GI Training in the COVID-19 Era: A Problem of Global Concern
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CORRESPONDENCE
GI Training in the COVID‑19 Era: A Problem of Global Concern Giovanni Marasco1 · Marcello Maida2 Received: 6 August 2020 / Accepted: 21 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
To the Editor We read with great interest the paper by Prof. Ming-Liang Ong[1] on the outrunning burnout in Singapore GI fellowship program during the COVID-19 pandemic. We agree with you that the COVID-19 pandemic highly impacted on Endoscopy Units activities, GI fellow’s endoscopy training and their psychological status [2–4]. We recently reported in an European survey[3] that among the reasons for the GI fellow’s burnout there was the fear to be infected or to infect relatives and patients, a low trust in the institutions of practice and satisfaction on the COVID-specific training received. Proposed solutions to address this distress may be increasing the knowledge on disease management and, as you proposed, providing psychological support [5]. On the other hand, we believe that an important factor associated to GI fellow’s distress is the training gap due to the pandemic. As example, in Europe, an alarming 90–96% reduction [2, 3] in all the endoscopic procedures performed by trainees have been reported, due to changes to institutional policies, unavailability of mentors, reduction in the volume of activities due to the lack of cases, and redeployment towards COVID-19 areas. Moreover, most of the trainees did not access any other educational resources, such as online courses and e-learning [2], leading to a considerable educational gap. Considerable differences in several GI training activities had already been reported both among and within European countries before the pandemic[6] and changes due to the COVID-19 emergency have further impacted the education of young trainees. It is not yet clear whether this reduction in training will be recovered in Europe, or if it will represent a permanent gap in
* Giovanni Marasco [email protected] 1
Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40126 Bologna, Italy
Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy
2
the curriculum of gastroenterologists. Nevertheless, urgent measures should be taken to ensure a restoration of full GI training in all the countries. First, a reintroduction of trainees among supervised procedures must be guaranteed, while maintaining full adherence to international recommendations on personal protection. Second, the reduction in the procedures’ volume must be balanced by the implementation of endoscopic training through alternative methods, such as e-learning, the attendance of online courses, web lessons. Finally, an extension of the training period, at the end of the emergency, should be considered to fill the educational gaps [3]. We believe that the training of young gastroenterologists should be preserved in all circumstances, to avoid irreversible consequences in the near future. In this regard, academies and
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