COVID-19 and Canadian Gastroenterology Trainees

Rishad Khan; Parul Tandon; Michael A Scaffidi; Kirles Bishay; Katarzyna M Pawlak; Jan Kral; Sunil Amin; Mohammad Bilal; Rashid N Lui; Dalbir S Sandhu; Almoutaz Hashim; Steven Bollipo; Aline Charabaty; Enrique de-Madaria; Andrés F Rodríguez-Parra; Sergio A Sánchez-Luna; Michał Żorniak; Keith Siau; Catharine M Walsh; Samir C Grover

doi:10.1093/jcag/gwaa034

COVID-19 and Canadian Gastroenterology Trainees

J Can Assoc Gastroenterol. 2020 Oct 24;4(3):156-162. doi: 10.1093/jcag/gwaa034. eCollection 2021 Jun.

Authors

Rishad Khan¹, Parul Tandon², Michael A Scaffidi³, Kirles Bishay², Katarzyna M Pawlak⁴, Jan Kral⁵, Sunil Amin⁶, Mohammad Bilal⁷, Rashid N Lui⁸, Dalbir S Sandhu⁹, Almoutaz Hashim¹⁰, Steven Bollipo¹¹, Aline Charabaty¹², Enrique de-Madaria¹³, Andrés F Rodríguez-Parra¹⁴, Sergio A Sánchez-Luna¹⁵, Michał Żorniak¹⁶, Keith Siau^{17

18}, Catharine M Walsh^{19

20

21}, Samir C Grover^{1

2

3

22}

Affiliations

¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
² Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
³ Division of Gastroenterology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁴ Hospital of the Ministry of Interior and Administration, Szczecin, Poland.
⁵ Institution for Clinical and Experimental Medicine, Prague, Czech Republic.
⁶ Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida.
⁷ Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
⁸ Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
⁹ Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio.
¹⁰ Department of Medicine at The University Of Jeddah, Jeddah, Saudi Arabia.
¹¹ Gastroenterology Department, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia.
¹² Division of Gastroenterology, Johns Hopkins-Sibley Memorial Hospital, Washington, DC.
¹³ Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research, Alicante, Spain.
¹⁴ General Hospital Dr. Manuel Gea González, National Autonomous University of Mexico, Mexico City, Mexico.
¹⁵ Division of Gastroenterology and Hepatology, The University of New Mexico School of Medicine, Albuquerque, New Mexico.
¹⁶ Department of Gastroenterology, Medical University of Silesia, Katowice, Poland.
¹⁷ Medical and Dental Sciences, University of Birmingham, Birmingham.
¹⁸ Institute of Translational Medicine, University Hospitals Birmingham, Birmingham.
¹⁹ Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, Toronto, Ontario, Canada.
²⁰ Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
²¹ The Wilson Centre, University of Toronto, Toronto, Ontario, Canada.
²² Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted endoscopy services and education worldwide. This study aimed to characterize the impact of COVID-19 on gastroenterology trainees in Canada.

Methods: An analysis of Canadian respondents from the international EndoTrain survey, open from April 11 to May 2 2020 and distributed by program directors, trainees, and national and international gastroenterology societies' representatives, was completed. The survey included questions on monthly endoscopy volume, personal protective equipment availability, trainee well-being and educational resources. The primary outcome was change in procedural volume during the COVID-19 pandemic. Secondary outcomes included trainee's professional and personal concerns, anxiety and burnout.

Results: Thirty-four Canadian trainees completed the survey. Per month, participants completed a median of 30 esophagogastroduodenoscopies (interquartile range 16 to 50) prior to the pandemic compared to 2 (0 to 10) during the pandemic, 20 (8 to 30) compared to 2 (0 to 5) colonoscopies and 3 (1 to 10) compared to 0 (0 to 3) upper gastrointestinal bleeding procedures. There was a significant decrease in procedural volumes between the pre-COVID-19 and COVID-19 time periods for all procedures (P < 0.001). Thirty (88%) trainees were concerned about personal COVID-19 exposure, 32 (94%) were concerned about achieving and/or maintaining clinical competence and 24 (71%) were concerned about prolongation of training time due to the pandemic. Twenty-six (79%) respondents experienced some degree of anxiety, and 10 (31%) experienced some degree of burnout.

Conclusion: The COVID-19 pandemic has substantially impacted gastroenterology trainees in Canada. As the pandemic eases, it important for gastrointestinal programs to adapt to maximize resident learning, maintain effective clinical care and ensure development of endoscopic competence.

Keywords: COVID-19; Education; Endoscopy.