Training in hepato-pancreato-biliary surgery during residency: past, present and future perspectives

The paradigm introduced by William Halsted for surgical residency training has been considered the most appropriate educational system to acquire the knowledge and surgical skills required to become a competent general surgeon. Hepato-pancreato-biliary (HPB) surgery is considered an important part of general surgery training because of its high prevalence and complexity. Nowadays, we are faced with a worldwide shortage of general surgeons candidates, restrictive working hours and less surgical exposure, situations that can undermine the objectives of training in HPB surgery during residency. Moreover, new generations of resident graduates are concerned about their lack of preparedness for independence. We cannot escape from this reality and therefore it justifies a reflection in our HPB surgical world community.