Utilization of and Adherence to the Gastroenterology Core Curriculum on Hepatology Training During a Gastrointestinal Fellowship

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Background & Aims:

The gastroenterology core curriculum (GCC) represents the knowledge/skills desired at the completion of fellowship training. The hepatology subset (H-GCC) is the focus of this research. The aims were to measure adherence of the H-GCC within gastrointestinal training programs, compare the perceptions of the H-GCC compliance by fellows and program directors, and provide comparative information to improve gastrointestinal training programs.


A questionnaire was designed to assess the general and hepatology components of the GCC. Fellows and program directors were invited to participate by means of 3 sequential mailings. Pearson χ2 and Fisher exact tests were used for statistics.


Of 971 potential respondents, the questionnaire was returned by 42% of program directors and 33% of fellows. There was <70% agreement by either fellows or program directors for minimum ≥18 months of clinical training (minimum ≥30% hepatology), and minimum ≥20 paracentesis/liver biopsies. Most prescribed hepatology core topics were covered; however, >10% of fellows claimed deficiency in physiology, pregnancy issues, angiography, immunosuppressant use, and congenital disorders. Fellows in non–liver transplant institutions more often reported lack of training in fulminant disease, transplant patient selection, and diagnosis/management of rejection (P < .001).


(1) Fellow and program director assessments were highly concordant, with most H-GCC criteria being met. (2) Attention is required to provide adequate time for clinical training and prescribed procedures. (3) Improved instruction in several hepatology topics seems warranted. (4) A nonevaluative questionnaire is a practical means to measure compliance. Future studies measuring compliance with other components of the GCC by using this methodology seem feasible.

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