Burnout in COVID-19 Residency

Journal of Clinical Orthopaedics | Vol 8 | Issue 1 |  Jan-Jun 2023 | page: 18-24 | Sachin Kale, Pratik Dhabalia, Ajit Chalak, Abhiraj Patel, Abhineet Chand, Sonali Das

DOI: :10.13107/jcorth.2023.v08i01.551

Author: Sachin Kale [1], Pratik Dhabalia [1], Ajit Chalak [1], Abhiraj Patel [1], Abhineet Chand [1], Sonali Das [1]

[1] Department of Orthopaedics, DY Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Abhiraj Patel,

Department of Orthopaedics, DY Patil Medical College and Hospital, Nerul, Navi Mumbai, Maharashtra, India.



Introduction: Burnout is a syndrome denoting the outcome of chronic work stress which has not been managed successfully. Burnout has only sometimes been at the forefront of studies in healthcare, where patient care and management have received more attention. This study focuses particularly on burnout of residents and healthcare workers during the COVID-19 pandemic that has changed the working environment.

Material and Methods: Questionnaires in the form of surveys have been used to receive feedback regarding work experience within the bubble of isolation and high patient load unique to COVID-19 pandemic. A full and complete analysis of the research is provided after the definition, description, and measurement of burnout are given.

Results: According to a review of the burnout literature, burnout affects medical students, residents, and practicing doctors, with prevalence rates ranging from 28% to 45% for each group. First-year residency during the COVID-19 pandemic, in particular, is plagued with unmanageable burnout symptoms and a depleted support system. Burnout among residents is said to be caused by time demands, a lack of control, poor work organization, naturally challenging employment settings, and interpersonal connections. Workplace solutions might take the form of burnout education, workload adjustments, diversifying job roles, stress management training, mentorship, emotional intelligence seminars, and training in emotional intelligence. In addition, developing interpersonal and professional relationships, meditation, therapy, and exercise are examples of self-directed behavioral, social, and physical activities..

Conclusion: Educators should consider including pertinent instructions and interventions during the process of instructing resident doctors. In addition, they should actively become aware of burnout. Early detection aids in better management of burnout.

Keywords: burnout, COVID-19, residency, work-life balance.


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How to Cite this article: Kale S, Dhabalia P, Chalak A, Patel A, Chand A, Das S. Burnout in COVID-19 Residency. Journal of Clinical Orthopaedics Jan-Jun 2023;8(1):18-24.

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Moving toward Regional Anaesthesia for Spine Surgery – Need of the Hour

Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 38-42 | Samidha Waradkar , Aaliya Mehmood , Saijyot Raut , Vishal Kundnani

DOI: 10.13107/jcorth.2022.v07i02.527

Author: Samidha Waradkar [1], Aaliya Mehmood [2], Saijyot Raut [3], Vishal Kundnani [4]

[1] Consultant Anesthesiology, at Lilavati Hospital and Research Centre, Mumbai, India,
[2] Senior Resident Anesthesiology at Lilavati Hospital and Research Centre, Mumbai, India,
[3] MS Ortho, Consultant Spine Surgeon at Spine Centre, Andheri and SL Raheja Hospital, Mahim, Mumbai, India,
[4] MS Ortho, Consultant Spine Surgeon at Lilavati Hospital and Research Centre, Mumbai, India.

Address of Correspondence
Dr. Aaliya Mehmood,
Flat 701, A-8, Al-Quba CHS, Millat Nagar, Andheri West, Mumbai 400053, India.


Background: In the last few decades, many studies have been conducted on comparison between general anaesthesia (GA) versus spinal anaesthesia (SA) for lumbar spine surgeries and each have reported discrepancies between the two methods of induction with equivalent pros and cons; ultimately failing to state a final conclusive method. With the ongoing COVID pandemic, and the fear of aerosol generation associated with GA; our focus has shifted on regional anesthesia completely, as it is been proven safer and more hassle-free to conduct during these challenging times.

Materials and Methods: A similar case study was conducted with 178 patients posted for lumbar spine procedures under the same surgeon. Wherein, 86 received GA and 92 SA. Appropriate statistical analysis was applied to identify differences in blood loss, operative time, time from entering the operating room (OR) until incision, time from bandage placement to exiting the OR, total anesthesia time, PACU time, and total hospital stay. Secondary outcomes of interest included incidence of postoperative spinal hematoma and death, incidence of paraparesis, paraplegia, paraesthesia, post-Dural puncture headache, signs of meningism, urinary retention, and other perioperative complications among the SA patients.

