Dr Jasmina Kevric is a General Surgical Trainee in Victoria who shares how restrictions on elective surgeries are not only impacting patients, but possibly also the skills of surgical trainee workforce.
It has been more than 4 months since surgical trainees last stepped into the elective operating theatre.
The same surgical trainees who, upon completion of their surgical training, are expected to perform your surgery. Many of these trainees have had significant shortage in accessing technical skills training, mainly due to the government’s restriction on elective surgery due to the Covid-19 pandemic.
Elective surgery is not what many may think. Many elective operations can change a person’s quality of life and in some instances their quantity of life. Operations such as cleft palate in children, endometriosis treatment for women, and debilitating musculoskeletal complications all fall under elective surgery.
Numerous change.org petitions are now active to showcase the importance of elective surgeries. Many patients are voicing their frustration with the current reductions. Many parents are hurting due to cancellations of the child’s operation. Recently, the government was forced to reinstate IVF treatment for families who were facing significant wait if the restrictions were to be implemented. The pressure was there, the government listened.
But we need more pressure. Many patients have waited for months to years to have their hernia repair so they may continue working, or that skin lesion that seems to be changing and requires prompt excision. Elective surgery is not a luxury, it is a necessity.
As many of our surgical trainee workforce progress to the end of their training, little is known how these elective surgery restrictions will affect their skills, and the care they provide to their patients. This is one of the many reasons why we urgently need the reintroduction of elective surgery.
The longer we delay the start of elective surgeries, the longer our waiting lists will grow. Victoria’s public healthcare system is already vastly underfunded, and this addition will push many healthcare staff to the edge. We have a workforce that is burnt out, in a Code Brown pandemic, many whom have not had the luxury of annual leave for months or years. As the public waiting list grows, without significant reintroduction, I anticipate that some may leave healthcare due to the high burn out rate, and leave an understaffed system to struggle further.
As a surgical trainee, I, among many of my colleagues, have not had access to the same level of training that we had prior to the pandemic. Our operating lists have been significantly reduced. Significantly. Our Royal Australasian College of Surgeons along with other colleagues are working hard to lobby the governments to change this. It is our patients who will be most disadvantaged, and we are desperately fighting for their right to be treated by well-trained surgeons. Therefore, we need elective surgeries to start now.
Whilst surgical trainees await the start of elective surgeries, many turn to surgical education, research, locum work in other subspecialities, and ward duties to ensure they keep up with their knowledge and skills. Some simulated training exists to help us keep our skills up. Emergency surgeries occur night and day, which keep many trainees late at night to keep our skills up. We are doing all we can, but we need to do more.
If you’re a patient who is on the waitlist, please rest assured that we are trying our best to bring your surgery forward. Many of you call the hospital, often multiple times a day to try and get answers. Many of you are in pain while you wait for your surgery. Many of you are anxious and unsure. Many of you present to the emergency department hoping to get your surgery, only to be told that it is not a surgical emergency. Many of you are then sent home again.
Our senior surgical colleagues and the Australian Medical Association is building pressure to hold the government to account. Of course, this has to be done responsibly and with great planning to ensure adequate beds are available for sick Covid-19 patients. Nevertheless, many day case surgeries fall under the elective framework and can be performed in the current environment. We are not asking for much, but we are asking for something.
Ultimately, as the future of the surgical workforce, we need elective surgeries to start in order to ensure that we can safely perform your surgery. We need elective surgeries to start in order to improve the lives of our patients. We need elective surgeries to start so that we reduce the enormous waitlist that is currently in the making.
For myself, as a surgical trainee, I want to know that I have received the best training so that I can use those skills and perform safe and competent surgeries. We need elective surgeries to restart so that we can achieve this. And we need it now.