10.14639/0392-100X-N1529
text/xml
1827-675X
1529
en
Vito Colacurcio
https://creativecommons.org/licenses/by-nc-nd/4.0
ACTA Otorhinolaryngologica Italica
otorhinolaryngology
To be a head and neck surgical trainee in the COVID-19 era. Residents’ perspectives after one year of residency 2.0
Text.Serial.Journal
https://www.actaitalica.it/
41
Letters to the Editor-in-Chief
2021-05-06
2021-03-02
2021-09-15
2021-09-15
383-384
1
Vito Colacurcio
2021/05/06
10.14639/0392-100X-N1529
383
Department of Medicine, Surgery and Dentistry. University of Salerno, Italy
1827-675X
otorhinolaryngology
384
To be a head and neck surgical trainee in the COVID-19 era. Residents’ perspectives after one year of residency 2.0
https://www.actaitalica.it/article/download/1529/553
41
ACTA OTORHINOLARYNGOLOGICA ITALICA 2021;41:383-384; doi: 10.14639/0392-100X-N1529




Letter to the Editor


To be a head and neck surgical trainee
in the COVID-19 era. Residents’ perspectives
after one year of residency 2.0
Specializzarsi in chirurgia testa-collo durante l’era COVID-19.
Prospettive degli specializzandi dopo un anno di “specializzazione 2.0”
Pietro De Luca, Pasquale Marra, Antonella Bisogno, Donato Troisi, Michele Petrosino, Egidio De Bonis,
Matteo Calvanese, Vito Colacurcio
Department of Medicine, Surgery and Dentistry. University of Salerno, Italy


KEY WORDS: COVID-19, pandemic, residency, surgical residents, otorhinolaryngology
PAROLE CHIAVE: COVID-19, pandemia, specializzazione, specializzandi in chirurgia,
otorinolaringoiatria


Dear Editor,
Since February 2020, the spreading of Coronavirus disease (COVID-19) from
Wuhan (China) has forced Academic Institutions to reallocate their healthcare
personnel into departments dedicated to COVID-19 and to confront unprec-              Received: March 2, 2021
edented and long-standing challenges in higher education 1. The impact of the         Accepted: March 15, 2021
first wave of the recent pandemic on surgical residency has been considerable,        Published online: May 6, 2021
with a dramatic change in our usual workflows and our medical and surgical
                                                                                      Correspondence
education never experienced by the previous generations of residents. After           Pietro De Luca
one year of the pandemic, what we need to understand is: should we consider           Department of Medicine, Surgery and Dentistry.
this “residency 2.0” as a standstill, or as a starting point? In trying to answer     University of Salerno, Italy
                                                                                      E-mail: dr.dlp@hotmail.it
this question, we provide some food for thought.
As a part of the national plan to flatten the curve of SARS-CoV-2 infections          Funding
and reduce the impact on local healthcare systems, all non-elective and non-          None.
urgent surgical procedures ceased 2; this reduction leaded to a decrease in resi-
                                                                                      Conflict of interest
dents’ involvement in the surgical theatre, with possible negative effects linked     The Authors declare no conflict of interest.
to the lack of training, especially for last-year residents. Meanwhile, surgery
and dissection courses on the national territory were also suspended, denying           How to cite this article: De Luca P, Marra P,
trainees the possibility to partially bridge the gap caused by the decrease of sur-     Bisogno A, et al. To be a head and neck surgi-
gical procedures. To run for cover, academic institutions dealt contracts with          cal trainee in the COVID-19 era. Residents’ per-
                                                                                        spectives after one year of residency 2.0. Acta
companies that provide online courses and distance learning; online education           Otorhinolaryngol Ital 2021;41:383-384. https://
became viral during the COVID-19 pandemic, with an exponential growth of                doi.org/10.14639/0392-100X-N1529
online classes. Although we participated in many courses at a distance, and we
                                                                                      © Società Italiana di Otorinolaringoiatria
ourselves gave online lectures for medical students, we are deeply convinced          e Chirurgia Cervico-Facciale
that face-to-face interaction will never be matched in quality by other modali-
ties of teaching and learning. We really appreciate this “resident-as-teacher”                       OPEN ACCESS
program and the pride of docere, but we experienced a notable frustration             This is an open access article distributed in accordance with
in these non-interpersonal classes, uncertain if this way of interaction with         the CC-BY-NC-ND (Creative Commons Attribution-Non-
                                                                                      Commercial-NoDerivatives 4.0 International) license. The
medical students may ensure a full understanding of the concepts explained.           article can be used by giving appropriate credit and mentio-
                                                                                      ning the license, but only for non-commercial purposes and
We also believe that watching high-quality surgical videos to make up for the         only in the original version. For further information: https://
significant loss of time in the operating room could be confusing in the long         creativecommons.org/licenses/by-nc-nd/4.0/deed.en




