Although redeployment had an impact on surgical training, it also provided a unique opportunity to learn from other specialties, write Pratik Shah, David Skipsey, and George Patrick Ashcroft
When covid-19 first came to the UK, there was a swift change in most doctors’ working lives to establish the “new normal.” The cancellation of most non-essential operations meant that orthopaedic surgery was particularly affected. As trainees on foot and ankle and lower and upper limb arthroplasty placements (PS and DS), our operative training was put on hold. Our initial disappointment at missing out on operating and learning was soon put into perspective when we came to understand the scale of the reduction in elective surgery across all specialties.
As lockdown began, the orthopaedic department shifted its primary focus to maintaining the care of trauma patients. Consultants and registrars present in the active clinical area were kept to a minimum to ensure social distancing. In the midst of this change, we were informed of our redeployment to medicine. While this caused many of us “surgeons” a slight feeling of dread at the thought of long medical ward rounds, there were positives to take from this experience too.
These benefits weren’t immediately obvious on our first day in medicine, it’s true, as we adjusted to a new rota and a new working pattern. The redeployed staff comprised orthopaedic, ENT, and ophthalmology registrars along with FY2s and interim FY1s. Each member of the team, apart from the interim FY1s, was well versed in ward “SHO” jobs, having done these in their foundation years. Despite the change in our working patterns and having to adjust to new specialties, having so many registrars from different specialties working together encouraged a great deal of learning from each other.
We frequently talked at length about our training, our on calls, and even enhancing our portfolios. There were often “in-house” consults on the medical wards, requiring input from different specialties. Discussing this with the relevant redeployed registrar in the ward rather than the busy on-call registrar for that speciality allowed us to gain a greater understanding of the nuances of each specialty.
That is not to say we lost touch with our own orthopaedic community. In fact, with the booming popularity of Zoom during the lockdown, we saw a striking increase in local postgraduate orthopaedic teaching. We had a weekly teaching session delivered online by a consultant focusing on different aspects of the curriculum. Along with this, senior trainees nearing their FRCS exam also delivered weekly teaching sessions on basic science to more junior trainees in a mutually beneficial scenario. With staffing on the medical wards also being at an all time high, we were afforded rare “protected” learning time to take the laptop away into the office for our teaching, without any impact on clinical care. This online teaching was so successful that we aim to continue it for the foreseeable future.
Now, having returned to our parent speciality as the covid-19 peak has settled for now, there is a certain excitement in getting back to doing what we know and love. We have been reinvigorated by the first few operations we have performed as trainees and it has reaffirmed all of the reasons that made us pick trauma and orthopaedics as our specialty in the first place.
We are all well aware of the fine balance that we find ourselves in and remain cautiously optimistic. Although the redeployment phase did have an impact on surgical training, we have had a unique opportunity to work closely with other specialties. Furthermore, the advent of online teaching has been a revelation that will continue to offer benefits for the foreseeable future. The connections developed between specialties during this time will no doubt help with patient care in the long term.
Pratik Shah is an ST4 in trauma and orthopaedics in the North of Scotland rotation. He is currently working in trauma and was redeployed to general medicine during the covid-19 pandemic during an attachment in elective foot and ankle surgery.
David Skipsey is an ST4 in trauma and orthopaedics in the North of Scotland rotation. He is currently working in paediatric orthopaedics and was redeployed to general medicine during the covid-19 crisis during an elective attachment in shoulder and lower limb reconstruction.
George Patrick Ashcroft is a consultant orthopaedic surgeon working at Aberdeen Royal Infirmary and Woodend General Hospital. He is a senior lecturer in orthopaedics at the University of Aberdeen.
Competing interests: None declared.