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The uncertain future of surgery and the voice of surgeons

By Antonio J. Torres, Professor of Surgery at the Complutense University of Madrid (UCM) yvicepresident of the National Commission of the Specialty of General Surgery and the Digestive System

The COVID-19 pandemic is having important repercussions on the practical training of medical students and from residents of surgical specialties, threatening their training to become better surgeons.

But also, surgeons must make themselves heard in the precarious situation in which they are currently working in Spain due to the pandemic, being practically all its work subject to the care of patients with COVID-19, the resolution of surgical emergencies and telematic consultations. We are witnessing the cancellation or delay of elective surgeries of all kinds, endangering the survival of those who require surgical intervention; non-COVID-19 patients must also be treated with the priority and speed that their illness requires.

There are cancer patients or with other non-oncological pathologies that seriously threaten health (obesity, inflammatory bowel disease …) that, if not operated on, can have serious consequences. Hospital managers do what they can; they follow the prediction models so as not to collapse the hospital. However, the reality is that many patients on the surgical waiting list are still unable to operate, and this is very serious: complications increase, prognosis worsens and survival of patients requiring surgical treatment decreases.

“Non-urgent hospital surgical activity in Spain is in danger”

Due to its high frequency, importance and clinical implications, The delay or the practical stoppage of surgical interventions in obese patients due to COVID-19 is especially paradigmatic, even more so knowing that obesity is an independent risk factor for serious diseases and death from COVID-19.

Both the scientific societies and the national commissions of surgical specialties have the ethical, moral and professional obligation to be much more present in the institutional bodies that make decisions at local, regional, national and European Union levels. These organizations are trying to implement all the measures at their disposal to be able to reverse this situation. Some alternatives to consider could be:

– At the level of Medicine students, arbitrate extraordinary measures for the management of material and human resources in medical schools and university hospitals that allow the entry of students into hospitals in an orderly and safe manner.

– With regard to residents of surgical specialties, establish measures to alleviate the situation, such as the increase in surgical activity without admission or the exceptional extension of their periods of residence.

The world is facing a truly unforeseen situation that requires all our efforts to overcome the obstacles imposed by the pandemic, without forgetting the assistance and training aspects of our students and residents.

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