Li Wenhao, Abbas Nadir, Brennan Paul N, Mcdowell Hannah, Navaratnam Janardhan, Phoolchund Anju, Scott Robert, Shearer Jessica, White Helen, Tavabie Oliver D
Barts Liver Centre, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK.
Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
Frontline Gastroenterol. 2023 Jan 6;14(4):326-333. doi: 10.1136/flgastro-2022-102307. eCollection 2023.
The increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and trainee attitudes towards future careers in hepatology.
An electronic survey was distributed to higher specialty gastroenterology and hepatology trainees in the UK between March and May 2022.
138 trainees completed the survey covering all training grades and regions of the UK. 73.7% reported receiving adequate hepatology training currently, with 55.6% intending to become future hepatologists. Trainee preference for future hepatology consultant posts in specialist liver centres were almost threefold higher compared with district general hospitals (60.9% vs 22.6%). All trainees, irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. Senior trainees (grade ST6 and higher), without advanced training programme (ATP) experience reported significantly lower confidence in managing viral hepatitis, hepatocellular carcinoma and post-transplant patients compared with equivalent trainees with ATP experience. For junior trainees (IMT3-ST5), remaining in their current deanery was the most important factor when considering future hepatology training application.
There is a significant need to deliver widely available training on the management of complex liver disease to improve non-ATP trainee confidence. Innovative job planning strategies are required to encourage trainees to pursue careers outside of specialist liver centres. Expansion of hepatology training networks with wider geographical coverage are needed to address the growing need for more hepatologists around the UK.
英国肝病患病率不断上升，这意味着迫切需要扩充肝病学专业人员队伍。本次调查旨在评估当前肝病学培训情况，以及学员对未来肝病学职业生涯的态度。
2022年3月至5月期间，向英国高等专科胃肠病学和肝病学学员发放了电子调查问卷。
138名学员完成了调查，覆盖了英国所有培训级别和地区。73.7%的学员报告称目前接受了足够的肝病学培训，55.6%的学员打算未来成为肝病学家。与地区综合医院相比，学员对专科肝病中心未来肝病学顾问职位的偏好高出近三倍（60.9%对22.6%）。所有学员，无论培训级别如何，均表示对住院和门诊环境中失代偿期肝硬化的管理有高度信心。与有高级培训计划（ATP）经验的同等学员相比，没有ATP经验的高级学员（ST6级及以上）在管理病毒性肝炎、肝细胞癌和移植后患者方面信心明显较低。对于初级学员（IMT3-ST5），在考虑未来肝病学培训申请时，留在当前的地区是最重要的因素。
迫切需要提供广泛可用的复杂肝病管理培训，以提高非ATP学员的信心。需要创新的职业规划策略，以鼓励学员在专科肝病中心以外追求职业发展。需要扩大地理覆盖范围更广的肝病学培训网络，以满足英国对更多肝病学家日益增长的需求。
