Perspectives on training in obstetrics and gynaecology during the COVID-19 pandemic: Thematic analysis of trainee responses from a pan-European survey.

Background: Coronavirus disease 19 (COVID-19) has affected many aspects of the lives of medical professionals. Postgraduate training has also been affected and mitigation plans are still ongoing. Objective: To understand the perspectives of trainees in obstetrics and gynaecology (ObGyn) during the pandemic. Materials and Methods: A cross-sectional exploratory survey conducted electronically from 20th of April 2020 to 1st July 2020. Main outcome measures: The original questionnaire comprised of 40 questions and a free-text option. The free-text questions covered five main domains: effect of the pandemic on training, worries about training, acquisition of skills during the pandemic, training period and extensions and responsibilities outside training during the pandemic. The responses to these questions in the survey were analysed using pragmatic thematic analysis. Results: Trainees felt there was lack of training as well as training opportunities. Some took the pandemic as an opportunity to gain new skills. Trainees were also worried about time in training and uncertainty about extensions. Lastly, many had concerns pertaining to patient care, an inability to contribute to departmental organisation, and dissatisfaction with the implemented policies. Conclusion: The difficulties in Obstetrics and gynaecology training due to the pandemic need to be mitigated. When planning for reshaping the training programmes to accommodate for the discrepancies caused, trainers need to consider the perspectives of trainees and actively involve them in the decision making, designing and executing future plans. What is new?: Efforts are currently underway to address the training time lost during the pandemic in Europe. Recognising the paramount importance of providing exceptional care for women and children across the continent, it becomes imperative to consider the valuable perspectives and insights offered by those who represent the future generation of specialists in the field.

Efficacy and causes of failure of endoscopic subureteric injection of Teflon in the treatment of primary vesicoureteric reflux.

A total of 135 consecutive patients with primary vesicoureteric reflux (VUR) were treated as day cases using submucosal Teflon injection (STING) between 1984 and 1988. Up to 3 repeat procedures were performed in the event of failure; 89% of patients and 92% of ureters were cured. None was obstructed and 2 recurred. Eight patients continue to have asymptomatic reflux Grade 2 or less, while 7 have had open surgery to correct the reflux. Most of the failures had a satisfactory appearance at STING but this deteriorated with time and appears to have been caused by leakage of Teflon from the injection site post-operatively. There were no signs or symptoms of embolisation or migration of the implant material.