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Original research
UK national trainee survey of hepatology training, research and the future workforce
  1. Wenhao Li1,
  2. Nadir Abbas2,
  3. Paul N Brennan3,
  4. Hannah Mcdowell4,
  5. Janardhan Navaratnam5,
  6. Anju Phoolchund6,
  7. Robert Scott7,
  8. Jessica Shearer8,
  9. Helen White9,
  10. Oliver D Tavabie10
  1. 1 Barts Liver Centre, Barts and The London School of Medicine and Dentistry Blizard Institute, London, UK
  2. 2 Liver Unit, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  3. 3 University of Dundee, School of Medicine, Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, UK
  4. 4 NIMDTA - Northern Ireland Medical Dental Training Agency, Belfast, UK
  5. 5 Prince Charles Hospital, Merthyr Tydfil, UK
  6. 6 University Hospital Southampton NHS Foundation Trust, Southampton, UK
  7. 7 NIHR Nottingham Biomedical Research Centre, Nottingham, UK
  8. 8 Hull University Teaching Hospitals NHS Trust, Hull, UK
  9. 9 Royal Bolton Hospital NHS Foundation Trust, Bolton, UK
  10. 10 Royal Free Hospital Sheila Sherlock Liver Centre, London, UK
  1. Correspondence to Dr Wenhao Li, Barts Liver Centre, Barts and The London School of Medicine and Dentistry Blizard Institute, London E1 2AT, UK;{at}


Objective The increasing prevalence of liver disease in the UK means there is a pressing need to expand the hepatology workforce. This survey aims to evaluate current hepatology training provision, and trainee attitudes towards future careers in hepatology.

Method An electronic survey was distributed to higher specialty gastroenterology and hepatology trainees in the UK between March and May 2022.

Results 138 trainees completed the survey covering all training grades and regions of the UK. 73.7% reported receiving adequate hepatology training currently, with 55.6% intending to become future hepatologists. Trainee preference for future hepatology consultant posts in specialist liver centres were almost threefold higher compared with district general hospitals (60.9% vs 22.6%). All trainees, irrespective of training grade reported high confidence in managing decompensated cirrhosis in both inpatient and outpatient settings. Senior trainees (grade ST6 and higher), without advanced training programme (ATP) experience reported significantly lower confidence in managing viral hepatitis, hepatocellular carcinoma and post-transplant patients compared with equivalent trainees with ATP experience. For junior trainees (IMT3–ST5), remaining in their current deanery was the most important factor when considering future hepatology training application.

Conclusions There is a significant need to deliver widely available training on the management of complex liver disease to improve non-ATP trainee confidence. Innovative job planning strategies are required to encourage trainees to pursue careers outside of specialist liver centres. Expansion of hepatology training networks with wider geographical coverage are needed to address the growing need for more hepatologists around the UK.


Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Twitter @drwenhaoli, @nadirabbas_x, @brennap9, @dr_robertscott, @Otavabie

  • Contributors Survey design led by WL, ODT. All authors involved in survey design review. WL led on data analysis and drafting of manuscript. All other authors involved in manuscript review and editing. PNB and ODT led on final manuscript review. WL is the guarantor for the data in this study.

  • 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.

  • Map disclaimer The inclusion of any map (including the depiction of any boundaries therein), or of any geographic or locational reference, does not imply the expression of any opinion whatsoever on the part of BMJ concerning the legal status of any country, territory, jurisdiction or area or of its authorities. Any such expression remains solely that of the relevant source and is not endorsed by BMJ. Maps are provided without any warranty of any kind, either express or implied.

  • Competing interests PNB has received an educational honorarium from Takeda. ODT has received an educational honorarium from Gilead Sciences. ODT is trainee editor for Frontline Gastroenterology.

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

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