1.A Review of Guidelines to Resuming Elective Orthopaedic Surgeries Amid COVID-19 Pandemic: Deriving a Simple Traffic Light Model
Attia AK ; Omar UF ; Kaliya-Perumal AK
Malaysian Orthopaedic Journal 2020;14(No.3):10-15
The COVID-19 pandemic has affected most healthcare
systems around the world. Routine care operations such as
outpatient clinics and elective surgery remain badly hit. This
situation cannot continue for long as it puts patients at a
higher risk for complications due to delayed management.
Hence, it is essential to resume routine, especially elective
surgery. Regarding orthopaedic practice, various authors and
organisations have come out with guidelines to resume
elective surgeries. However, clear consensus and common
strategies need be derived. With this motive, we conducted a
review of the literature for guidelines to resume elective
orthopaedic surgery amid COVID-19 pandemic and
shortlisted scholarly publications and information from
regional organisations. We have summarised the information
and derived an organised algorithm considering the
guidelines provided by various sources. In this extraordinary
time, guidelines come in as a relief for every surgeon who is
in a dilemma whether to resume electives or not. Putting
safety first, these guidelines or suitable versions should be
followed at all levels wherever possible to avoid the lack of
trained manpower in the event of staff morbidity.
2.Orthopaedic Resident Burnout: A Literature Review on Vulnerability, Risk Factors, Consequences and Management Strategies
Wong KP ; Kaliya-Perumal AK ; Oh JYL
Malaysian Orthopaedic Journal 2019;13(2):15-19
Introduction: Orthopaedic surgery is physically demanding. Surgeons may have to work long unpredictable hours especially during residency training. This arduous task comes with the risk of burnout leading to negative repercussions to the surgeon and the patient. In view of strategising peer support, we intend to review the literature and analyse whether orthopaedic resident burnout is a global issue. We also intend to derive common strategies to tackle burnout at individual and organisational levels. Materials and Methods: A literature search was carried out in the databases including PubMed, Scopus, SciELO, and Google Scholar to shortlist studies dealing with orthopaedic residency and related burnout. Those studies that used the Maslach Burnout Inventory (MBI) for quantifying burnout were collectively interpreted. Other studies were reviewed to analyse the vulnerability, risk factors, consequences and management strategies related to burnout. Results: Among a total of 72 titles shortlisted, eight studies independently reported burnout among orthopaedic surgery residents/trainees and used MBI as a tool for assessing burnout. Based on the three subscales of MBI, 37.2% had high degree of emotional exhaustion (EE), 48% had high degree of depersonalisation (DP) and 33.1% perceived low personal accomplishment. This signifies the high prevalence of burnout among orthopaedic residents/trainees. Conclusion: Burnout among orthopaedic surgery residents seems to be a universal problem. Risk factors could be multifactorial, influenced by clinical competency and workhome environment. This can be tackled at the individual level by being aware of burnout syndrome, involving in adequate physical activity and spending quality social time; and at the organisational level by duty hour limitation, professional appreciation and mentorship programme.