Hepatopancreaticobiliary (HPB) Surgery: What Is the Right Fellowship for the Right Training?

Rassadi, Roozbeh; Dickerman, Richard M.; Dunn, Ernest L.; Tarnasky, Paul R.; Linder, Jeffrey D.; Mejia, Alejandro; Cheng, Stephen S.; Jeyarajah, D. Rohan

doi:10.1016/j.jsurg.2007.11.012

« Previous Next »Journal of Surgical Education
Volume 65, Issue 3 , Pages 186-190, May 2008

Hepatopancreaticobiliary (HPB) Surgery: What Is the Right Fellowship for the Right Training?

Presented at the AHBPA meeting, Las Vegas, April 2007.

Roozbeh Rassadi, MD
- Department of Surgery, Methodist Dallas Medical Center, Dallas, Texas
Richard M. Dickerman, MD
- Department of Surgery, Methodist Dallas Medical Center, Dallas, Texas
Ernest L. Dunn, MD
- Department of Surgery, Methodist Dallas Medical Center, Dallas, Texas
Paul R. Tarnasky, MD
- Department of Gastroenterology, Methodist Dallas Medical Center, Dallas, Texas
Jeffrey D. Linder, MD
- Department of Gastroenterology, Methodist Dallas Medical Center, Dallas, Texas
Alejandro Mejia, MD
- Department of Organ Transplantation, Methodist Dallas Medical Center, Dallas, Texas
Stephen S. Cheng, MD
- Department of Organ Transplantation, Methodist Dallas Medical Center, Dallas, Texas
D. Rohan Jeyarajah, MD
- Department of Surgery, Methodist Dallas Medical Center, Dallas, Texas
- Correspondence: Inquiries to D. Rohan Jeyarajah, MD, 221 West Colorado Blvd., Suite 100, Dallas, TX 75208; fax: (214) 946-8339

published online 21 January 2008.

Background

Reduced resident work hours over the last several years have led to inadequate exposure to hepatopancreaticobiliary (HPB) and complex upper gastrointestinal (UGI) surgical procedures. Therefore, residents are seeking additional training in this field. The purpose of this study is to determine the role of a new fellowship model in the training of general surgery residents in complex HPB/UGI diseases.

Methods

We propose a surgical training model in benign as well as malignant diseases of the UGI tract. The proposed model would focus on an integrated approach that involves allied specialties such as gastroenterology (GI) and radiology.

Results

The fellowship was set as 1-year duration with 1-month rotations on interventional GI and transplantation. The fellow spent the remaining 10 months on a UGI laparoscopic and open surgery service caring for complex benign and malignant disease of the esophagus, stomach, bile duct, pancreas, and liver. Didactic conferences were focused specifically at an organ-based approach to diseases of these organs.

During a 12-month fellowship, exposure to complex diseases of the UGI tract was accomplished without negatively impacting the general surgery residency program.

Conclusion

This new mode of advanced training provides a bridge between surgical oncology and transplantation, and it is an excellent model for postgraduate surgical training in UGI diseases.

Key Words: hepatobiliary training, forgut, post graduate, team

Competency: Patient Care, Practice Based Learning and Improvement, Systems Based Practice