Impact of covid-19 on subspecialty training in obstetrics and gynaecology

Abstract

The Covid-19 pandemic brought substantial changes in clinical practice in Obstetrics and Gynaecology (O and G). Redeployment of staff and restrictions in elective services raised training concerns. We sought to assess the impact on subspecialty training, to identify issues to help mitigate the impact. We conducted cross-sectional anonymous electronic surveys of UK subspecialty trainees at three time points: June 2020, February 2021, September 2021. Surveys were analysed by descriptive statistics and thematic analysis of free-text responses. Response rates ranged from 30% to 40%, with higher response rates from urogynaecology trainees. Up to 72% reported an impact on training, most notable in gynaecological subspecialties, and particularly urogynaecology, which persisted over time. More than a third anticipated needing extra time to complete training. This raises serious future workforce and patient care concerns. Clinical recovery should consider training needs as essential when re-establishing services. Subspecialty trainees may need additional time to achieve competencies required of future consultants.

IMPACT STATEMENT

• What is already known on the subject? Covid-19 led to dramatic changes in clinical practice in Obstetrics and Gynaecology. Previous studies on training in O and G during the pandemic in the UK and internationally highlighted issues from redeployment, trainee absence, and changes in service provision, that had potential to severely impact training.

• What do the results of this study add? Subspecialty training in Obstetrics and Gynaecology has been affected by the pandemic. Urogynaecology was worst affected and continues to be affected over the course of the pandemic.

• What are the implications of these findings for clinical practice and/or further research? Covid-19 recovery plans need to incorporate training requirements. Extended training due to the pandemic may affect consultant workforce numbers and thus service provision in tertiary care.

Keywords:

• Covid-19
• training
• obstetrics
• gynaecology
• subspecialty
• recovery

Acknowledgements

We are grateful to support from the RCOG to conduct the survey and to subspecialty trainees who completed the survey.

Ethical approval

The survey was carried out as part of service/training evaluation and ethical approval was not sought (as per HRA decision tool http://www.hra-decisiontools.org.uk/research/). Approval was sought from the RCOG executive committee to conduct the survey. Informed consent was sought from participants and responses were anonymous without identifying information.

Author contributions

MD instigated the surveys. JC researched and wrote the article. JC, SS and MD designed, conducted and analysed the surveys. All authors edited the article and approved the final version.

Disclosure statement

All authors are current or former members of the Royal College of Obstetricians and Gynaecologists (RCOG) Subspecialty training committee. There are no other declarations of interest.

Data availability statement

Data are available from the corresponding author.