Arif KALKANLI, Nusret Can ÇİLESİZ, Cem Tuğrul GEZMİŞ, Coskun KAYA, Onur FİKRİ, Ateş KADIOĞLU

COVİD-19 pandemisinin Türkiye’deki üroloji asistanlığındaki etkisi

Amaç: Hayatın her alanını etkisi altına alan Covid-19 pandemisi, akademik ve sağlık hizmetlerini de derinden etkilemiştir. Daha önce pandeminin Türkiye’deki üroloji asistanlarının akademik ve sağlık hizmetleri üzerindeki etkilerine ilişkin herhangi bir değerlendirme yapılmamıştır. Biz çalışmamızda bunu değerlendirmeyi amaçladık.Gereç ve Yöntemler: Anket dört ana başlıkta (eğitim ve araştırma faaliyetleri, sağlık hizmetlerinde çalışma koşulları, sosyal-psikolojik etkiler ve kişisel sağlık) toplam 31 sorudan oluşmakta ve Temmuz-Ağustos 2020 tarihleri arasında gerçekleştirilmiştir. Türkiye’de 89 üroloji eğitim merkezi olup, bunların 76’sı (%85,4; 38 üniversite ve 38 devlet hastanesi) anketi doldurmuş ve geri dönmüştür.Bulgular: Asistanların ortalama haftalık eğitim saatleri azaldı (2,43±2,46 saatten 1,3±1,8 saate; p=0,00) ve 67 merkez (%88,15) web seminerleri ve video konferans gibi yeni teknolojileri kullandı.Haftalık araştırma faaliyetlerine ayrılan süre de pandemi sırasında azaldı (2,15±2,54 saatten 1,8±1,93 saate; p<0.001). Üniversite hastaneleri araştırma faaliyetlerini artırırken (%9,9) devlet hastanelerinde ise azaldı (%44). Haftalık ortalama poliklinik saati 86.23±86.54’ten 37.22±19.88’e (p<0.001) geriledi ve devlet hastanelerinde (%63.61) üniversite hastanelerine (%42.41) göre daha yüksekti (p<0.05). Pandemi öncesi döneme göre haftalık ameliyat sayısında önemli bir azalma gözlendi (40.7±24.25’ten 14,3±16.44’e; p<0.001). Ayrıca 74 merkez (%97,36) acil ürolojik vakaları uygulamaya devam ettiğini, 41 merkez (%53,9) toplam çalışma saatlerinin azaldığını, 72 merkez (%94,7) ise üroloji dışı alanlarda Covid poliklinikleri veya hizmetleri gibi çalıştığını bildirdi. Asistanlar için 10 merkez (%13.15) çocuk bakımı, 55’i (%72.36) konaklama, 18’i (%23.68) ulaşım sağladı fakat 33 merkez (%43.42) kişisel koruyucu donanımdan yoksundu. 26 merkez (%34.21) komorbiditesi olan çalışanlarına izin verdi. Asistanlar 57 merkezde (%75) yeterli cerrahi vaka olmamasından, 73 merkezde (%96.05) Kovid-19’un ailesine bulaşmasından ve 34 merkezde (%44.73) ailelerini korumak için evlerinden taşınmış olmasından endişe duyuyorlardı. Ayrıca 25 merkezde (%32.89) asistan izole edilmiş, 54 merkezde (%71.85) hastalık sorgusu (şüphe) nedeniyle sürüntü alınmıştır. Asistanlara 14 merkezde (%18.42) Kovid-19 teşhisi konuldu.Sonuç: Bu araştırma, Covid-19 pandemisinin yaşamın tüm alanlarını etkilediği gibi üroloji asistanlarının akademik (eğitim ve araştırma), sosyal ve psikolojik yaşamlarında da ciddi olumsuzluklara neden olduğunu göstermiştir.

Anahtar Kelimeler:

Covid-19, asistanlık, pandemi, üroloji eğitimi, cerrahi eğitim, COVID-19, residency, pandemic, urology training, surgical training

The impact of COVID-19 pandemic on urology residency in Turkey: a nationwide survey

Objective: The Covid-19 pandemic, which affects all areas of life, has also deeply affected academic and health services. There has previously been no assessment of the effects of the pandemic on academic and health services of urology residents in Turkey, for this purpose, a survey was conducted.Material and Methods: The survey consisted of a total of 31 questions under four main topics (education and research activities, working conditions in health services, social-psychological effects, and personal health) and was carried out between July-August 2020. The survey was 89 urology training centers in Turkey, among them 76 (85.4%; 38 university and 38 state hospitals) completed and returned the questionnaire.Results: The average weekly education hours decreased (2.43±2.46 hours to 1.3±1.8 hours; p=.00) and 67 centers (88.15%) used new technologies such as webinars and videoconferencing. The time devoted to weekly research activities also decreased during the pandemic (2.15±2.54 hours to 1.8±1.93 hours; p<0.001). However, university hospitals increased their research activities (9.9%), while state hospitals decreased (44%). The average weekly outpatient clinic hours decreased from 86.23±86.54 to 37.22±19.88 (p<0.001) and the regression was higher in state hospitals (63.61%) compared to university hospitals (42.41%) (p <0.05). A significant decrease was observed in the number of operations per week compared to the pre-pandemic period (from 40.7±24.25 to 14.3±16.44; p<0.001). In addition, 74 centers (97.36%) reported that they continued to perform emergency urological cases and 41 centers (53.9%) reported that the total working hours decreased, but 72 centers (94.7%) reported that they were employed in non-urology areas such as Covid outpatient clinics or services. For the residents, 10 centers (13.15%) provided childcare, 55 centers (72.36%) provided accommodation, and 18 centers (23.68%) provided transportation, but 33 centers (43.42%) lacked protective personal equipment and 26 centers (34.21%) gave leave to employees with comorbidity. Residents were concerned about not having enough surgical cases in 57 centers (75%), the transmission of Covid-19 to their family in 73 centers (96.05%), and in 34 centers (44.73%), they had moved away from their homes to protect their families. Furthermore, residents were isolated in 25 centers (32.89%) and swabs were taken in 54 centers (71.85%) due to the query (doubt, suspicion) of illness. Residents were diagnosed with Covid-19 in 14 centers (18.42%).Conclusion: This survey has shown that as the Covid-19 pandemic affects all areas of life, it also causes serious negatives in the academic (educational and research), social, and psychological lives of urology residents.

Keywords:

COVID-19, residency, pandemic, urology training, surgical training,

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