Orthopaedic residency in the time of COVID-19: navigating a new normal

Sir,

I am writing to bring attention to the significant impact that the COVID-19 pandemic had on the training programs of orthopaedic residents in India. While the pandemic has ended, the consequences are still felt, particularly by those in the orthopaedic community.

The pandemic had affected outpatient clinics, emergency and elective surgery, rehabilitation, resident training, personnel management, use of personal protective equipment, telemedicine and all sub-specialties of orthopaedics.¹

One significant impact of the pandemic was the nationwide lockdown that led to a reduction in the number of trauma surgeries performed. As a result, orthopaedic residents had less exposure to trauma management, which is an essential part of their training. The reduction in trauma surgeries also had negative implications for patient care, as the management of traumatic injuries requires specialized expertise.

Additionally, the pandemic has resulted in orthopaedic residents lagging behind their peers and contemporaries due to the challenges they faced during their training. Clinical duty hours and case volume were reported to have substantially decreased, with a large portion of residents viewing their overall resident education as worsened and reporting negative impacts on their overall well-being.² The cancellation of elective surgeries and reduced exposure to trauma management has resulted in residents having limited opportunities to develop and improve their skills. This is particularly concerning given the rapid pace of technological advancements in the field of orthopaedics.

Another significant challenge is the reduction in conferences and continued medical education (CME) sessions, which are crucial to keeping young budding ortho-paedicians up-to-date with current evidence-based medicine. These educational opportunities provide a platform for residents to learn from experienced physicians and interact with their peers, enhancing their skills and knowledge.

To overcome these challenges, it is essential to develop programs that incorporate the use of virtual platforms and innovative teaching methods. The use of technology can help to bridge the gap by providing opportunities for residents to observe and learn from surgeries remotely. Additionally, virtual CME sessions can help keep residents up-to-date with the latest developments in the field of orthopaedics. The utilization of the internet to distribute educational materials and hold instructional gatherings has created virtual connections between students and educators. Novel methods for teaching and administering assessments have been implemented. The use of a rotating team system has enabled teaching to continue safely.³

In conclusion, the COVID-19 pandemic has had significant implications for orthopaedic residents in India. As we move forward, it is critical that we recognize the impact of the pandemic on orthopaedic residency training programs and develop strategies to address the challenges faced by residents. By doing so, we can ensure that the next generation of orthopaedic professionals receives the necessary training and education to provide high-quality patient care and stay abreast of the latest developments in the field.

REFERENCES

1. 1. Chatterji G, Patel Y, Jain V, Geevarughese NM, Haq RU. Impact of COVID-19 on orthopaedic care and practice: a rapid review. Indian J Orthop. 2021;55(4):839-52.
2. 2. Higginbotham DO, Zalikha AK, Stoker SK, Little BE. The impact of COVID-19 on the orthopaedic surgery residency experience. Spartan Med Res J. 2021;6(2):25963.
3. 3. Giordano L, Cipollaro L, Migliorini F, Maffulli N. Impact of COVID-19 on undergraduate and residency training. Surgeon. 2021;19(5):199-206.