Training and practice of the next generation HPB surgeon: analysis of the 2014 AHPBA residents' and fellows' symposium survey.
BACKGROUND
Hepato-pancreato-biliary (HPB) surgery is a complex subspecialty drawing from varied training pools, and the need for competency is rapidly growing. However, no board certification process or standardized training metrics in HPB surgery exist in the Americas. This study aims to assess the attitudes of current trainees and HPB surgeons regarding the state of training, surgical practice and the HPB surgical job market in the Americas.


METHODS
A 20-question survey was distributed to members of Americas Hepato-Pancreato-Biliary Association (AHPBA) with a valid e-mail address who attended the 2014 AHPBA. Descriptive statistics were generated for both the aggregate survey responses and by training category.


RESULTS
There were 176 responses with evenly distributed training tracks; surgical oncology (44, 28%), transplant (39, 24.8%) and HPB (38, 24.2%). The remaining tracks were HPB/Complex gastrointestinal (GI) and HPB/minimally invasive surgery (MIS) (29, 16% and 7, 4%). 51.2% of respondents thought a dedicated HPB surgery fellowship would be the best way to train HPB surgeons, and 68.1% felt the optimal training period would be a 2-year clinical fellowship with research opportunities. This corresponded to the 67.5% of the practicing HPB surgeons who said they would prefer to attend an HPB fellowship for 2 years as well. Overall, most respondents indicated their ideal job description was clinical practice with the ability to engage in clinical and/or outcomes research (52.3%).


CONCLUSIONS
This survey has demonstrated that HPB surgery has many training routes and practice patterns in the Americas. It highlights the need for specialized HPB surgical training and career education. This survey shows that there are many ways to train in HPB. A 2-year HPB fellowship was felt to be the best way to train to prepare for a clinically active HPB practice with clinical and outcomes research focus.
Carolinas Medical Center, Charlotte, NC, USA.
Ramanathan M
RM
Seshadri
Akron General Medical Center, Akron, OH, USA.
Noaman
N
Ali
University of Michigan, Ann Arbor, MI, USA.
Susanne
S
Warner
Carolinas Medical Center, Charlotte, NC, USA.
Allyson
A
Cochran
Carolinas Medical Center, Charlotte, NC, USA.
Dionisios
D
Vrochides
Carolinas Medical Center, Charlotte, NC, USA.
David
D
Iannitti
The Methodist Hospital, Dallas, TX, USA.
D Rohan
DR
Jeyarajah
D000328:Adult; D001291:Attitude of Health Personnel; D001662:Biliary Tract Surgical Procedures / Q000193:education; D002321:Career Choice; D002568:Certification; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum; D013505:Digestive System Surgical Procedures / Q000193:education* / Q000592:standards; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards; D005257:Fellowships and Scholarships / Q000592:standards; D005260:Female; D006498:Hepatectomy / Q000193:education; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D007587:Job Description; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000193:education; D013038:Specialization; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods* / Q000592:standards; D013997:Time Factors; D014481:United States