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P. De Luca et al.




run and is not helpful in replacing the lost hours of surgery.   more on deferred surgical cases, such as sinus surgery, ear
Next, most of the elective rotations were also up in the air;    surgery and cochlear implants, since not all types of head
indeed, many hospitals denied the possibility of trainees’       and neck procedures were affected equally, with necessary
rotation to avoid the hazardous crowding in departments,         prioritisation on urgent procedures. In addition, residency
with a further reduction in training.                            programmes should expand and give priority to hospitals
On the other hand, we must absolutely consider that being        in the training network; in this way, trainees will have the
residents in a global pandemic and the experience gained         opportunity to try their hand at different realities, even pe-
in the COVID-19 dedicated departments has definitely im-         ripheral ones, with a direct approach to the operating room.
proved our decision-making and management skills, mak-           Finally, during the pandemic we were able to dedicate more
ing us better future leaders.                                    time to scientific research, and in line with the literature
First of all, we developed better competence in managing         trend 5 we decided to focus our efforts on issues related
patients from home, whenever it was possible. When re-           to COVID-19, to help develop better strategies for diagno-
quired to evaluate a patient in person, we gradually refined     sis and treatment; in the next future, a substantial amount
our skill of gathering personal history before the examina-      of time should continue to be dedicated to developing re-
tion, pressed by the urgent need to minimise as much as          search skills.
possible the risk of a misdiagnosis, and subsequent unnec-       After one year of the pandemic, a full restart of surgical
essary procedures that could be both risky for the personnel     residency programs is necessary to bridge the surgical gap
involved and for waste of resources in this time of shortag-     created by the COVID-19 pandemic and to avoid that this
es. In addition, visiting patients using face masks, goggles     global crisis will not be a “lesson to be learned”. Desper-
and other inconvenient protective equipment forced us to         ate times call for desperate measures. We sacrificed part of
spend more energy and effort in trying to conduct an appro-      our training with a thought in mind: to make a contribu-
priate examination: this could reflect in greater confidence     tion, however small, in the global fight against COVID-19.
when the situation will resume to normal.                        Hopefully, this effort will also speed up the return to our
Since a nasopharyngeal swab remains the gold standard for        residency program.
specimen sampling and subsequent molecular analysis 3,
ENT trainees were involved in teaching this procedure to         Acknowledgements
healthcare personnel, giving their knowledge of this ana-
tomical location. We were often asked to explain critical        The authors would like to thank Ettore Cassandro, Chief,
anatomic landmarks and we gladly gave tips for a more sen-       Head and Neck Department, University of Salerno (Saler-
sitive and safe test. This had the added benefit of strength-    no, Italy), for his critical review and for the leadership dur-
ening the relationship with other trainees, specialists and      ing the COVID-19 pandemic.
nurses from all branches of medicine, equally involved in
the current pandemic. Moreover, all the procedures we had        References
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                                                                 5
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To reschedule appropriate training, we think that in the             outbreak. Biomed Pharmacother 2020;129:110451. https://doi.
second and third phase the residency training should focus           org/10.1016/j.biopha.2020.110451




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