Young GI Societies in Europe: 2019 update

Abstract

Background

One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive to young fellows interested in gastroenterology (GI), and to actively involve them in UEG activities and the activities of their respective national societies. In 2017, we conducted a survey among the Friends of the UEG YTG with the aim of identifying the state of organization and needs of Young GI Sections (YGISs) throughout Europe, highlighting areas for further development and improvement.

Aims

The aim of the current web-based survey was to assess the progress of YGISs over 1 year, and persisting hurdles in forming and running a YGIS.

Results

Overall, 38 of 42 Friends answered the survey (91%). The number of YGISs has increased significantly from 12 in 2017 to 25 in 2019. Young gastroenterologists remained supported, but not influenced, by national societies. Results of the survey suggest that a lack of dedicated and motivated fellows has replaced a lack of funding as the most prevalent hurdle in forming these types of sections.

Conclusion

Our survey shows that the development of YGISs has improved markedly within the last 2 years. However, several limitations, like underrepresentation in subcommittees of national societies, remain and need to be addressed in order to involve young gastroenterologists in their respective national societies and within UEG, to pave the way for future research, education and excellent quality of care, and reduce health inequalities across Europe.

Background

United European Gastroenterology (UEG) actively promotes the education of and interaction between young specialists working throughout Europe in the management of gastrointestinal diseases. Thus, in 2013, the UEG Young Talent Group (YTG) was founded as a working group with the specific aim of promoting educational activities for young European clinicians and basic scientists, including their active participation during UEG week. It is composed of seven members and a Chair, who serves as a cross-representative in all UEG committees, taskforces and the Council of UEG.

The YTG exchanges information with their target group via a network of young ambassadors called the ‘Friends of the YTG’ (FYTG), the young national representative in each national society that is a member of UEG. In 2017, we conducted a survey among the FYTG with the aim of identifying the state of organization and needs of young gastroenterology (GI) sections throughout Europe.¹ We found that only one-half of the participant countries had an established young section in their national society at the time of the survey. Furthermore, many important limitations were reported including a lack of resources, absence of interest and limited support from their national societies.

With the current paper, the YTG gives an update on the current situation of the Young GI Sections (YGISs) and of changes within the last 3 years by reporting on the results of a follow-up survey. Our main objective was to describe the current situation of YGISs in Europe, their current relationship with their national societies, and address any putative limitations that remain and needs for the future. These results may help us to develop further specific activities to support young clinicians and researchers during the early years of their professional careers.

Methods

Target population

The FYTG are young (< 40 years) gastroenterologists and digestive health specialists, most of them still in training, who act as ambassadors of the YTG across UEG national societies. ‘Friends’ are appointed by the respective national society. Each national FYTG gives feedback about UEG activities and informs UEG about activities promoted by their national society. They provide information about the needs of the trainees and young gastroenterologists in their countries, and also help to disseminate information about UEG’s Young GI Network initiatives in their own country. To date, UEG comprises 48 national societies, 42 of which have appointed an FYTG delegate. Four countries have two national societies (Belgium, Italy, Spain and The Netherlands), and in this case there is one FYTG appointed by each Society.

Questionnaire structure

A standard questionnaire containing 16 questions examining the current status of YGISs across Europe was developed using a web-based survey and data-collection tool (SurveyMonkey®, San Mateo, California, USA). The following areas of interest were explored: (a) the presence of national YGISs in Europe, (b) the structure of YGISs, (c) Representation of YGISs in national societies and (d) hurdles faced in setting up or running a YGIS.

Data were collected in the form of single- or compound-answer multiple-choice questions for nominal data, and open-ended text boxes for descriptive exploration. The complete questionnaire is available as a supplementary file (Supplementary file 1).

Questionnaire distribution

The questionnaire was distributed via email between May and August 2019 to all FYTG. No incentive was utilized to increase the response rate. Participants who did not answer by the deadline were contacted repetitively in order to achieve the highest possible response rate. Data were collected and held within the requirements of the Data Protection Act. The study did not use clinical data, and did not require or seek specific ethical approval.

