COVID-19 and Global Neurosurgery: Perspectives from Aspiring Neurosurgeons
1 Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA. ulrick_kanmounyekouokam@hms.harvard.edu 2 Neurology and Neurosurgery Interest Group, Medical Sciences Division, University of Oxford, Oxford, UK. soham.bandyopadhyay@yahoo.co.uk 3 Global Surgery Student Alliance, Northwestern University Feinberg School of Medicine, Chicago, USA. caroline.canning@northwestern.edu 4 Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. yukiiphk@hku.hk 5 Association of Future African Neurosurgeons, Abidjan, Côte d’Ivoire 6 Department of Neurosurgery, Felix Houphouet Boigny University, Abidjan, Côte d’Ivoire. ghomsi1christelle@gmail.com
Introduction
The COVID-19 pandemic has impacted already fragile health systems across the globe.1 The struggle to provide timely, safe and affordable neurosurgical care is essential, particularly in this public health crisis. The leadership of the World Federation of Neurosurgical Societies (WFNS) has spearheaded initiatives to increase care throughout the world, targeting low- and middleincome countries (LMICs). These efforts have included the distribution of operative equipment, the creation of a Global Neurosurgery ad-hoc committee, support of accredited training centers, and provision of scholarships for aspiring neurosurgeons from underserved communities.2–4 Unfortunately, the pandemic has challenged the neurosurgical community in a variety of ways that have yet to be fully understood.
As the world witnesses the pandemics’ impact, many aspiring neurosurgeons in medical school or transitioning to training from all over the world are becoming more engaged in the neurosurgical community. In the following, we report the engagement of aspiring neurosurgeons in Africa, Asia, Europe, and North America with the global neurosurgical community. Our youngest members across the world describe a variety of activities and educational opportunities during the COVID-19 pandemic: virtual webinars, research, and participation in career development sessions. Practicing neurosurgeons are helping and encouraging aspiring neurosurgeons develop germane neurosurgical interests and skills. Aspiring neurosurgeons propose additional ways in which neurosurgeons can support and strengthen these student-led initiatives.
Africa
The Association of Future African Neurosurgeons (AFAN) is a student and resident neurosurgery interest group that organizes education, research, and networking events for its members. To reduce the spread of COVID-19, governments have ordered the suspension of academic and non-essential clinical activities. AFAN’s objective during this pandemic has been to maintain the training of its members. Hence, it created a structured neurosurgery/global neurosurgery curriculum and has organized research activities for students and residents.
AFAN members present weekly on Zoom; however, these presentations have been affected by unstable broadband networks and power outages. To reduce the effects of these two problems, AFAN uploads its videos on its YouTube channel so members can watch them at a later time. Also, members are asked to disconnect their video feed during live sessions to reduce bandwidth.
Figure: Analytics data - Association of Future African Neurosurgeons’ Facebook page
An equally important AFAN activity is advocacy for global neurosurgery and COVID-19. Our members have been assigned to research subgroups under the supervision of at least one consultant neurosurgeon and two residents. Each team will write an original article within the next few months. Some groups have submitted letters to the editor to regional and international neurosurgery journals. These pieces cover global neurosurgery and COVID-19. Locally, AFAN advocates for responsible sharing of information and the adoption of prevention measures. This is done primarily via the sharing of visual abstracts on social media. There has been a significant increase in enrollment and participation (+62%) in all these activities from students, junior doctors, and residents in our region. Our members lack information on African training programs and wish to network with local neurosurgeons. AFAN invites regional neurosurgeons to present on the training, research, and mentorship opportunities available at their institutions.
Asia
In February, Hong Kong was one of the first places struck by COVID-19. This pandemic brought back devastating memories of the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak. What was striking was the drastic difference outbreak preparedness made this time around. Disaster preparedness and the SARS experience did not avert the feelings of uneasiness and uncertainty. With the suspension of clinical teaching, the medical faculty have transitioned to Zoom teaching, to meet specialty clerkship requirements. This has been planned carefully, with some professors uploading teaching videos for early trainees to learn at their own pace, and others voluntarily offering additional online case discussion sessions. Aspiring neurosurgeons in Asia have used this time to nurture their passion for neurosurgery both locally and globally, and continue to identify regional neurosurgeons to help facilitate activities.
Europe
The Neurology and NeuroSurgery Interest Group (NANSIG) is the largest interest group in the United Kingdom. NANSIG has aimed to minimize the disruption to medical students and junior doctors, while encouraging social distancing. As such, it has moved its educational and advocacy activities online. Online learning approaches can be a versatile way to keep medical students engaged in their learning. The NANSIG website, with its associated YouTube channel and Instagram account, has regularly uploaded new videos and infographics on neurosurgery. In addition, NANSIG is releasing interactive weekly case studies for students to discuss and formulate ideas over social media. This is being supplemented by the production of a series of podcasts looking at the effects of COVID-19 on neurosurgical services. These podcasts will form the basis of NANSIG’s latest initiative: a bank of video interviews with neurosurgeons about their day-to-day lives. This should allow students to appreciate the diversity within neurosurgery globally and promote engagement to create more opportunities for equity. For those interested in research, NANSIG is running monthly global neurosurgery journal clubs and invites any interested practicing neurosurgeon to participate. The group has also launched multiple collaborative research studies. We have also purposefully placed the deadline for our essay competition in late August, for those who have helped the nation on the front line during the first peak of the pandemic.
Figure: YouTube Channel - Neurology and NeuroSurgery Interest Group (NANSIG)
North America
When COVID-19 quarantine began, the Global Surgery Student Alliance (GSSA) National Board decided to ramp up online programming to keep the global surgery pipeline strong. GSSA organized a series of webinars for its members. In the latest webinar, 80 participants from around the world gathered to learn about global neurosurgery efforts and career development from several North American neurosurgeons: Dr Gail Rosseau of George Washington University, Drs Sandi Lam Ann and Robert Luries of Children’s Hospital of Chicago, and Dr Roxanna Garcia, senior resident at Northwestern University. GSSA is distributing resources of upcoming neurosurgery webinars, inviting regional neurosurgeons to develop online learning opportunities, and plans to continue to offer virtual events to North American aspiring neurosurgeons.
Conclusion
The COVID-19 pandemic has changed the way we all live temporarily, but the long-term impact may create new avenues to engage young neurosurgeons in ways not previously possible. Aspiring neurosurgeons are adapting to difficult circumstances in a variety of ways and feel supported by neurosurgical residents and faculty all over the world. Neurosurgeons can volunteer as guest lecturers for the webinars organized by student interest groups, present their work via journal clubs, and create opportunities to conduct research remotely if there is need and interest. Another way neurosurgeons can help students is by sharing research, education, and training opportunities with student groups. Finally, mentorship has never been so valuable – practicing neurosurgeons can strengthen relationships for these passionate students and early career trainees.
References
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