[Postgraduate surgical training and system for board-certified surgeons in gastroenterology].

The board-certified surgeon in gastroenterology is one of the subspecialties based on the board-certified general surgeon. Certification is given to those who pass the qualifying and certifying examinations administered by the Japanese Society of Gastroenterological Surgery, after achieving specified standards of surgical experience and demonstrating excellence in presentation, publication, and training provided by the curriculum. The level of acquired surgical skill for the initial certification is the ability to perform surgery for the treatment of gastroenterological diseases at the lower-middle degree of difficulty under laparotomy or thoracotomy. As of January 2009, there were 4,554 (about 21.6%) board-certified surgeons in gastroenterology among the 12,087 members of the Japanese Society of Gastroenterological Surgery. Creating a database of gastroenterological surgeries plays an important role in the evaluation of training facilities and gastroenterological specialists, information disclosure to the public, and analysis of the balance between the supply of and demand for surgeons. It is necessary to correct the gap between the tentative plan proposed by the Association of Social Insurance Committees of Societies for Surgery (Gaihoren) and payment for surgical treatment and to establish a system to evaluate specialist surgeries fairly to provide greater incentive for surgeons to become board certified.