A competency-based medical education pilot for training and certification in gastroenterology and transplant hepatology
AASLD LiverLearning®. Reddy S. Nov 14, 2016; 144608
Topic: Health Services Research
Label: Cost-Effectiveness and Economics of Care
Sheela Reddy
Sheela Reddy

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ABSTRACT FINAL ID: 1716

TITLE: A competency-based medical education pilot for training and certification in gastroenterology and transplant hepatology

SPONSORSHIP - THIS STUDY WAS SPONSORED BY: (IF THIS ABSTRACT WAS NOT SPONSORED PLEASE INDICATE):
This abstract was not sponsored

ABSTRACT BODY:
BACKGROUND: The American Board of Internal Medicine (ABIM) and the AASLD began an innovative pilot program in 2012 that utilizes competency-based medical education concepts for training in both gastroenterology (GI) and transplant hepatology (TH) in 3 years as opposed to the traditional 4-year pathway. Pilot fellows who achieve competence in GI and TH are eligible to take ABIM certification exams in both specialties.

METHODS: An AASLD Taskforce establishes eligibility requirements and is responsible for approving programs and fellows for pilot participation. The Taskforce surveys pilot fellows annually and tracks outcomes, including satisfaction, readiness for independent GI and TH practice, certification exam pass rates, and commitment to a career in hepatology.

RESULTS: To date, 31 fellows and 26 programs have participated in the pilot program. Overall response rate to annual surveys was 93%. One fellow did not complete the pilot program but completed standard GI training and passed the GI certification exam. 97% of fellows who completed the pilot were satisfied with the program. All but one felt prepared for the independent practice of GI at the end of the pilot year, and all felt prepared for the independent practice of TH at the end of the pilot. 62% would have pursued a 4th year TH fellowship if the pilot program were not an option, while 38% would have stopped training after standard GI fellowship. All 17 eligible fellows took and passed the GI certification exam. Of the four fellows who have been eligible to sit for the TH exam, three have taken and passed it and one deferred the exam until 2016 for personal reasons. None of the graduates reported difficulty finding a job despite the shortened training. 90% are currently in a practice or will enter a practice that is predominantly hepatology and 86% are involved in liver transplant-related work. Concerns have been raised about whether the pilot allows sufficient time for endoscopy, liver biopsies and research. Respondents recommended that the program offer a training exam and a standardized curriculum.

CONCLUSION: The GI/TH pilot program has successfully trained 30 fellows who have achieved competence in GI and TH during a combined 3-year program. Almost all fellows are satisfied with their training and remain in the field of hepatology. Improvements can be made in endoscopic and research training. A research focus, however, may be better suited to the traditional 4-year pathway. There remains a need for the traditional 4-year training pathway, but the pilot program shows promise to be developed into a standard pathway for clinically-focused training and certification in GI and TH.
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