The annual AHPBA HPB fellows' course: an analysis of impact and feedback.

BACKGROUND: Since 2012, the AHPBA has hosted an annual HPB Fellows' Course at Carolinas Medical Center. All fellows training in an accredited HPB fellowship are eligible to attend. The aim of this study was to evaluate the impact of this conference and assess possible areas of improvement. METHODS: The Carolinas Fellows' Course (CFC) is a structured educational activity involving didactics, skills labs, and live case presentations. The course emphasizes minimally invasive surgery (MIS) and intraoperative ultrasound (IOUS) technique. This is a retrospective review of a survey emailed to 95 fellows who have attended the course over a 7-year period. RESULTS: Fifty-two attendees completed the survey (54.7% response rate). Sixty-eight percent of respondents now practice primarily HPB surgery. Seventy-six percent agreed that the CFC encouraged them to incorporate IOUS into their practice, while 74% were encouraged to incorporate MIS HPB procedures into their practice. Eighty percent felt that the course laid groundwork for long term communication with peers. CONCLUSION: The study demonstrates that a multisite instructional course can be an effective way to encourage the development of new skills, boost operational confidence, impact real world practices, and foster long term communication and networking among fellows after graduation.

The influence of fellowship training on the practice of pancreatoduodenectomy.

BACKGROUND: There has been a proliferation of gastrointestinal surgical fellowships; however, little is known regarding their association with surgical volume and management approaches. METHODS: Surveys were distributed to members of GI surgical societies. Responses were evaluated to define relationships between fellowship training and surgical practice with pancreatoduodenectomy (PD). RESULTS: Surveys were completed by 889 surgeons, 84.1% of whom had completed fellowship training. Fellowship completion was associated with a primarily HPB or surgical oncology-focused practice (p < 0.001), and greater median annual PD volume (p = 0.030). Transplant and HPB fellowship-trained respondents were more likely to have high-volume (≥20) annual practice (p = 0.005 and 0.029, respectively). Regarding putative fistula mitigation strategies, HPB-trained surgeons were more likely to use stents, biologic sealants, and autologous tissue patches (p = 0.007, <0.001 and 0.001, respectively). Surgical oncology trainees reported greater autologous patch use (p = 0.003). HPB fellowship-trained surgeons were less likely to routinely use intraperitoneal drainage (p = 0.036) but more likely to utilize early (POD ≤ 3) drain amylase values to guide removal (p < 0.001). Finally, HPB fellowship-trained surgeons were more likely to use the Fistula Risk Score in their practice (29 vs. 21%, p = 0.008). CONCLUSION: Fellowship training correlated with significant differences in surgeon experience, operative approach, and use of available fistula mitigation strategies for PD.