Statistical analysis

Analysis was performed using Microsoft Excel (Microsoft®, Redmond, WA, USA). Means and percentages were calculated for data originating from multiple-choice questions. Data obtained were compared to the previously published survey¹ in order to highlight changes over time. Answers from open questions were gathered and, when possible, synthesized.

Results

Questionnaire responses

In total, 42 individuals responded to the survey. Four duplicate responses from individuals within the same country and national society were received. In each of these cases, the second response was discarded. Out of 42 FYTG members from 36 countries, 38 valid responses from 34 European countries were received, as some members have more than one national society (90.5% response rate). FYTG representatives from four national societies did not respond.

Geographic distribution

At the time of our previous survey in 2017, UEG had 47 national societies, 29 of which had appointed an FYTG. In 2019, UEG had 48 national societies, 45 of which had appointed an FYTG. This represents an important increase in the representation of young gastroenterologists via their national societies (29 vs. 45 YGIS).

Demographic data

The mean age of the FYTG respondents was 34 ± 4 years with a markedly altered gender distribution in comparison to 2017 (55% male and 45% female in 2019 vs. 75% male and 25% female in 2017).

Presence of YGISs in Europe

In 2017, 12 of UEG’s 47 national societies (25%) had a YGIS¹ (Figure 1(a)). In 2019, 25 of UEG’s 48 national societies (50%) had established a YGIS. Eleven of these sections were newly built up between 2017 and 2019, markedly increasing the representation of young Eastern European gastroenterologists within UEG. The growing diversity of UEG and the YGISs is shown in Figure 1(b).

Figure 1.

Presence of Young Gastroenterology Sections in Europe.

In 2017, only 25% of national societies had a Young GI Section (a). Meanwhile, in 2019, 50% of all national societies within UEG had supported the formation of a Young GI Section, with a notable increase in Eastern European countries (b). After the survey, closed Ireland and Egypt each formed a Young GI Section.

GI: gastroenterology; UEG: United European Gastroenterology.

Structures of YGISs

Admission to a YGIS was regulated in a variety of ways. To be a part of a YGIS and benefit from its advantages, the sections usually chose to only include trainees (10/24; 42%), while 29% (7/24) chose to base admission on age with the maximum cut-off being reported as 40 years. The other seven YGISs (29%) had either no limitations regarding training or age, or extended membership to up to 3 years after completion of training in GI.

The criteria for the selection of board members of YGISs across Europe are summarized in Table 1. Appointments of YGIS members to the boards of national societies are less driven by respective national societies and more by YGIS members, when data are compared to practice in 2017. More YGIS board representatives are directly elected at YGIS meetings (3/12 (25%) vs. 9/29 (32%)).The gender balance of the YGIS governing boards has improved when comparing 2017 and 2019, with gender balance increasingly being taken into account in 2019 (40% in 2017 vs. 63% in 2019) (Table 2). Regional representation in the YGIS governing boards was taken into account by 67% of YGISs in 2019.

Table 1.

Appointment of Young Gastroenterology Section board members.

	2017	2019
Open call by YGIS	42%	42%
Direct election at YGIS meeting or national society meeting	25%	32%
By national society	17%	10%
By trainee delegates of gastroenterology training schools	8%	0%
No governing board exists	17%	17%

YGIS: Young Gastroenterology Section.

Table 2.

Gender balance and regional composition of Young Gastroenterology Sections.

	2017	2019
Gender balance considered for YGIS board appointments	40%	63%
Regional balance considered in YGIS board appointments	80%	63%

YGIS: Young Gastroenterology Section.

Representation of YGIS in National Societies

Approximately two-thirds of YGISs (14/24; 67%) reported representation in the board of their national societies in 2019. This is an increase compared to only 33% of YGISs being represented in national boards in 2017. However, representation in national society subcommittees (i.e. education or scientific committees) remained at a low level with only 33% (8/24) of YGISs represented in these bodies. This was also reflected in the low involvement (7/24; 29%) of YGIS members in educational issues and the development of curriculum items. Organization of educational events like symposia, and hands-on training for fellows and trainees were the most reported activities in the group surveyed (5/7; 70%).

