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Is it time to consider liver ultrasound and elastography training for advanced hepatology trainees in the UK?
  1. Ahmed Hashim1,
  2. Matteo Rosselli2
  1. 1 King's College Hospital, London, UK
  2. 2 University College London, Royal Free Hospital, London, UK
  1. Correspondence to Dr Ahmed Hashim, King's College Hospital, London, UK; ahmedsir37{at}

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Ultrasound (US) is undoubtedly an important modality for diagnosing a wide range of gastrointestinal and liver conditions. In addition, recently introduced non-invasive liver assessment techniques, particularly US-based modalities such as elastography and contrast-enhanced US, have resulted in a dramatic shift in the management of patients with chronic liver disease by allowing rapid and accurate assessment of hepatic fibrosis and liver lesions.1 Although these techniques are used by clinicians in many European countries where abdominal US is recognised as one of the skills to be developed by hepatologists, this opportunity appears to be disregarded in the UK where gastroenterology and hepatology trainees do not receive any formal US training. The training resources in this important clinical area are limited to short courses organised by a small number of institutions. However, although these courses provide the basic theoretical and practical knowledge in US and non-invasive liver assessment, there are no ongoing opportunities for trainees to practise and improve their skills continuously in the workplace, with interested trainees only left to seek further training opportunities individually in their spare time. Without dedicated training slots, competing endoscopy requirements and the current clinical workload in the National Health Service (NHS), US training is virtually impossible. However, despite all of that, the liver US courses still seem to be well attended with many gastroenterology trainees showing interest in learning US and elastography techniques. More interestingly, a survey published 20 years ago confirmed that the majority of UK Gastroenterology trainees were interested in US training with a focus on hepatobiliary conditions but it is unclear what happened to this proposal.2

Why liver US and elastography training?

In many European countries, formal abdominal US training is considered to be a necessary part of the gastroenterology training curriculum. Training in US and its use in invasive procedures requiring US guidance has been part …

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  • Contributors Both authors (AH and MR) contributed to the writing of this manuscript and the subsequent revisions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.