Checking Our Blind Spots: Examining Characteristics of Interviewees Versus Matriculants to a Hepatopancreatobiliary Surgical Fellowship Program

Preferred content, construct, and duration of a fellowship structure in HPB surgery: a cross-sectional, pan-European survey among trainees and trainers

BACKGROUND

Fellowships in HPB surgery are lacking across Europe. The aim of this survey was to investigate preferences towards an HPB-fellowship structure among trainees and trainers.

METHODS

A cross-sectional pan-European survey of trainees and consultants in HPB across Europe. Preferred content, duration and construct of a fellowship program was explored.

RESULTS

Responses from 221 eligible participants were analysed, covering all European regions (40 % trainees, of which 31 % women). Preferred duration was 2 years (53 %), international availability (71 %) and in English language (by two-thirds overall; 74 % among trainees). A majority About two-thirds (63 %) preferred an official fellowship teaching curriculum provided by the E-AHPBA. Most The vast majority of participants (n = 211; 95 %) supported accreditation of HPB-fellowships by the E-AHPBA. Trainees reported higher priorities towards technical training (i.e. time in operating room; first surgeon opportunity; minimal-invasive technique training) than consultants, while time for non-operative activities (i.e. ward rounds; responsibility for multidisciplinary team meetings etc) was valued higher by consultants.

CONCLUSIONS

We identified preferences and needs towards construct and competence in HPB fellowships with strong support for involvement of E-AHPBA in providing a involvement teaching curriculum and accreditation. A unified HPB fellowship construct and registry across Europe guided by E-AHPBA may take this into consideration.

Benefits and barriers to accreditation of HPB center and fellowship programs in Europe: a strength-weakness-opportunity-and-threats (SWOT) analysis by an E-AHPBA-ESSO-UEMS ad hoc working committee

BACKGROUND

Training in HPB surgery lacks uniformity across regions covered by the E-AHPBA. Accreditation has been in place for centers and fellowship programs, but with low uptake. The decision whether to continue, change or cease such accreditation is being discussed. Thus, a strengths, weaknesses, opportunities, and threats (SWOT) analysis was conducted.

METHODS

A mixed-methods, cross-sectional study among stakeholders in E-AHPBA, ESSO and UEMS under the E-AHPBA executive council was founded, ensuring representation by gender and geographic distribution.

RESULTS

Responses were collected from across E-AHPBA regions, with response from 15 of 24 subchapters. The most frequent and recurring themes are presented in a SWOT matrix which allows for paired evaluations of factors deemed to be helpful (Strengths and Opportunities), those that are harmful (Weaknesses and Threats).

CONCLUSION

This study identified both helpful and harmful effects to an accreditation process of HPB centers or HPB fellowship training across the E-AHPBA membership region. Formal accreditation of centers is not within the scope, nor jurisdiction nor financial capacity for E-AHPBA in the current situation. A strong interest in formal HPB training should be capitalized into E-AHPBA strategic planning towards a structured accreditation system for HPB fellowship programs or HPB training tracks.

Importance of Diversity, Equity, and Inclusion in the Hepatopancreatobiliary Workforce

Diversity is a catalyst for progress that prevents institutional stagnation and, by extension, averts descent to mediocrity. This review focuses on the available data concerning hepatopancreatobiliary (HPB) surgical workforce demographics and identifies evidence-based strategies that may enhance justice, equity, diversity, and inclusion for HPB surgeons and their patients. We report that the current United States HPB surgical workforce does not reflect the population it serves. We review data describing disparity-perpetuating hurdles confronting physicians from minority groups underrepresented in medicine at each stage of training. We further examine evidence showing widespread racial and socioeconomic disparities in HPB surgical care and review the effects of workforce diversity and physician-patient demographic concordance on healthcare outcomes. Evidence-based mitigators of structural racism and segregation are reviewed, including tailored interventions that can address social determinants of health toward the achievement of true excellence in HPB surgical care. Lastly, select evidence-based data driving surgical workforce solutions are reviewed, including intentional compensation plans, mentorship, and sponsorship.