Experiences and challenges of neurosurgical residents during the COVID 19 pandemic in Sabah Malaysia

A qualitative study of neurosurgical residents at Queen Elizabeth Hospital in Kota Kinabalu, Malaysia, found that the COVID 19 pandemic disrupted operative training, reshaped residents’ professional identities, intensified concerns about household safety and increased their reliance on informal support networks. The research examined the professional, educational, emotional and family experiences of residents training at a tertiary referral neurosurgical centre in Sabah.

Researchers conducted one-on-one, semi-structured interviews between 2020 and 2022 with postgraduate neurosurgical residents in years two through four who had direct experience providing neurosurgical care during the pandemic. Ten residents were recruited, but eight completed the interviews and were included in the analysis; two were transferred to the main campus. Their interviews were treated as pilot sessions to refine the questions. Each formal interview lasted about 40 minutes and was conducted voluntarily during hospital rotations.

The recorded interviews were transcribed verbatim and analysed with reflexive thematic analysis following Braun and Clarke’s six-phase framework. Codes were generated inductively, grouped into categories and refined into themes through repeated comparison of transcripts and discussions among the research team. The researchers evaluated the sample through “information power,” considering the specificity of the study aim, participant relevance, quality of the dialogue and richness of the data rather than sample size alone. Later interviews did not yield substantially new issues across training, family, emotional well-being or coping.

Training disruption extended beyond interruptions to lectures and other educational activities. Residents reported reduced access to operating-room cases, postponed examinations, limited continuous medical education and a shift toward individual learning. Screening requirements and resource limitations also delayed treatment for some neurosurgical emergencies, concerning residents about patients’ deteriorating conditions. Junior and mid-level residents were particularly anxious that fewer operations could delay competency acquisition despite extensions to the time-based programme, whereas senior residents generally perceived less effect on their own progression.

For many participants, reduced operative exposure threatened not only technical development but also their transition from supervised trainee to autonomous neurosurgeon. Consultants increased online continuing medical education sessions, but residents differed in how they interpreted this support. Some viewed the sessions as evidence that supervisors were concerned about their progression, while others perceived limited attention to training. Views of cadaveric skills laboratories were also divided, with simulation approaches generally regarded as useful supplements rather than substitutes for operative experience. Virtual learning helped preserve academic engagement but could not fully replace workplace-based procedural training.

Residents also negotiated the risk of occupational infection and possible transmission to household members. They adopted measures including showering and changing clothes at the hospital, washing items after returning home, removing clothing and masks before entering the house and disinfecting bags. Housemates sometimes temporarily isolated from one another because of concern about exposure. Most families nevertheless supported residents’ continued clinical responsibilities, although one participant recalled that worried parents initially asked the resident to stop working. Reduced contact with relatives was balanced in some households by more time together and opportunities for rest.

The emotional burden included stress, anxiety, isolation, frustration and helplessness. Infection-control procedures made care of suspected or confirmed COVID-19 patients more physically demanding, while quarantine-related staff shortages increased workloads for the remaining team. Some residents described fatigue and emotional exhaustion consistent with burnout-related stressors, although they did not identify themselves as experiencing burnout. More time at home, opportunities for reflection and stronger bonds with colleagues were also reported as unexpected positive effects. None of the eight participants reported accessing formal counselling. Some believed colleagues in intensive care, anaesthesia or internal medicine faced greater pressure, while others were concerned that seeking help could bring stigma or affect their professional records.

Instead, residents relied on communication with family, exercise, social support, online meetings with supervisors, modified training plans, leisure activities and spiritual practices. The authors interpret these accounts as showing that resilience depended on relationships with families, peers, mentors and institutions rather than individual endurance alone. They also note that the prominent role of family responsibility and faith-based coping reflected Sabah’s multicultural social context. The findings support programme planning that includes contingency education, simulation, structured mentorship, protected educational activities and accessible psychological support, while recognizing that residents may rely on informal and culturally grounded support networks when formal help-seeking is limited.

The findings come from one small regional training programme with only eight interviewees, and statistical generalization is not warranted. The centre’s limited number of trainees and consultants, close consultant–trainee relationships, geographically dispersed referral population and particular sociocultural setting may have shaped the results. The researchers cautioned that experiences in larger programmes or different healthcare systems could differ. Within those boundaries, the study provides qualitative evidence that pandemic-related service disruption can affect neurosurgical training, professional development, psychological well-being and household life simultaneously.

Subject of Research: Qualitative study of neurosurgical residents’ training, well-being and family experiences during COVID 19 in Sabah, Malaysia

Article Title: Experiences and challenges of neurosurgical residents during the COVID 19 pandemic in Sabah Malaysia

Article References: Joseph J. Naesarajoo, J., Muir, F., & Abdul Karim, H. (2026). Experiences and challenges of neurosurgical residents during the COVID 19 pandemic in Sabah Malaysia. Discover Education, 5(1), Article 930. https://doi.org/10.1007/s44217-026-02145-x

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02145-x

Keywords: COVID 19, neurosurgical residents, Sabah, Malaysia, medical education, operative training, qualitative interviews, resident well-being, family safety, thematic analysis, Experiences, challenges