title: Medical training fails to prepare providers to care for patients with chronic hepatitis B infection.
abstract: OBJECTIVE
  To investigate physicians' knowledge including chronic hepatitis B (CHB) diagnosis, screening, and management in various stages of their training.
  
  
  METHODS
  A voluntary 20-question survey was administered in Santa Clara County, CA where Asian and Pacific Islanders (API) account for a third of the population. Among the 219 physician participants, there were 63 interns, 60 second-year residents, 26 chief residents and 70 attending physicians. The survey asked questions regarding respondents' demographics, general hepatitis B virus knowledge questions (i.e., transmission, prevalence, diagnostic testing, prevention, and treatment options), as well as, self-reported practice behavior and confidence in knowledge.
  
  
  RESULTS
  Knowledge about screening and managing patients with CHB was poor: only 24% identified the correct tests to screen for CHB, 13% knew the next steps for patients testing positive for CHB, 18% knew the high prevalence rate among API, and 31% knew how to screen for liver cancer. Wald chi-square analysis determined the effect of training level on knowledge; in all cases except for knowledge of liver cancer screening (P = 0.0032), knowledge did not significantly increase with length in residency training or completion of residency.
  
  
  CONCLUSIONS
  Even in a high-risk region, both medical school and residency training have not adequately prepared physicians in the screening and management of CHB.
authors.affiliation: Stephanie D Chao, Department of Surgery, Stanford University School of Medicine, Asian Liver Center at Stanford University, School of Medicine, Palo Alto, CA 94304, United States.
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Chao
authors.affiliation: Stephanie D Chao, Department of Surgery, Stanford University School of Medicine, Asian Liver Center at Stanford University, School of Medicine, Palo Alto, CA 94304, United States.
authors.forename: Bing-Mei
authors.initials: BM
authors.lastname: Wang
authors.affiliation: Stephanie D Chao, Department of Surgery, Stanford University School of Medicine, Asian Liver Center at Stanford University, School of Medicine, Palo Alto, CA 94304, United States.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Chang
authors.affiliation: Stephanie D Chao, Department of Surgery, Stanford University School of Medicine, Asian Liver Center at Stanford University, School of Medicine, Palo Alto, CA 94304, United States.
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.affiliation: Stephanie D Chao, Department of Surgery, Stanford University School of Medicine, Asian Liver Center at Stanford University, School of Medicine, Palo Alto, CA 94304, United States.
authors.forename: Samuel K
authors.initials: SK
authors.lastname: So
mesh_terms: D000328:Adult; D001213:Asian; D002140:California / Q000453:epidemiology; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D044468:Native Hawaiian or Pacific Islander; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013038:Specialization; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Asian Pacific Islander; Health disparity; Hepatitis B; Liver cancer; Liver disease