Psychological Outcomes of Surgery Trainees in the Era of COVID-19 at a Tertiary Care Hospital of Karachi, Pakistan: A Cross-Sectional Study

Objectives

The COVID-19 pandemic has resulted in interruptions in training for surgical residents in particular. This has been compounded by burnout and mental health concerns among surgical trainees across the world. We aim to determine the impact of the COVID-19 pandemic on psychological outcomes of surgical trainees in a tertiary-care hospital in Pakistan.

Setting

A cross-sectional, online survey-based study was conducted at a private tertiary care hospital of Karachi, Pakistan.

Participants

All the surgery trainees including; residents, fellows and instructors acquiring training at a private tertiary care hospital of Karachi, Pakistan were included in the study.

Outcome measures

The participants were assessed for their perceptions, and concerns regarding the COVID-19 pandemic, impact on their quality of life and generalized anxiety disorder (GAD).

Results

A majority (85%) of surgical trainees were concerned regarding contracting COVID-19 infections. Residents were more concerned with fellow residents developing burnout and anxiety as compared to their own psychological concerns. A strong, significant positive correlation (r=0.66, p <0.001) was noted between negative impact on QoL scores and developing GAD in surgical residents. On multivariable analysis, significant associations with GAD remained for family system, and negative impact of COVID-19 on QoL. The increased working hours for junior trainees showed more likelihood of developing GAD as compared to senior trainees.

Conclusion

Our investigation on QoL and psychological outcomes of surgical residents showed significant rates of burnout and GAD, which were attributed to concerns with the COVID-19 pandemic. We showed the impact this had on surgical trainees’ perception regarding their training and concerns with infecting others. This calls for structural interventions to address mental health concerns and provide psychological and educational support to surgical residents.

Strengths and Limitations of the study

• Validated measures were used for evaluating the outcomes

• The study results can be generalized to all the surgery resident trainees working at private tertiary care hospitals.

• The response rate of trainees was 50%, the authors attempted to mitigate this through regular follow-up emails and reminders for responses.