16.6% (11/66) from countries with a national training program vs 49.1% (30/61) from countries with no national training program, p=0.02) perceived they would require additional time to complete their training fellowship. The additional training time anticipated did not differ between trainees from countries with or without national training programs (p=0.11) or trainees at the beginning or end of their fellowship (p=0.12). Surgical exposure was reduced for 50% of trainees. Departmental teaching continued throughout the pandemic for 69% (87/126) of trainees, although at reduced frequency for 16.1% (14/87), and virtually for 88.5% (77/87). Trainees reporting adequate pastoral support (defined as allocation of a dedicated mentor/access to occupational health support services) had better mental well-being with lower levels of anxiety/depression (p=0.02) and distress (p<0.001). Trainees from countries with a national training program experienced higher levels of distress (p=0.01). Mean (SD) pre-pandemic mental well-being scores were significantly higher than post-pandemic scores (8.3 (1.6) vs 7 (1.8); p<0.01).

CONCLUSION: SARS-CoV-2 has negatively impacted the surgical training, household income, and psychological/mental well-being of surgical gynecological oncology trainees. The overall clinical impact was worse for trainees in countries with no national training program than for those in countries with a national training program, although national training program trainees reported greater distress. COVID-19 sickness increased anxiety/depression. The recovery phase must focus on improving mental well-being and addressing lost training opportunities.

© IGCS and ESGO 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: COVID-19; surgery

Conflict of interest statement

Competing interests: FG declares research funding from the NHS Grampian Endowment Fund, Medtronic and Karl Storz outside this work. RM declares research funding from Barts & the London Charity, Eve Ap

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