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Mandating hepatology rotation may lead to more hepatologists
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Findings recently published in Hepatology suggest requiring internal medicine residents to perform a rotation in chronic liver disease — rather than making it optional — leads to a greater understanding of hepatic diseases and more residents expressing interest in hepatology.
“We previously demonstrated that when internal medicine residents are offered an elective exposure to hepatology, they often chose not to rotate through it, despite viewing it as critical to their education,” Adam E. Mikolajczyk, MD, gastroenterology fellow, Center for Liver Diseases at The University of Chicago Medicine, told Healio.com/Hepatology.
“We hypothesized that mandatory educational interventions in internal medicine residency training would be able to address the lack of knowledge as well as generate career interest for hepatology. … We demonstrated these changes led to significant improvements in knowledge of and comfort with management of the most common chronic liver diseases as well as an increase in career interest for hepatology.”
Mikolajczyk presented interim data at The Liver Meeting in 2015.
In the updated analysis, Mikolajczyk and colleagues handed out an anonymous paper-based self-evaluation to 28 internal medicine residents over the course of year, both before and after the residents’ 2-week rotation. The required questionnaires had Likert-type and multiple-choice questions to gauge how much residents knew and the comfort level regarding chronic liver disease (CLD) management. During their mandatory rotation, the residents also attended didactic sessions, multidisciplinary conferences and completed learning modules and readings.
Participants’ comfort level in managing several frequently-occurring CLDs increased after completing the mandatory rotation, specifically in regards to liver transplant care, nonalcoholic steatohepatitis liver disease, cirrhosis and hepatitis B (P <.001) along with hepatitis C (P =.002). Correct answers on the post-test improved over the pre-test, increasing from 62% to 77% (P = .03).
Mikolajczyk and colleagues also found more residents expressed interest in pursuing hepatology as a career than before the mandatory rotation (P =.03).
“There is a well-recognized shortage of hepatologists to treat the burden of chronic liver disease in this country,” Mikolajczyk told Healio.com/Hepatology. “This study highlights that incorporating chronic liver disease as a mandatory component of an internal medicine residency curriculum is not only an effective educational strategy, but also a possible effective recruitment tool for the field.”– by Janel Miller
Disclosure: Mikolajczyk reports no relevant financial disclosures. Healio.com/Hepatology was unable to determine relevant financial disclosures of the other researchers at the time of publication.