Expectativas y realización profesional en Cirugía General y subespecialidades quirúrgicas: situación actual de los cirujanos jóvenes en Córdoba / Expectations and professional fulfillment in general surgery and surgical sub-specialties: current situation of young surgeons in Cordoba

RESUMEN Antecedentes: en la Argentina, la especialidad Cirugía General se encuentra en crisis y esta situación alarmante se halla vinculada a las malas condiciones laborales del cirujano general. Objetivo: describir la percepción que el cirujano joven tiene al terminar su programa de formación, en relación con su perspectiva laboral, actividad quirúrgica y académica. Material y métodos: estudio transversal basado en una encuesta dirigida a cirujanos jóvenes en Córdoba, Argentina. Resultados: participaron 53 encuestados. El 58% eran hombres y la mediana de edad fue 32 años. El 72% ejercía Cirugía General y el 55% trabajaba en el sector privado. El 34% pertenecía a la Asociación de Cirugía de Córdoba y el 23% a la Asociación Argentina de Cirugía. En cuanto a la experiencia profesional, el 53,1% eran cirujanos junior y el 64% eran competentes para realizar procedimientos de baja o mediana complejidad. En relación con la perspectiva laboral, el 89% consideró que el cirujano joven no consigue salida laboral rápida y el 96,2% refirió que sus prácticas no eran bien remuneradas. Respecto de la calidad de vida personal y laboral, el 57% manifestó frustración e incertidumbre económica. En cuanto a las cirujanas, la tasa de inequidades de género y hostigamiento sexual en el ámbito laboral fue del 73% y 50%, respectivamente. Conclusión: encontramos la percepción de un bajo nivel de competencia para las cirugías de mayor complejidad y una baja tasa de adherencia a sociedades quirúrgicas. Debido a la escasa oferta laboral existe gran frustración e incertidumbre económica. Actualmente, predomina y persiste el maltrato y hostigamiento hacia las cirujanas.

ABSTRACT Background: In Argentina, the specialty of general surgery is in crisis, and this alarming situation is associated with the poor working conditions of general surgeons. Objective: The aim of this study is to describe the perception of young surgeons at the end of their training program, in relation to their job prospects, surgical and academic activity. Material and methods: We conducted a cross-sectional study based on a survey responded by young surgeons in Cordoba, Argentina. Results: The survey was responded by 53 young surgeons; 58% were men and median age was 32 years. Seventy-two percent practiced general surgery and 55% worked in the private setting. Thirtyfour percent were members of Asociación de Cirugía de Córdoba and 23% belonged to Asociación Argentina de Cirugía. As for professional experience, 53.1% were junior surgeons and 64% were capable of performing low or medium complexity procedures. Eighty-nine percent considered that young surgeons do not get a job quickly and 96.2% reported that they were not well paid for their practice. When asked about their personal and professional quality of life, 57% expressed frustration and economic uncertainty. Among women surgeons, 73% reported gender inequities and 50% reported sexual harassment in the workplace. Conclusion: Young surgeons perceived they had low level of competencies for high complexity surgical procedures and reported low rate of membership in surgical societies. Most of them feel frustrated due to scarce job opportunities and expressed economic uncertainty. Nowadays, abuse and harassment of women surgeons still prevails and persists.

Complicated jejunal diverticulosis with intestinal perforation and obstruction: delay in hospital visit during confinement due to COVID-19.

Diverticulosis of the small bowel is a rare entity. It can cause acute, complications such as diverticulitis, perforation, intestinal bleeding and obstruction. During the pandemic, patients were reluctant to visit hospitals for fear of contracting coronavirus disease 2019. This caused the patients to wait until the extreme deterioration of many acute surgical conditions. An 83-year-old man with multiple comorbidities showed up at the emergency department with generalized abdominal pain of 7 days of evolution. The computed tomography scan revealed a large distention of the small intestine and a small inflammatory abscess. He was transferred to the operating room where a segment of the jejunum affected by multiple diverticula located on the mesenteric side of the intestine and a mesenteric abscess related to a perforated jejunal diverticulum were identified. Complicated jejunal diverticulosis is a difficult entity to diagnose, which can cause significant morbidity and mortality. To avoid this, its timely diagnosis is essential.

Concerns and reflections on the second wave of COVID-19 in Argentina: A perspective by general surgery residents.

In Argentina, the second wave of COVID-19, which started in May, clearly differentiates us from the rest of the Latin American countries, whose current growth may be the announcement of the expected autumn-winter expansion. There is a lot of uncertainty about how the pandemic will evolve, which contrasts with the expectations that had been generated in society after the end of the confinement, both of the control of the health system and access to effective vaccines. Thus, a group of surgeons in training raised a series of concerns concerning the critical situation that we are facing.

Surgical education in the COVID-19 era: What did the general surgery residents' report in Argentina leave us? Part 2.

Social distancing to curb the COVID-19 pandemic has impacted medical and surgical education. This health crisis led us to raise doubts, controversies, and dilemmas in health care in general, and in surgery in particular, understanding that residents are possibly as or more vulnerable than all health professionals. During the 32nd International Congress of General Surgery in Cordoba, which was the first general surgery congress held in Argentina during 2021; The Association of Residents and Concurrent Surgery of Cordoba presented its official report about the current challenges faced by residents during their surgical training.

Surgical education in the COVID-19 era: What did the General Surgery Residents' report in Argentina leave us? Part 1.

Social distancing to curb the COVID-19 pandemic has impacted medical and surgical education. This health crisis led us to raise doubts, controversies, and dilemmas in health care in general, and in surgery in particular, understanding that residents are possibly as or more vulnerable than all health professionals. During the 32nd International Congress of General Surgery in Cordoba, which was the first general surgery congress held in Argentina during 2021; The Association of Residents and Concurrent Surgery of Córdoba presented its official report about the current challenges faced by residents during their surgical training.

Analysis of the impact of the pandemic on surgical residency programs during the first wave in Argentina: A cross - sectional study.

INTRODUCTION: COVID - 19 emerged as a global pandemic in 2020 and affected the teaching methods at all levels. Surgical education has also been significantly affected by this pandemic, but the effect remains unknown. We developed a survey in order to obtain more information on how this pandemic affected the training and education of surgical residency programs. MATERIAL AND METHODS: Cross-sectional study. We surveyed 195 residents of various surgical programs, from August 20th to September 30th, 2020, in Córdoba, Argentina. The effect of the COVID - 19 pandemic was analyzed on surgical training, on the academic program, and professional burnout. RESULTS: The volume of surgical cases performed during the pandemic decreased dramatically, affecting mainly residents of lower years. Comparing the number of cases (>7) that residents carried out per week (Pre pandemic vs pandemic), we found that PGY - 1: 47% vs 9%; p = 0.01 and PGY - 2: 46% vs 8%; p = 0.03. 83.2% reported that the impact of the pandemic affected their surgical training negatively and 45% were not adequately trained to carry out their surgical activity in the residency program. On the other hand, 71.3% affirmed that this health emergency allowed them to dedicate more time to the development of their academic training. CONCLUSION: This is the first cross - sectional survey study that shows the impact of the pandemic on surgical residences during the first wave in Argentina. Surgical training performed by residents had a negative impact.