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

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.