UK national trainee survey of hepatology training, research and the future workforce

Abstract

ObjectiveThe increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and trainee attitudes towards future careers in hepatology.MethodAn electronic survey was distributed to higher specialty gastroenterology and hepatology trainees in the UK between March and May 2022.Results138 trainees completed the survey covering all training grades and regions of the UK. 73.7% reported receiving adequate hepatology training currently, with 55.6% intending to become future hepatologists. Trainee preference for future hepatology consultant posts in specialist liver centres were almost threefold higher compared with district general hospitals (60.9% vs 22.6%). All trainees, irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. Senior trainees (grade ST6 and higher), without advanced training programme (ATP) experience reported significantly lower confidence in managing viral hepatitis, hepatocellular carcinoma and post-transplant patients compared with equivalent trainees with ATP experience. For junior trainees (IMT3–ST5), remaining in their current deanery was the most important factor when considering future hepatology training application.ConclusionsThere is a significant need to deliver widely available training on the management of complex liver disease to improve non-ATP trainee confidence. Innovative job planning strategies are required to encourage trainees to pursue careers outside of specialist liver centres. Expansion of hepatology training networks with wider geographical coverage are needed to address the growing need for more hepatologists around the UK.

Regional variations in inpatient decompensated cirrhosis mortality may be associated with access to specialist care: results from a multicentre retrospective study

“…Finally, increasing Consultant Gastroenterologist/Hepatologist numbers at non-specialist centres remains a challenge. Nearly half of UK Consultant Gastroenterologist/Hepatologist advertised posts remained unfilled in 2020, and a recent survey demonstrated that less than one-third of Hepatology trainees would want to be a Consultant in a non-specialist centre 24 25. Innovative job planning, including roles split across specialist and non-specialist centres particularly in areas of deprivation, may address this.…”