title: The adequacy of Hepato-Pancreato-Biliary training: how closely do perceptions of fellows and programme directors align?
abstract: BACKGROUND
  Hepatopancreatobiliary fellowship programmes have recently undergone significant changes with regards to training standards, case-volume thresholds and multimodality educational platforms. The goals of this study were to compare the perspectives of fellows and programme directors (PDs) on perceptions of readiness to enter practice and identify core Hepato-Pancreato-Biliary (HPB) procedures that require increased emphasis during training.
  
  
  METHODS
  This survey targeted PDs and trainees participating in the Fellowship Council/AHPBA pathway. Data related to demographics, education and career plans were collected. Analysis of PD and fellow opinions regarding their confidence to perform core HPB procedures was completed.
  
  
  RESULTS
  The response rate was 88% for both fellows (21/24) and PDs (23/26). There was good agreement between PDs and fellows in the perception of case volumes. Select differences where PDs ranked higher perceptions included major hepatectomies (PDs: 87% versus fellows: 57%, P = 0.04), pancreaticoduodenectomies (100% versus 81%, P = 0.04) and laparoscopic distal pancreatectomies (78% versus 43%, P = 0.03). 'Good or excellent' case volumes translated into increased fellow readiness, except for some pancreatitis procedures, laparoscopic distal pancreatectomies and potentially major hepatectomies.
  
  
  CONCLUSIONS
  This study provides insight into content domains that may require additional attention to achieve an appropriate level of proficiency and confidence upon completion of training.
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Alexsander K
authors.initials: AK
authors.lastname: Bressan
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Janet P
authors.initials: JP
authors.lastname: Edwards
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Grondin
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Elijah
authors.initials: E
authors.lastname: Dixon
authors.affiliation: University of Michigan, Ann Arbour, MI, USA.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Minter
authors.affiliation: Methodist Dallas Medical Center, Dallas, TX, USA.
authors.forename: D Rohan
authors.initials: DR
authors.lastname: Jeyarajah
authors.affiliation: University of Calgary, Calgary, AB, Canada.
authors.forename: Chad G
authors.initials: CG
authors.lastname: Ball
mesh_terms: D000328:Adult; D001660:Biliary Tract Diseases / Q000601:surgery*; D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards*; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D010182:Pancreatic Diseases / Q000601:surgery*; D016730:Program Development; D014481:United States