Impact of COVID-19 on orthopaedic surgery clinical exposure for medical students: A retrospective study at a teaching hospital in Pretoria, South Africa

Background: This study examined the impact of the COVID-19 pandemic and national lockdown restrictions on the clinical exposure of final-year medical students rotating through the orthopaedic surgery department at a medical school in Pretoria, South Africa. Methods: A retrospective review (1 April through 30 June 2020) of final-year students at Sefako Makgatho Health Sciences University, whose departmental rotation was disrupted due to the national lockdown (COVID group), was conducted. Their attendance was compared with that of the previous year’s final-year students (non-COVID group) who experienced uninterrupted lectures during the equivalent duration in 2019. The two groups were statistically compared, with the threshold for statistical significance set at P<0.05. Results: The COVID group attended 13 days of the orthopaedic block, while the non-COVID group attended 15 days. The overall attendance of the COVID group, in different clinical settings, was significantly less (P<0.001) than that of the non-COVID group. Even after accounting for online and in-person attendance, the COVID group attended significantly fewer lectures (13 vs 15; P=0.001) than the non-COVID group. Conclusions: This study demonstrated a significant reduction in musculoskeletal training and clinical exposure of final-year medical students at our institution in 2020. To adapt to the national lockdown regulations, a number of measures were put in place, such as online teaching, extension of the academic calendar, and distribution of personal protective equipment. These steps were crucial for maintaining the standard of teaching for final-year students during the national lockdown, as suggested by the exam results.