Feasibility of an international multicentric HPB fellowship training program in Latin America

Hepatopancreatobiliary (HPB) surgery is a complex subspecialty requiring high-volume centers and structured training. In Latin America (LA), comprehensive training programs are scarce, leading many surgeons to seek education abroad, often limited by financial, certification, or migration barriers. This study describes the development and implementation of the first multinational, multicentric HPB fellowship in LA, established through collaboration among institutions in Brazil, Chile, and Mexico, and accredited by the Fellowship Council and the Americas Hepato-Pancreato-Biliary Association (AHPBA).

This two-year program consists of three 8-month rotations, allowing fellows exposure to diverse surgical environments. Each center offers complementary strengths, including minimally invasive techniques, living donor liver transplantation, and complex biliary reconstruction. Program outcomes were evaluated using case logs, structured exit interviews, and faculty reports. Fellows were also assessed on educational activities, research participation, adaptability, and cultural integration.

All inaugural fellows exceeded surgical volume requirements and engaged in academic activities, simulation training, and research. Challenges such as migration, certification, and language barriers were eased by institutional support and peer collaboration.

The LA HPB Fellowship shows that a multinational, multicenter rotational model can provide high-quality, accredited training in resource-limited settings, fostering professional growth and regional collaboration.