The adequacy of hepatopancreatobiliary training: How does operative exposure and perceived readiness in fellowship translate into subsequent practice?

The adequacy of hepatopancreatobiliary training: How does operative exposure and perceived readiness in fellowship translate into subsequent practice?

Can J Surg 2017;60(2):140-143 | PDF

Jean-Michel Aubin, MD; Alexsander K. Bressan, MD; Janet P. Edwards, MD; Sean C. Grondin, MD; Elijah Dixon, MD; Rebecca M. Minter, MD; D. Rohan Jeyarajah, MD; Paul Hansen, MD; Amanda B. Cooper, MD; Chad G. Ball, MD, MSc

Summary

Over the last 3 decades, expansion in the scope and complexity of hepatopancreatobiliary (HPB) surgery has resulted in significant improvements in postoperative outcomes. As a result, the importance of dedicated fellowship training for HPB surgery is now well established, and the definition of formal program requirements has been actively pursued by a collaboration of the 3 distinct accrediting bodies within North America. Although major advances have been made in defining minimum case volume requirements, qualitative assessment of the operative experience remains challenging. Our research collaborative (HPB Manpower and Education Study Group) has previously explored the perceived case volume adequacy of core HPB procedures within fellowship programs. We conducted a 1-year follow-up survey targeting the same cohort to investigate the association between operative case volumes and comfort performing HPB procedures within initial independent practice.


Presented at the 12th World Congress of the International Hepato-Pancreato-Biliary Association in Sao Paulo, Brazil in April, 2016.

Accepted Oct. 25, 2016; Early-released Feb. 1, 2017

Affiliations: From the University of Calgary, Calgary, Alta. (Aubin, Bressan, Edwards, Grondin, Dixon, Ball); the University of Texas Southwestern Medical Centre, Dallas, TX (Minter); the Methodist Dallas Medical Center, Dallas, TX (Jeyarajah); the Providence Medical Center, Portland, OR (Hansen); and the Penn State Hershey Medical Center, Hershey, PA (Cooper).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.014216

Correspondence to: C.G. Ball, Department of Surgery, Foothills Medical Centre, University of Calgary, Calgary AB T2N 1N4; ball.chad@gmail.com