Fellows perspective of HPB training in Latin America.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
01 2020
Historique:
received: 13 03 2019
revised: 25 04 2019
accepted: 20 05 2019
pubmed: 7 7 2019
medline: 9 7 2021
entrez: 7 7 2019
Statut: ppublish

Résumé

Currently, no standards for HPB training exist in Latin America. The aim of this work is to evaluate fellows' experience of HPB training and the areas of opportunity to improve. A 35 points survey was developed and distributed among fellows from dedicated HPB training programs in Latin America. The survey was applied by direct phone call (37%) or web based (63%), to fellows graduated between 2010 and 2014, from 7 different programs. Thirty-nine fellows from Argentina, Brazil, Chile and México were considered with a response rate of 82% (32/39). Most fellows (90%) shared cases with more than one co-fellow. Scrubbing with chief residents ocurred to 60% of fellows; only 14% of fellows noted having a primary surgeon role in more than 70% of cases. Median number of major hepatectomies during training was 15 (1-100), Whipple procedures 6 (1-40), and major bile duct repair 20 (1-80). Limited funding was the main reason to avoid HPB programs outside the country of origin. HPB training in Latin America requires more operative volume and autonomy. Financial burden is the main limitation to pursue training overseas. A multinational fellowship that takes advantage of each center may overcome differences in volume and type of cases.

Sections du résumé

BACKGROUND
Currently, no standards for HPB training exist in Latin America. The aim of this work is to evaluate fellows' experience of HPB training and the areas of opportunity to improve.
METHODS
A 35 points survey was developed and distributed among fellows from dedicated HPB training programs in Latin America. The survey was applied by direct phone call (37%) or web based (63%), to fellows graduated between 2010 and 2014, from 7 different programs.
RESULTS
Thirty-nine fellows from Argentina, Brazil, Chile and México were considered with a response rate of 82% (32/39). Most fellows (90%) shared cases with more than one co-fellow. Scrubbing with chief residents ocurred to 60% of fellows; only 14% of fellows noted having a primary surgeon role in more than 70% of cases. Median number of major hepatectomies during training was 15 (1-100), Whipple procedures 6 (1-40), and major bile duct repair 20 (1-80). Limited funding was the main reason to avoid HPB programs outside the country of origin.
CONCLUSION
HPB training in Latin America requires more operative volume and autonomy. Financial burden is the main limitation to pursue training overseas. A multinational fellowship that takes advantage of each center may overcome differences in volume and type of cases.

Identifiants

pubmed: 31277838
pii: S1365-182X(19)30566-0
doi: 10.1016/j.hpb.2019.05.016
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

124-128

Informations de copyright

Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Auteurs

Ismael Domínguez-Rosado (I)

Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14000 Ciudad de México, Mexico.

Johana L Espinoza (JL)

Department of Surgery, Hospital Italiano de Buenos Aires, Presidente Juan Domingo Perón 4190, Buenos Aires, Argentina.

Fernando A Alvarez (FA)

Department of Surgery, Hospital Italiano de Buenos Aires, Presidente Juan Domingo Perón 4190, Buenos Aires, Argentina.

Agustin Vintimilla (A)

Department of Gastroenterology, Sao Paulo University School of Medicine, Hospital das Clinicas, Ave Doutor Eneas Carvalho Aguiar 255, Brazil.

Marco Quintero (M)

Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14000 Ciudad de México, Mexico.

David Barzallo (D)

Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14000 Ciudad de México, Mexico.

Juan Pekolj (J)

Department of Surgery, Hospital Italiano de Buenos Aires, Presidente Juan Domingo Perón 4190, Buenos Aires, Argentina.

Gabriel Gondolesi (G)

Department of Surgery, Fundación Favaloro, Av Belgrano 1746, Buenos Aires, Argentina.

Pablo B Schelotto (PB)

Department of Surgery, Fundación Favaloro, Av Belgrano 1746, Buenos Aires, Argentina.

Paulo Herman (P)

Department of Gastroenterology, Sao Paulo University School of Medicine, Hospital das Clinicas, Ave Doutor Eneas Carvalho Aguiar 255, Brazil.

Luiz A Carneiro D'Albuquerque (LA)

Department of Gastroenterology, Sao Paulo University School of Medicine, Hospital das Clinicas, Ave Doutor Eneas Carvalho Aguiar 255, Brazil.

Wellington Andraus (W)

Department of Gastroenterology, Sao Paulo University School of Medicine, Hospital das Clinicas, Ave Doutor Eneas Carvalho Aguiar 255, Brazil.

Jorge Padilla (J)

Department of Surgery, BP-Hospital Beneficencia Portuguesa de Sao Paulo, Rua Maestro Cardim 769, Sao Paulo, Brazil.

Nicolas Jarufe (N)

Department of Surgery, Pontificia Universidad Católica de Chile, Libertador Bernardo O'Higgins 340, Santiago, Chile.

Oscar Chapa (O)

Department of Surgery, Hospital General de México, Dr. Balmis 148 Doctores, 06720 Ciudad de México, Mexico.

Miguel Mercado (M)

Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14000 Ciudad de México, Mexico.

Carlos Chan (C)

Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Vasco de Quiroga 15, Tlalpan, 14000 Ciudad de México, Mexico.

Adnan Alseidi (A)

Department of Surgery, Virginia Mason Hospital, 1100 9th Avenue, Seattle, WA 98101, USA. Electronic address: AdnanAlseidi@virginiamason.org.

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Classifications MeSH