Seshadri Ramanathan M, Ali Noaman, Warner Susanne, Cochran Allyson, Vrochides Dionisios, Iannitti David, Jeyarajah D Rohan
Carolinas Medical Center, Charlotte, NC, USA.
Akron General Medical Center, Akron, OH, USA.
HPB (Oxford). 2015 Dec;17(12):1096-104. doi: 10.1111/hpb.12498. Epub 2015 Sep 10.
Hepato-pancreato-biliary (HPB) surgery is a complex subspecialty drawing from varied training pools, and the need for competency is rapidly growing. However, no board certification process or standardized training metrics in HPB surgery exist in the Americas. This study aims to assess the attitudes of current trainees and HPB surgeons regarding the state of training, surgical practice and the HPB surgical job market in the Americas.
A 20-question survey was distributed to members of Americas Hepato-Pancreato-Biliary Association (AHPBA) with a valid e-mail address who attended the 2014 AHPBA. Descriptive statistics were generated for both the aggregate survey responses and by training category.
There were 176 responses with evenly distributed training tracks; surgical oncology (44, 28%), transplant (39, 24.8%) and HPB (38, 24.2%). The remaining tracks were HPB/Complex gastrointestinal (GI) and HPB/minimally invasive surgery (MIS) (29, 16% and 7, 4%). 51.2% of respondents thought a dedicated HPB surgery fellowship would be the best way to train HPB surgeons, and 68.1% felt the optimal training period would be a 2-year clinical fellowship with research opportunities. This corresponded to the 67.5% of the practicing HPB surgeons who said they would prefer to attend an HPB fellowship for 2 years as well. Overall, most respondents indicated their ideal job description was clinical practice with the ability to engage in clinical and/or outcomes research (52.3%).
This survey has demonstrated that HPB surgery has many training routes and practice patterns in the Americas. It highlights the need for specialized HPB surgical training and career education. This survey shows that there are many ways to train in HPB. A 2-year HPB fellowship was felt to be the best way to train to prepare for a clinically active HPB practice with clinical and outcomes research focus.
肝胰胆（HPB）外科是一个复杂的亚专业，其培训来源多样，对能力的需求也在迅速增长。然而，在美洲地区，尚无HPB外科的委员会认证程序或标准化培训指标。本研究旨在评估当前学员和HPB外科医生对美洲地区培训状况、外科实践及HPB外科就业市场的态度。
向参加2014年美洲肝胰胆协会（AHPBA）且有有效电子邮件地址的成员发放了一份包含20个问题的调查问卷。对汇总的调查回复以及按培训类别进行了描述性统计。
共收到176份回复，培训方向分布均匀；外科肿瘤学（44份，28%）、移植（39份，24.8%）和HPB（38份，24.2%）。其余方向为HPB/复杂胃肠道（GI）和HPB/微创手术（MIS）（分别为29份，16%和7份，4%）。51.2%的受访者认为专门的HPB外科进修是培训HPB外科医生的最佳方式，68.1%的人认为最佳培训期为为期2年的临床进修并提供研究机会。这与67.5%的在职HPB外科医生表示他们也更愿意参加为期2年的HPB进修相呼应。总体而言，大多数受访者表示他们理想的工作描述是能够从事临床和/或结果研究的临床实践（52.3%）。
本次调查表明，在美洲地区，HPB外科有多种培训途径和实践模式。它凸显了对专门的HPB外科培训和职业教育的需求。本次调查显示，HPB培训有多种方式。人们认为为期2年的HPB进修是为专注于临床和结果研究的活跃临床HPB实践做准备的最佳培训方式。
