The Surgical Director and I have both provided blog entries recently regarding surgical training during the current COVID-19 crisis. We all know that there is little, if anything, about daily life that hasn’t been impacted during these turbulent and tragic times. As surgeons much of daily life is being focused on ‘service provision’ work that might fall far from our usual area of practice. This means that standard training in surgery has changed and is not as we all know it. However, it should not mean that the ethos of surgical training should disappear.
Mentorship is a critical part of surgical training and we suggest this is one area of our work that can be expanded during this crisis. The idea of mentorship is not new – surgeons of all levels will identify with someone who has supported, nurtured and provided guidance at some stage of their career. The benefits of mentorship are now formally recognised – indeed surgical societies are advocating programmes to support surgeons at all levels of training.
Most of us are now fortunate to have ready access to technology that allows for remote meetings and conferences to take place from inside the home. Indeed, many hospitals are now using video calls as a way of following up patients and our experience is that this can be very effective if used correctly. There is no reason that these platforms cannot be used to provide surgical development, training and mentorship.
Schools are closed and activities for young people are now limited to what can be done in the home. We are not yet able to say how this may impact on young people’s aspirations. The major worry is that those young people from more disadvantaged backgrounds will be impacted the most. Many access to medicine programmes have been impacted and, of course, work experience placements have had to be postponed or cancelled throughout the NHS. Those who are seeking a taste of life in medicine (as a surgeon or other) will therefore lose out. If there was enough support from the surgical profession, a formal mentorship programme for those senior school children and sixth form students interested in surgical careers could be organised.
Any mentorship programme can also be extended. Medical schools have been severely disrupted with many students having placements and training activities completely cancelled. Events that have been lost include surgical careers talks, networking meetings and training days. To ensure we maintain a healthy level of undergraduate interest in surgery we should embrace the use of technology and move toward online training and development. From our own work with medical students we anticipate there would be very significant demand for a programme that can help with career planning and development.
We all appreciate the COVID crisis has resulted in significant levels of re-deployment. Foundation doctors in surgery and core surgical trainees have found their placements change overnight to specialties such as respiratory medicine and elderly care. For those who have stayed in a surgical environment, cancellations of elective work have seen training opportunities decimated. As is often the case in ‘normal times’ it is often the most junior member of the surgical team who will miss out the most. Coupled with this has been the cancellation or delay of very important events such as national recruitment and examinations. We all fully appreciate how many months of lost preparation time can be deeply demoralising. To help improve morale we feel that having regular meetings with a senior surgeon can be encouraging and motivating.
Of course, even at the most senior levels of training and for consultants, being able to discuss issues in a confidential environment can be very helpful. Many of us have also been faced with caring for patients from specialties with which we are not familiar. For someone who has not worked outside their area of expertise for many years this can be extremely worrying and stressful. A platform to share ideas and lessons learnt can be healthy. We hope that there would be significant support for improving mentorship and any ideas or interest, from anybody at any stage of training, are welcomed to the senior author. Please submit your ideas to firstname.lastname@example.org.
About the Author:
Michael Gooseman MFSTEd, Specialty Registrar in Cardiothoracic Surgery at Leeds Teaching Hospitals NHS Trust.
David O’Regan FFSTEd, Director, Faculty of Surgical Trainers at The Royal College of Surgeons of Edinburgh.
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