AHPBA graduated fellows’ assessments of strengths, weaknesses, opportunities and threats facing fellowship training in HPB surgery: “HPB training excellence means volume, knowledge, and mentorship”

Published:September 30, 2022DOI:



      Many fellowship programs in North America prepare surgeons for a career in Hepato-Pancreato-Biliary (HPB) surgery. Recent fellowship graduates were surveyed as part of a strengths, weaknesses, opportunities, and threats (SWOT) analysis commissioned by Americas Hepato-Pancreato-Biliary Association (AHPBA).


      This was a cross-sectional study surveying AHPBA-certified fellowship graduates conducted August–December 2021. Survey data were analyzed using descriptive statistics. Free-text answers were analyzed using both grounded theory principles and thematic network analyses.


      Four main themes were identified: (i) concerns regarding the lack of standardization between HPB fellowship curricula (ii) concern for job market oversaturation, (iii) need to emphasize the value in HPB fellowship training and (iv) importance of diversity, inclusion, and equity in HPB training.


      Based on themes identified, the strengths of AHPBA-certified HPB programs include superior case volume and technical training. Areas of weakness and growth opportunities include standardizing training experiences. According to AHPBA-certificate awardees, optimizing future HPB fellowships would include strong sponsorship for job placement after graduation, and more intentional investments in diversity, equity, and inclusion.
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        • Jeyarajah D.R.
        • Abouljoud M.
        • Alseidi A.
        • Berman R.
        • D'Angelica M.
        • Hagopian E.
        • et al.
        Training paradigms in hepato-pancreatico-biliary surgery: an overview of the different fellowship pathways.
        J Gastrointest Surg. 2021 Aug; 25: 2119-2128
        • Warner S.G.
        • Alseidi A.A.
        • Hong J.
        • Pawlik T.M.
        • Minter R.M.
        What to expect when you’re expecting a hepatopancreatobiliary surgeon: self-reported experiences of HPB surgeons from different training pathways.
        HPB. 2015 Sep; 17: 785-790
        • Chapman A.
        • Hadfield M.
        • Chapman C.
        Qualitative research in healthcare: an introduction to grounded theory using thematic analysis.
        J Roy Coll Phys Edinb. 2015 Sep; 45: 201-205
        • Berthelsen C.
        • Grimshaw-Aagaard S.
        • Hansen C.
        Developing a guideline for reporting and evaluating grounded theory research studies (GUREGT).
        Int J Health Sci. 2018 Mar; 6: 64-76
        • Kogon B.
        • Karamlou T.
        • Baumgartner W.
        • Merrill W.
        • Backer C.
        Congenital cardiac surgery fellowship training: a status update.
        J Thorac Cardiovasc Surg. 2016 Jun; 151: 1488-1495
        • Jackson T.
        • Lim J.S.
        • Cho E.
        • Osman H.
        • Nagatomo K.
        • Jeyarajah D.R.
        Hepatopancreatobiliary fellowship graduates: where do they stand today?.
        Am Surg. 2022 Jun; 88: 1250-1255
        • Merrill A.
        • Beal E.W.
        • Ackah R.
        • Patterson K.
        • Horning P.
        • Ejaz A.
        • et al.
        Women in hepatopancreaticobiliary surgery: is there a pipeline problem?.
        HPB. 2021 Jun; 23: 817-820