title: Objective assessment of trainee operative experience in a tertiary hepatobiliary unit.
abstract: BACKGROUND
  Indicative numbers for completion of training (CCT) in the UK requires 35 upper Gastrointestinal/Hepatobiliary resections and 110 (50 non HPB trainees) cholecystectomies. We aim to identify whether the training experience in our centre meets the CCT requirements for hepatobiliary surgery and compare training opportunities to those in international fellowships.
  
  
  METHODS
  We retrospectively reviewed our hospital's operating theatre database for all patients undergoing a liver or gallbladder resection between January 2008 and July 2015 using corresponding procedural codes and consultant name. The cohort was categorized based on case and primary operating surgeon. The training grade of the surgeon was split into junior registrar (ST3/5), senior registrar (ST6/8) and senior fellow (post-CCT).
  
  
  RESULTS
  Over a 7.5 year period we performed 2301 hepatobiliary procedures. The senior fellows and senior registrars performed a median of 42 liver resections (range 15-94) and 77 (range 35-110) cholecystectomies as the primary operator in any given 12 month period. The academic output for the unit was 104 over this period, with a median publication rate of 1.34 papers/trainee in any given 12 months. 15/16 senior fellow/senior registrars went on to secure substantive hepatobiliary consultant posts.
  
  
  CONCLUSIONS
  Our centre delivers in excess of the required operative volume and clinical competencies for CCT in Hepatobiliary surgery in a 12 month period and exposure of trainees to operative experience is commensurate to the best performing international fellowships.
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK. Electronic address: hemanjoshi@doctors.org.uk.
authors.forename: H M
authors.initials: HM
authors.lastname: Joshi
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: E
authors.initials: E
authors.lastname: Alabraba
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tufo
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: A
authors.initials: A
authors.lastname: Zone
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: P
authors.initials: P
authors.lastname: Ghaneh
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: S W
authors.initials: SW
authors.lastname: Fenwick
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Poston
authors.affiliation: Department of Hepatobiliary Surgery, University Hospital Aintreee, Longmoor Lane, L7 9AL, UK.
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
mesh_terms: D002763:Cholecystectomy / Q000193:education*; D004521:Educational Measurement; D005257:Fellowships and Scholarships; D006498:Hepatectomy / Q000193:education*; D006801:Humans; D012189:Retrospective Studies
keywords: Fellowship; Liver surgery; Training