Coronavirus Disease 2019 (COVID-19) and Neurosurgery Residency Action Plan: An Institutional Experience from the United States

Abstract

Background: The current pandemic crisis, caused by a novel human coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), has forced a dramatic change in our society. A key portion of the medical work force on the frontline is composed of resident physicians. Thus, it becomes imperative to create an adequate and effective action plan to restructure this valuable human resource amid the SARS-CoV2 pandemic. We sought to describe a comprehensive approach taken by a Neurosurgery Department in quaternary care academic institution in the United States of America amid the SARS-CoV2 pandemic focused in resident training and support.

Objective: To describe a comprehensive approach taken by a Neurosurgery Department in quaternary care academic institution in the United States of America amid the SARS-CoV2 pandemic focused on resident training and support.

Results: A restructuring of the Neurosurgery Department at our academic institution was performed focused on decreasing their risk of infection/exposure and transmission to others, while minimizing negative consequences in the training experience. An online academic platform was built for resident education, guidance, and support, as well as continue channel for pandemic update by the department leadership.

Conclusions: The SARS-CoV2 pandemic constitutes a global health emergency full of uncertainty. Treatment, scope, duration, and economic burden forced a major restructuring of our medical practice. In this regard, academic institutions must direct efforts to diminish further negative impact in the training and education of the upcoming generation of physicians, including those currently in medical school. Perhaps the only silver lining in this terrible disruption will be greater appreciation of the role of current health care providers and educators, whose contributions to our society are often neglected or unrecognized.

Keywords: COVID-19; Coronavirus; Education; Neurosurgery; Pandemic; SARS-CoV2.

Figure 1

Timeline of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic. Summary of the events that have occurred since the very first cases in Wuhan, China to the implementation of the comprehensive approach at the Department of Neurological Surgery at the University of Pittsburgh Medical Center (Pittsburgh, Pennsylvania, USA). WHO, World Health Organization.

Figure 2

Restructure overview. OR, operating room.

Figure 3

Outpatient clinic workflow. SARS-CoV2, severe acute respiratory syndrome coronavirus 2; ER, emergency room.

Figure 4

Live pituitary adenoma surgery transmitted through virtual platform (participants were covered with blue circles to respect privacy). (A) Faculty responsible for the case discuss the clinical history, imaging findings, and treatment alternatives with the residents. (B) endoscopic endonasal approach (EEA) through the left nostril. (C) Exposure of the sella turcica. (D) Eura matter opening and exposure of the pituitary adenoma. (E) Tumor appearance after intravenous fluorescein injection. (F) Final reconstruction and closing.