The uncertain future of surgery and the voice of surgeons

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

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

But also, surgeons need to make themselves heard given the precarious situation they are currently working in in Spain due to the pandemic, with virtually all of his 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 in need of surgery; even non-COVID-19 patients must be treated with the priority and speed required by their disease.

There are cancer patients or with other non-oncological pathologies that seriously threaten health (obesity, inflammatory bowel diseases …) which, if not operated on, can have serious consequences. Hospital managers do what they can; they follow the forecast models in order 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 surgery in Spain is in danger”

Due to its high frequency, importance and clinical implications, The delay or discontinuation of surgery in obese patients due to COVID-19 is particularly paradigmatic, even more so knowing that obesity is an independent risk factor for serious illness and death from COVID-19.

Both scientific societies and national surgical specialty commissions 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 level. These organizations are trying to implement all measures at their disposal to be able to reverse this situation. Some alternatives to consider could be:

– At the level of medical students, arbitrating extraordinary measures for the management of material and human resources in medical schools and university hospitals that allow students to enter 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 hospitalization or the exceptional extension of 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 aspects of care and education of our students and residents.