Fellows' perspective of HPB training programs in North America: results of a survey.

ABSTRACT

BACKGROUND: Sixteen hepatopancreatobiliary fellowship programs in North America are accredited by the Fellowship Council. This study aims to assess fellows' perceptions of their training program. METHODS: A multiple-choice questionnaire was sent to 35 fellows to assess how they perceived their training academics, research, operative experiences, autonomy, mentorship, program quality and weaknesses. The survey was developed using the SurveyMonkey® tool. RESULTS: Twenty-four of 35 fellows completed the survey. Sixteen fellows reported structured didactics; 10 reported mandatory research. As to operative experiences; 9 fellows reported exposure to minimally-invasive liver surgery; 5 reported exposure to robotics. Fourteen fellows reported using ablation; 5 reported using ablation laparoscopically; 8 reported using mostly radiofrequency ablation; 1 reported using irreversible electroporation. Eighteen fellows reported excellent training; 20 reported mentorship; 19 reported operative autonomy. Limited exposure to medical oncology/multidisciplinary care, portal hypertension surgery, and robotics surgery were perceived as program weaknesses by 7, 9, and 7 fellows, respectively. CONCLUSION: Most fellows ranked their program quality and academic content as excellent, but they perceived a need for more exposure to medical oncology, portal hypertension surgery, and minimally-invasive surgery, with an emphasis on robotics. Fellowship training may need to integrate fellows' desires for enhanced proficiency in these clinical areas.