Future generation of surgeons must not be disadvantaged in the long term as a result of covid

The impact of the pandemic on NHS staff’s mental health over the last year has been immense. Unlike anything most of us have ever experienced in our lifetimes—the pressure, demanding working conditions, and sheer relentlessness of the pandemic—has been nothing short of traumatic for doctors facing these challenges on a daily basis.  

Of course all healthcare workers, and indeed the population as a whole, has suffered in one way or another as a result of the pandemic. However, I am particularly concerned about the unique set of challenges trainee surgeons have faced over the last twelve months.  

The Royal College of Surgeons of Edinburgh recently reached out to our trainee membership to conduct a survey in order to gauge how they have been impacted by covid-19. The findings were stark.  

67% of those surveyed said their mental health has suffered as a result of working during the pandemic. While this statistic is truly shocking, sadly, I am not completely surprised that so many are feeling this way.  

As the majority of elective surgery has been paused for large periods of the last year, many trainee surgeons have missed out on valuable learning experiences.  Many have found themselves moved into different roles within the NHS, often working in particularly demanding areas such as A&E, covid wards, or with severely ill patients in intensive care units.  

While the trainees I have spoken to were only too happy and willing to help in any way they could, given the unprecedented position the NHS was in, it is completely understandable that the lack of surgical training experience they have had is now starting to cause anxiety.  

Our survey showed that nine in ten trainees feel their craft skills as a surgeon have suffered as a result of the pandemic, and over half said they do not feel prepared to embark on the next stage of their career or training because of the disruption.  

This is entirely understandable, and I have a great deal of empathy for the trainees who are currently in this situation. Not only have they had to deal with the pressures of working in the NHS for the last year, they now also have the added difficulty of obtaining enough practical experience to move comfortably into the next stage of their surgical career.  

Our Trainees’ Committee at the RCSEd recently held a Wellbeing Week, which involved peer coaching skills and interactive webinars where coping mechanisms for stress were explored. I think it is fantastic that the conversation around mental health and wellbeing has moved on so much in recent years, and the impact this can have on the surgical workforce is being more openly discussed. Feedback from the various activities during Wellbeing Week has been incredible.  

While of course wellbeing is a major priority for the trainee workforce, we must now also turn our attention to practical solutions and focus on how we get our trainee surgeons back on track.

There is a huge backlog of patients whose elective operations were cancelled as a result of the pandemic, and trainees will play a vital role in helping to address this.  

Trainees are perfectly placed to assist with and carry out important, yet straightforward, procedures that form large parts of waiting lists. Many routine and high volume operations are excellent opportunities for trainees to gain experience. 

Giving trainees the chance to carry out these procedures will ensure our future surgeons are adequately equipped to join the profession. It will also help clear huge sections of the surgical backlog—something that is going to be essential in allowing the NHS to fully recover.  

It is of the utmost importance that trainee surgeons are given the essential training and experience they need in the coming months, or we risk facing not just a serious skills shortage, but a longer term issue with a delay in surgical trainees completing training and entering the consultant workforce.  

Opportunities for training during the service recovery, whether in NHS hospitals, treatment centres, or the independent sector, must be made available for our surgeons of the future. 

Trainees are truly the lifeblood of our profession. They are our future. I firmly believe we are only as good as the next generation of surgeons. We must ensure their development is not disadvantaged in the long-term as a result of the pandemic.  

We are wholly committed to supporting trainees at the Royal College of Surgeons of Edinburgh, and we will continue to provide support for, and lobby on behalf of the next generation of surgeons, to ensure the future of our profession is protected.  

Michael Griffin, President of the Royal College of Surgeons of Edinburgh.

Competing interests: none declared.