Background and Objectives To combat the increasing prevalence of liver disease in the UK, there is a need to expand the Hepatology workforce.¹ Previous national trainee survey of Hepatology training in the UK was conducted in 2010 and reported suboptimal Hepatology training.² This survey aims to evaluate current Hepatology training provision and trainee attitudes towards future careers in Hepatology.

Method An electronic survey was designed by the British Association of the Study of the Liver (BASL) Trainees’ committee and distributed to higher specialty gastroenterology trainees in the UK between March to May 2022 through mailing lists of BASL, British Society of Gastroenterology (BSG), Gastroenterology Trainee Programme directors and social media platforms.

Results 138 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 jobs in Level 2 or 3 liver centres were almost three-fold higher compared to level 1 centres (60.9% vs 22.6%). All trainees irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. In senior trainees (grade ST6 and higher), those without Hepatology ATP experience reported significantly lower confidence in managing viral hepatitis, HCC and post-transplant patients compared to senior trainees with Hepatology ATP experience. For junior trainees (IMT3 – ST5), remaining in their current deanery was the most important factor when considering future Hepatology ATP application.

Conclusions Overall, the majority of trainees in the UK were satisfied with their current level of Hepatology training. There is a need to deliver widely available training/teaching on the management of patients with; viral hepatitis, hepatocellular carcinoma and post-liver transplant. More than half of the trainees wished to pursue a career in Hepatology but most wished to work in level 2/3 liver centres rather than level 1 centres. Innovative job planning strategies are required to address this imbalance. Expansion of Hepatology ATP networks with wider geographical coverage are needed to address the growing need for more Hepatologists around the UK.

References

1. Williams R, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet 2014;384:1953–1997.

2. Patanwala I, Hudson M. Hepatology training in the UK. Frontline Gastroenterol. 2012;3:52–56.