Strengths and opportunities for improvement in surgical education in Ukraine: A qualitative study

Author:

Dzhemiliev Ali1ORCID,Antoniv Marta2,Huivaniuk Inesa3,Kizub Darya4,Reich Amanda J.5,Kochis Michael6,Prystaia Anastasiia7,Beliechenko Svitlana8,Danylyshyn Maksym9,Ivanykovych Taras10,Semeniv Solomiia11,Beznosenko Andriy12,Shabat Galyna13,Kopetskyi Viacheslav3,Zmijewski Polina14,Melnitchouk Nelya1

Affiliation:

1. Division of General and Gastrointestinal Surgery Center for Surgery and Public Health Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA

2. Division of General and Gastrointestinal Surgery Department of Surgery Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA

3. Kyiv Regional Oncology Center Hepato‐Pancreato‐Biliary Surgery Department Kyiv Ukraine

4. Division of Cancer Medicine Department of Breast Medical Oncology University of Texas MD Anderson Cancer Center Houston Texas USA

5. Center for Surgery and Public Health Harvard Medical School Boston Massachusetts USA

6. Department of Surgery Massachusetts General Hospital Boston Massachusetts USA

7. Feofaniia Clinical Hospital Department of General Surgery and Oncology Kyiv Ukraine

8. Division of Cardiac Surgery Massachusetts General Hospital Boston Massachusetts USA

9. Division of General and Gastrointestinal Surgery Brigham and Women's Hospital Boston Massachusetts USA

10. Danylo Halytsky Lviv National Medical University Lviv Ukraine

11. Department of General, Oncological, Metabolic and Emergency Surgery University Hospital Krakow Poland

12. National Cancer Institute Kyiv Ukraine

13. Division of General and Foregut Surgery IRCCS Policlinic San Donato San Donato Milanese Italy

14. The University of Alabama at Birmingham Birmingham Alabama USA

Abstract

AbstractBackgroundThe full‐scale invasion of Ukraine by Russia in 2022 has significantly impacted the country's healthcare system including surgical education. To assess the current state and identify the strengths and opportunities for the improvement of Ukraine's surgical education system during the peri‐war period, this study is one of the first to explore the state of surgical education across Ukraine in peri‐war, providing essential insights for current and postwar healthcare reconstruction.MethodsThis qualitative study involved semi‐structured interviews with 24 Ukrainian surgical residents, surgeons, and program leadership from various regions. The study focused on clinical training, didactics, mentorship, autonomy, resident evaluation, the impact of war, and gender disparities in surgical education. Data analysis was conducted using a rapid qualitative analysis technique.ResultsInterviews revealed strengths in surgical education such as adaptability to war conditions and international collaborations. However, opportunities for improvement were identified including a lack of structured clinical and didactic experiences, limited autonomy and access to simulators, gender discrimination, and war‐time challenges. These issues highlight a need for more comprehensive training and support systems for surgical trainees in Ukraine.ConclusionsThe study underscores the resilience and adaptability of Ukrainian surgical education in the face of war while also emphasizing the need for significant improvements. It calls for implementing structured training programs, enhanced mentorship, and attention to gender equality. These findings are crucial for improving surgical education in Ukraine and can be used as an example for other lower‐middle‐income countries, especially in conflict settings.

Publisher

Wiley

Reference26 articles.

1. “WHO Records More Than 1000 Attacks on Health Care in Ukraine over the Past 15 Months of Full‐Scale War.” Accessed: Oct. 06 2023. [Online]. Available:https://www.who.int/europe/news/item/30‐05‐2023‐who‐records‐1‐000th‐attack‐on‐health‐care‐in‐ukraine‐over‐the‐past‐15‐months‐of‐full‐scale‐war

2. “GDP (Current US$) ‐ Ukraine | Data.” Accessed: Dec. 16 2023. [Online]. Available:https://data‐worldbank‐org.ezp‐prod1.hul.harvard.edu/indicator/NY.GDP.MKTP.CD?locations=UA

3. “Current Health Expenditure (% of GDP) | Data.” Accessed: Dec. 16 2023. [Online]. Available:https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

4. Patient Care and Surgical Training During Armed Conflict: Experiences and Perspectives of Surgical Residents in Ukraine

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