The impact of COVID-19 on endoscopy training needs to be considered in the context of a global pandemic.

To the Editor:

The international survey by Pawlak et al of the impact of COVID-19 on endoscopy training has reported that 93.8% of 770 trainees from 63 countries have had reduced endoscopy training, with associated anxiety.

It is established that the pandemic has resulted in endoscopy services being curtailed globally to minimize risk to patients and to healthcare professionals (HCPs), along with the pivot of services toward caring for inpatients with COVID-19 and a consequential, predictable impact on training. ,

There have been >7 million COVID-19 cases, with >400,000 deaths globally (so far). Furthermore, there has been a profound economic, social, and emotional impact with unquantifiable ongoing suffering. Many HCPs have made personal sacrifices, isolating to protect themselves and loved ones from COVID-19, working in different ways in challenging circumstances. HCPs have been unwell with COVID-19; some have died. The moral distress caused by the pandemic will be profound.

When we contemplate the pandemic’s full impact, it is difficult to state the reported anxiety of respondents in this study being solely due to loss of endoscopy training (and without prepandemic baseline for reference). The finding that female gender was associated with increased anxiety has limited value and has potential to offend.

Endoscopy services are in place to serve patients, and limitation of services will result in significant harms: delayed diagnosis, adverse outcomes, and psychological distress. As solutions are proposed and endoscopy services resume it is important that the benefit to patients, the safety of patients and HCPs, and endoscopy training are considered together. Importantly, this study did not reflect on important confounders; the differences between countries in terms of the stage and severity of the pandemic, and the way it was managed.

We commend the considerable effort to collate data, but without the appropriate COVID-19 pandemic context, this study adds little to the known impact of COVID-19 to endoscopy services, now and in the future.

Disclosure

All authors disclosed no financial relationships.