September 11, 2021
The following Statement on Resident Access to Personal Protective Equipment (PPE) was developed by the American College of Surgeons (ACS) Resident and Associate Society (RAS) and approved by the (ACS) Board of Regents at its June 11-12, 2021, meeting in Chicago, IL.
The American College of Surgeons has long stood for quality and safety in health care. This principle was demonstrated in the April 2020 “ACS Statement on PPE Shortages during the COVID-19 Pandemic,” which called for adequate PPE for all involved in health care. This statement included our colleagues in training. The Centers for Disease Control and Prevention (CDC), Occupational Safety and Health Agency, and other public health advocates stress the importance of adequate, available, and appropriate PPE to ensure the safety of patients and health care professionals and to mitigate spread of contagious diseases.
A survey of residents from across the U.S. last year identified that a lack of access to personal protective equipment (PPE) amid the coronavirus (COVID-19) pandemic was predictive of depression and burnout.
In response to this data, the ACS is issuing the following statement regarding PPE for surgical residents. The recommendations are outlined below, and the ACS leadership affirms that if any resident feels uncomfortable or unsafe wearing their PPE in its current state when taking care of patients, the resident should be entitled to PPE replacement without question or opposition. Residents are encouraged to speak up immediately with concerns regarding their safety during patient care. In line with recommendations from the CDC regarding N95 respirators/masks
The ACS is aware of reports of residents being asked to provide their own PPE or pay for PPE supplied to them. There also have been reports of PPE being locked in storage by hospital personnel, making it difficult for residents to acquire what they need in a timely fashion. Similarly, the College has received reports of PPE usage for extended periods of time and beyond the recommended duration, which renders the N95 mask ineffective in preventing infection and placing residents at risk of acquiring COVID-19 infection. Our trainees are part of the front line, and the ACS leadership strongly condemns these practices.
Lastly, if trainees encounter macro- or microaggressions when attempting to acquire new PPE according to the recommendations above or are denied PPE when requested, an expeditious institutional mechanism should be in place to report these events and have them corrected by program or hospital leadership. We recommend this statement be made accessible to all hospital personnel so that institutional staff are educated regarding these policies and to avoid these instances from occurring.
Looking forward, the ACS leadership affirms that residents taking care of patients with known COVID-19 or COVID-19 unknown status should be given priority in the future for protective equipment and practices, including vaccinations and booster vaccinations, if found to be merited.
The ACS leadership recognizes, respects, and supports surgical trainees. Any surgical resident who is confronted with issues acquiring PPE despite the above statement should contact their institutional Accreditation Council for Graduate Medical Education representation.