The national societies surveyed provided different types of financial support for young trainees (independently or in coordination with the YGISs, when present) including: reduced fees for subscriptions and participation in national congresses (29/38; 76%), free educational events (21/28; 55%), travel grants for international meetings (16/38; 42%), travel grants for national meetings (16/38; 42%), visiting fellowships (4/38; 10%) and awards for young trainees (20/38; 50%). According to the FYTG, only two national societies (5%) did not support young trainees financially and 95% of national societies offered more than one form of support for young trainees.

Hurdles faced in setting up or running a YGIS

The FYTG were surveyed regarding the most important challenge faced when forming a YGIS. The results are summarized in Figure 2. Of the 13 FYTG with no YGIS, 8 countries were planning to form or in the process of forming a YGIS. The main reason given by the majority of the remaining 6 FYTG without a YGIS why they had not formed a section was a lack of funding and resources.

Figure 2.

The most important hurdle young gastroenterologists were faced with when forming a Young Gastroenterology Section was a lack of proactive and motivated trainees, followed by a lack of funding.

YGIS: Young Gastroenterology Section.

Discussion

The UEG National Societies Committee and YTG are committed to increasing representation of young GI specialists across Europe, within their national societies and within UEG, by promoting the formation of YGISs. The presence of these sections in national societies potentially gives young gastroenterologists more influence in training, education and professional opportunities. While the previous survey performed in 2017 focused on the prevalence, structure and organization of YGISs throughout UEG national society member countries, the latest web-based survey evaluated not only the current status, but also progress of and changes, in YGISs across Europe over a 2-year period.

The most relevant finding of the reported survey is the strong increase in YGISs across Europe, especially Eastern Europe, in a relatively short time frame. This number is likely to increase even further in the coming years since a large proportion of national societies without a YGIS are planning to start their own section. Since the end of the survey, Egypt and Ireland have reported that YGISs have been newly formed in their national societies (personal communication). Within the FYTG respondents and YGISs, the male to female ratio changed remarkably in comparison to 2017, with greater gender balance when compared to 2019. Furthermore, representation of YGISs within national societies remained stable and YGISs had taken increasing control of selection processes for YGIS boards; however, although more YGISs are represented in boards of national societies, involvement of YGISs in national society subcommittees and the development of educational activities has remained fairly stable throughout Europe.

In countries with no YGIS, a lack of motivated and proactive young fellows replaced a lack of resources and capabilities as the most important factor resulting in a YGIS not being formed. Lack of interest by the reference national society, and sometimes even outright opposition by them, were still described as a driving force, but to a lesser extent than in the previous survey.

While this survey shows significant change across Europe, with more YGIS being formed and actively being included and supported by their national societies, several areas for improvement and future studies remain. Although more YGISs are represented in the national societies boards, it is unclear how representatives are involved in decision-making. The fact that young gastroenterologists remain underrepresented in subcommittees of national societies is a concern as this limits the impact of trainees. A clear aim should be to include young gastroenterologists not only in the governing boards of national societies but also in subcommittees. This has been practiced successfully by UEG with cross-representatives in all UEG subcommittees and task forces, with the positive result that more young colleagues are being selected as speakers and chairs during scientific and educational meetings, and involved in other projects within UEG.²

An important hurdle to be considered in the near future is the lack of motivated fellows to contribute to the formation of YGISs. It remains to be explored in further studies if potential cuts in funding,³ the structure of training or other reasons prevent young gastroenterologists from getting involved.

In summary, YGISs have increased in number, yet need to be supported further if they are to achieve more say and greater support in their respective national societies. This could lead to a increased motivation and satisfaction rates of young members of the national societies, and subsequently to a strengthening of the YGISs within Europe. Including future specialists in national societies at an early stage might train them to become the future volunteers for national societies, and give them important leadership and management skills. The YTG will continue to for working and promote active collaboration between national societies, UEG and the YTG in order to improve representation, training and education across Europe.

Declaration of conflicting interests

There are no conflicts of interest.

Funding

Not applicable.