Follow-up of participants in the Canadian Association of Gastroenterology Scholars’ Program, 2006 to 2012

This brief article provides an updated review of a program founded in 2001, held in conjunction with the annual Canadian Digestive Diseases Week conference, to encourage trainees to pursue a subspecialty career in gastroenterology in support of the Canadian Association of Gastroenterology’s strategic plan of attracting the best and brightest to gastroenterology.

Abstract

The Canadian Association of Gastroenterology (CAG) Scholars’ Program (previously known as the Bright Lights Course) is designed to encourage trainees to consider a subspecialty career in gastroenterology. A formal analysis of the Scholars’ Program performed in 2007 revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. The positive results are consistent with the CAG’s strategic plan of developing “the next generation of gastroenterology clinical practitioners, researchers, educators, and leaders” and to “attract, train, and retain the best and the brightest to gastroenterology”. The present study was a follow-up analysis of participants in the Scholars’ Program between 2006 and 2012. Although 93.1% of participants had an interest in gastroenterology before attending the Scholars’ Program, the majority (68.7%) reported a greater interest in gastroenterology after the program. Similar to the study from 2007, the present study again illustrates the importance and success of the Scholars’ Program in generating interest and retaining candidates in gastroenterology.

The Canadian Association of Gastroenterology (CAG) Scholars’ Program was founded in 2001, when it was previously known as the Bright Lights Course. The purpose of the program is to encourage trainees to consider a subspecialty career in gastroenterology. Its target audience includes senior medical students, and first- and second-year internal medicine and pediatric residents. Candidates are nominated by medical schools across Canada and, typically, one to three candidates from each school are selected to participate.

This two-day program is held annually in conjunction with the Canadian Digestive Diseases Week conference. Participants are given an opportunity to interact with world leaders in academic and clinical gastroenterology. The program addresses recent research advances, medical education, career development and ethics challenges. The curriculum is interactive in nature. This is achieved through small group activities, presentations as well as hands-on learning with Fibroscan (Echosens, France) and endoscopy simulators.

Gastroenterology manpower is a concern in Canada. A recent analysis revealed that while the United States has, on average, 3.9 gastroenterologists per 100,000 population, Canada has only 1.83 per 100,000. A comparison of five countries (United States, France, Australia, Canada and United Kingdom) showed that Canada had the fourth-lowest ratio of gastroenterologists per population (1).

A formal analysis of the Scholars’ Program was performed in 2007 (2). The results revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. Of the candidates who were undecided on a subspecialty before the program, 39% pursued gastroenterology after the Scholars’ Program. Thus, the program appeared to support the CAG strategic plan of attracting the best and brightest to gastroenterology (3).

The present study was a follow-up analysis of the Scholars’ Program between 2006 and 2012.

METHODS

A survey consisting of questions specifically addressing participants’ interest in gastroenterology before and after the Scholars’ Program and current career status was distributed through an Internet-based survey (Survey Monkey [4]). The survey was scored on a five-point Likert scale (1 = strongly disagree; 2 = disagree; 3 = neutral; 4 = agree; and 5 = strongly agree); a score of 4 or 5 was considered to be a positive response. All participants in the course between 2006 and 2012, inclusive, were sent an electronic survey by e-mail. Participants were given two months to complete the survey with a reminder at one month and six weeks. Because of suboptimal response (response rate of 46.6%), the survey was redistributed eight months later to nonresponders only. Participants were given one month to complete the survey with a reminder at two weeks and three weeks. Results were analyzed using a spreadsheet program (Excel, Microsoft Corporation, USA).

RESULTS

Of 221 Scholars’ Program participants, 131 responded to the survey, yielding a response rate of 59.3%. The average age of surveyed participants was 31.4 years and 52.9% were male (P=0.6) (Table 1). The survey participants were evenly distributed among each of the program years from 2006 to 2012 (P=0.3). Most were postgraduate year 2 internal medicine residents at the time of program participation (51.1%) (Figure 1). The majority of participants were from the University of Alberta (Edmonton, Alberta), University of Toronto (Toronto, Ontario) and Dalhousie University (Halifax, Nova Scotia) (Figure 2).

TABLE 1.

Demographics

Characteristics (n=103)	n (%)
Sex
Male	70 (53.4)
Female	61 (46.6)
Age, years, mean ± SD	31.4±3.9
Current status
Gastroenterology	68 (51.9)
Gastroenterologist	26 (19.8)
Gastroenterology fellow	42 (32.1)
Internal medicine/pediatric resident	33 (25.2)

Figure 1).

Level of training at the time of the Scholars’ Program. PGY Postgraduate year

Figure 2).

Distribution of participants according to the medical school granting the medical degree

Before the Scholar’s Program, 93.1% of participants had an interest in gastroenterology (Figure 3). On completion of the program, 68.7% of participants had a greater interest in gastroenterology (Figure 4); 65.6% participants found the program important to their decision-making process for a subspecialty career. More than one-half (53.4%) of respondents found that the program was valuable for their curriculum vitae and their success with the Canadian Resident Matching Service, and 87.0% of participants would recommend the Scholars’ Program to their junior colleagues.

Figure 3).

Percent of response to ‘I had an interest in gastroenterology before the Scholars’ Program’ (1 = strongly disagree; 5 = strongly agree)

Figure 4).

Percent of response to “I had more interest in gastroenterology after the Scholars’ Program” (1 = strongly disagree; 5 = strongly agree)

Currently, 51.9% of the program participants are practising gastroenterology or are in a gastroenterology fellowship program.

DISCUSSION

The Scholars’ Program has been providing quality education for students and residents interested in gastroenterology for >10 years. The present report is an updated review of the program over a six-year period (2006 to 2012).

There was a fair response rate (59.3%) to the survey. The survey was distributed twice because the initial response rate was low. The reason for this low response rate may be due to the busy schedules of students, residents and physicians, and the frequent need to relocate during medical training. Similar to the 2007 study, most participants were residents, with equal distribution between males and females. A trend toward more graduates of the Scholar’s Program intent on pursuing a career in gastroenterology compared with our previous study was observed, although differences in methodology precludes direct comparison between the two studies (2).

It is interesting that most participants completed their undergraduate medical degree from the University of Alberta, University of Toronto and Dalhousie University. Although our data were not adjusted for medical school size, because this is a constantly changing variable, it is noteworthy that Dalhousie has one of the smallest programs in the country yet is one of the greatest contributor to the Scholars’ Program. This may reflect career interest developed during the gastroenterology block in medical school training programs.

A limitation to the present survey-based study was recall bias; future directions would be a prospective study to survey the participants before and after the Scholars’ Program.

Similar to our study from 2007, the present study again illustrates the importance and success of the Scholars’ Program in generating interest and retaining candidates in gastroenterology.

CONCLUSION

The Scholars’ Program is a valuable Canadian program that is ensuring the persistent growth in the next generation of gastroenterologists.