Hepatopancreaticobiliary (HPB) surgery: what is the right fellowship for the right training?
BACKGROUND
Reduced resident work hours over the last several years have led to inadequate exposure to hepatopancreaticobiliary (HPB) and complex upper gastrointestinal (UGI) surgical procedures. Therefore, residents are seeking additional training in this field. The purpose of this study is to determine the role of a new fellowship model in the training of general surgery residents in complex HPB/UGI diseases.


METHODS
We propose a surgical training model in benign as well as malignant diseases of the UGI tract. The proposed model would focus on an integrated approach that involves allied specialties such as gastroenterology (GI) and radiology.


RESULTS
The fellowship was set as 1-year duration with 1-month rotations on interventional GI and transplantation. The fellow spent the remaining 10 months on a UGI laparoscopic and open surgery service caring for complex benign and malignant disease of the esophagus, stomach, bile duct, pancreas, and liver. Didactic conferences were focused specifically at an organ-based approach to diseases of these organs. During a 12-month fellowship, exposure to complex diseases of the UGI tract was accomplished without negatively impacting the general surgery residency program.


CONCLUSIONS
This new mode of advanced training provides a bridge between surgical oncology and transplantation, and it is an excellent model for postgraduate surgical training in UGI diseases.
Department of Surgery, Methodist Dallas Medical Center, 221 West Colorado Boulevard, Dallas, TX 75208, USA.
Roozbeh
R
Rassadi
Richard M
RM
Dickerman
Ernest L
EL
Dunn
Paul R
PR
Tarnasky
Jeffrey D
JD
Linder
Alejandro
A
Mejia
Stephen S
SS
Cheng
D Rohan
DR
Jeyarajah
D000328:Adult; D013505:Digestive System Surgical Procedures / Q000193:education*; D005257:Fellowships and Scholarships; D005762:Gastroenterology / Q000193:education*; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D017145:Models, Educational