Results: SA was associated with significantly lower operative time, blood loss, total anaesthesia time, time from entering the OR until incision, time from bandage placement until exiting the OR. SA was also associated with shorter stay in the PACU, and overall lesser total duration of hospital stay. None of the 92 patients in SA group needed conversion to GA or had an episode of high/complete sympathetic blockade. No incidences of paraparesis or paraplegia, or episodes of persistent post-operative paraesthesia or weakness, Bagai (vasovagal) syncope, PONV, post-op meningism, post-dural puncture headache, spinal hematoma, intraoperative dural Cerebrospinal Fluid leak or post-op fistula, were noted. There were two incidences of failed spinal which were easily managed with a lower dose repeat SA. Overall better post-op analgesia and higher patient and surgeon satisfaction compared to GA was observed.

Conclusion: SA is effective for use in patients undergoing elective lumbar spine surgeries and very efficient alternative technique to GA. SA offers efficient OR functioning with decreasing overall operation theatre time and shown to be the more convenient anesthetic choice in the perioperative setting.

Keywords: Spinal Anaesthesia, Regional Anaesthesia, Covid-19, Spine Surgery, Lumbar Discectomy, Fast Track Anaesthesia, Aerosol Generation


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How to Cite this article: Waradkar S, Mehmood A, Raut S, Kundnani V. Moving toward Regional
Anesthesia for Spine Surgery – Need of the Hour. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):38-42.

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Financial Ignorance among Orthopedic Surgeons: A Survey In COVID-19 Era

Journal of Clinical Orthopaedics | Vol 6 | Issue 2 |  Jul-Dec 2021 | page: 8-11 | Sachin Kale, Ajit Chalak, Sanjay Dhar, Prasad Chaudhari, Sushmit Singh, Aditya Gunjotikar

Author: Sachin Kale [1], Ajit Chalak [1], Sanjay Dhar [1], Prasad Chaudhari [1], Sushmit Singh [1], Aditya Gunjotikar [1]

[1] Department of Orthopaedics, Dr. D. Y. Patil Medical College and Hospital, Nerul, Navi Mumbai, India

Address of Correspondence
Dr. Sushmit Singh,
Department of Orthopaedics, Dr. D Y Patil Medical College and Hospital, Nerul, Navi Mumbai, India.


Background: COVID-19 pandemic has severely affected the finances of orthopedic surgeons around the globe due to recurring lockdowns and fewer elective surgeries. It has forced surgeons to reflect on their wealth management status and look for a second source of income as well.
Objectives: The objectives of the study were to determine the effect of the COVID-19 pandemic on the personal finances of orthopedic surgeons and gauge their knowledge regarding the stock market as a second source of income.

Methods: An online survey was conducted among the orthopedic surgeons practicing in Maharashtra, India. The survey included assessment of demographic data, financial knowledge, knowledge of the stock market, and wealth management status.

Results: Most respondents (75.6%) were forced to think about the second source of income after the COVID-19 pandemic. Seventy-nine percent of surgeons felt the need for training for investment in stock markets.
Conclusion: Most of the respondents lack proper knowledge about funds management and retirement planning. This study indicates a strong need for formal education of orthopedic surgeons in the field of personal finance, stock markets, and retirement planning.

Keywords: COVID-19, orthopedic surgeons, personal finance


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How to Cite this article: Kale S, Chalak A, Dhar S, Chaudhari P, Singh S, Gunjotikar A. Financial Ignorance among Orthopedic Surgeons: A Survey in COVID-19 Era. Journal of Clinical Orthopaedics July-Dec 2021;6(2):8-11.

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Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols

Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page: 20-24 | Sajeev Shekhar, Vivek Shetty, Yash Wagh

Author: Sajeev Shekhar [1], Vivek Shetty [1], Yash Wagh [1]

[1] Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016

Address of Correspondence
Dr. Vivek Shetty,
Department of Orthopedics, P.D. Hinduja National Hospital & MRC, Veer Savarkar Marg, Mahim West, Mumbai – 400016


Introduction: Since the major outbreak of COVID-19 in March 2020, all hospitals and surgeons opted to postpone elective scheduled surgeries for personal and patient safety
Aim of this study: In this study of 45 consecutive patients, we changed the surgical protocols during this pandemic, our study highlights difficulties faced and how they were tackled.
Materials and Methods: 45 patients were included in this study operated by a single Senior Surgeon at a tertiary centre and their results were compared to similar surgeries performed in the pre-Covid era, in terms of length of hospital stay, duration of surgery, complications/mortality post operatively and overall risk of infection to the patients and hospital staff.
Results: It was found that the, mortality and morbidity in both times were same in Covid-19 negative patients, overall time taken for the surgery was increased, the hospital stay was increased, usage of resources was increased, difficulties faced were not only by the patients but also the health workers.
Keywords: COVID-19, protocols, donning in, doffing off, operation time, aerosol,.


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How to Cite this article: Shekhar S, Shetty V, Wagh Y. Challenges and Difficulties faced by Orthopedic Surgeons during the COVID-19 Pandemic: A Review of Modified Surgical Protocols. Journal of Clinical Orthopaedics July-Dec 2020;5(2):20-24.

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