Table 1.
Outline of the electronically distributed questionnaire evaluating five major aspects of preparedness to enter a hepatopancreatobiliary (HPB) surgery fellowship
| Category | Questions | Answer choices |
|---|---|---|
| Fellow's prior training background | Setting prior to HPB fellowship | Residency, fellowship, or practice |
| Type of residency programme | University, community, hybrid, other | |
| Number of major cases performed during residency | <800, 800–999, 1000–1200, >1200a | |
| Pre-fellowship HPB experience: number of pancreatic, hepatic and biliary (excluding cholecystectomy) cases | <5, 5–10, >10a | |
| Degree of independence in performing general surgery procedures at the completion of residency training | Need for supervision in various basic and advanced open and laparoscopic procedures | No supervision, minimal supervision, full supervision |
| Challenges associated with entering independent practice after surgical residency | Reasons for lack of comfort in performing procedures independently | Work hour restriction, lack of autonomy, lack of time to prepare, lack of case volume (all during residency) |
| Areas of more concern and lack of comfort | Preoperative workup, performing procedures, complications, postoperative management | |
| Clinical and technical preparedness for HPB fellowship (during the first 3 months of fellowship) | Preparedness for handling: benign disease in pancreas; malignant disease in pancreas; hepatic disease; benign biliary disease, and malignant biliary disease | Poor, fair, adequate, excellent |
| Level of comfort in performing procedures with faculty supervision: open pancreas; MIS in pancreas; open liver surgery; MIS in liver, and biliary surgery | Comfortable with both anatomy and steps, comfortable with anatomy but not steps, comfortable with steps but not anatomy, uncomfortable with anatomy and steps | |
| Overall preparedness for HPB fellowship | Poor, fair, adequate, excellent | |
| Potential adjustments during residency to improve preparedness for HPB fellowship | Adjustments to improve preparedness for independent practice after residency | Operative autonomy, studying and didactic time, total training time, use of simulation |
| Surgical rotations that might prepare general surgery residents for HPB training | Vascular, transplant, bariatric, MIS, colorectal, general surgery |
a
Answer choices are based on the American Board of Surgery requirements for required experience for graduating residents.
MIS, minimally invasive surgery.