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Workforce projections for hepato-pancreato-biliary surgery
John E Scarborough1, Ricardo Pietrobon, Kyla M Bennett
1Department of Surgery, Division of General Surgery, Duke University Medical Center, Durham, NC 27710, USA. scarb005@mc.duke.edu
Journal of the American College of Surgeons
|April 5, 2008
Summary
Current hepato-pancreato-biliary (HPB) surgery fellowship training exceeds future demand. Projections indicate an oversupply of HPB subspecialists by 2020, suggesting a need to adjust training numbers.
Area of Science:
- Surgical Workforce Analysis
- Hepato-Pancreato-Biliary (HPB) Surgery
- Medical Education Projections
Background:
- Assessing the adequacy of current fellowship training in hepato-pancreato-biliary (HPB) surgery.
- Forecasting the future demand for HPB procedures in the United States.
Purpose of the Study:
- To determine if current fellowship training levels in HPB surgery will meet projected demand for procedures in 2020.
- To analyze the supply and demand dynamics of HPB subspecialists.
Main Methods:
- Utilized the Nationwide Inpatient Sample database (1988-2003) for procedure projections.
- Analyzed workforce literature to estimate the supply of HPB subspecialists.
- Conducted sensitivity analyses on procedures per subspecialist and required annual training numbers.
Main Results:
- Projected 16,800 HPB procedures annually by 2020, a 25% increase.
- Estimated 28 fellowship-trained HPB subspecialists entering the workforce yearly.
- Calculated that only 15 new HPB fellows annually are needed if high-volume surgeons perform 50% of procedures.
Conclusions:
- Current fellowship training levels are projected to result in an excess of HPB subspecialists in 2020.
- The number of trained HPB subspecialists may surpass the capacity for performing procedures, particularly if high-volume centers are prioritized.
