The impact of EAES Fellowship Programme: a five-year review and evaluation

Background The European Association of Endoscopic Surgery (EAES) fellowship programme was established in 2014, allowing nine surgeons annually to obtain experience and skills in minimally invasive surgery (MIS) from specialist centres across the Europe and United States. It aligns with the strategic focus of EAES Education and Training Committee on enabling Learning Mobility opportunities. To assess the impact of the programme, a survey was conducted aiming to evaluate the experience and impact of the programme and receive feedback for improvements. Methods A survey using a 5-point Likert scale was used to evaluate clinical, education and research experience. The impact on acquisition of new technical skills, change in clinical practice and ongoing collaboration with the host institute was assessed. The fellows selected between 2014 and 2018 were included. Ratings were analysed in percentage; thematic analysis was applied to the free-text feedbacks using qualitative analysis. Results All the fellows had good access to observing in operating theatres and 70.6% were able to assist. 91.2% participated in educational activities and 23.5% were able to contribute through teaching. 44.1% participated in research activities and 41.2% became an author/co-author of a publication from the host. 97.1% of fellows stated that their operative competency had increased, 94.3% gained new surgical skills and 85.7% was able to introduce new techniques in their hospitals. 74.29% agreed that the clinical experience led to a change in their practices. The most commonly suggested improvements were setting realistic target in clinical and research areas, increasing fellowship duration, and maximising theatre assisting opportunities. Nevertheless, 100% of fellows would recommend the fellowship to their peers. Conclusion EAES fellowship programme has shown a positive impact on acquiring and adopting new MIS techniques. To further refine the programme, an individualised approach should be adopted to set achievable learning objectives in clinical skills, education and research.

Introduction to the Special Issue on "Analysing the Politics of Health Policy Change in Low- and Middle-Income Countries: The HPA Fellowship Programme 2017-2019"

This special issue presents a set of seven Health Policy Analysis (HPA) papers that offer new perspectives on health policy decision-making and implementation. They present primary empirical work from four countries in Asia and Africa, as well as reviews of literature about a wider range of low- and middle-income country (LMIC) experience.

Nutrition training in residency and fellowship programme: time for a change

Background: Despite several measures, the nutrition education during undergraduate and postgraduate training has been identified to be suboptimal. The objective of this study was to assess the nutrition knowledge, attitudes and practice of residents, fellows and teaching faculties, following a reformation in the training curriculum, in a tertiary teaching hospital. Method: We conducted an anonymous survey involving residents, fellows and teaching faculties in medical and surgical speciality. We assessed four domains: (a) recognition, (b) knowledge, (c) application of basic principles of nutritional and (d) attitude towards clinical nutrition during residency and fellowship training. Each domain had five multiple choice questions and the attitude section was assessed using a five-point Likert scale. Result: We distributed the survey to 305 doctors: 265 completed the first three domains and 259 completed all the domains. The overall mean ± SD score between residents (6.5 ± 1.9), fellows (6.8 ± 1.8) and teaching faculties (6.5 ± 2.2) was similar. All scored similarly in the recognition, knowledge and application domain of the questionnaire. When subcategorised, the gastroenterology sub-speciality scored significantly higher than the rest (8.1 ± 2.2 vs. 6.4 ± 1.9, p = 0.001). Sixty-three per cent and 44% of the responders felt there was lack of adequate focus on clinical nutrition training in residency and during daily ward round, respectively. Only 10% of responders felt confident in providing nutritional counselling and treatment for malnourished patients. Conclusion: Our study shows the current nutritional education during residency and fellowship training is still inadequate and falls short in achieving the recommended goals.

Demonstrating the value of postgraduate fellowships for physicians in quality improvement and patient safety

BackgroundAcademic fellowships in quality improvement (QI) and patient safety (PS) have emerged as one strategy to fill a need for physicians who possess this expertise. The authors aimed to characterise the impact of two such programmes on the graduates and their value to the institutions in which they are housed.MethodsIn 2018, a qualitative study of two US QIPS postgraduate fellowship programmes was conducted. Graduates’ demographics and titles were collected from programme files,while perspectives of the graduates and their institutional mentors were collected through individual interviews and analysed using thematic analysis.ResultsTwenty-eight out of 31 graduates (90%) and 16 out of 17 (94%) mentors participated in the study across both institutions. At a median of 3 years (IQR 2–4) postgraduation, QIPS fellowship programme graduates’ effort distribution was: 50% clinical care (IQR 30–61.8), 48% QIPS administration (IQR 20–60), 28% QIPS research (IQR 17.5–50) and 15% education (7.1–30.4). 68% of graduates were hired in the health system where they trained. Graduates described learning the requisite hard and soft skills to succeed in QIPS roles. Mentors described the impact of the programme on patient outcomes and increasing the acceptability of the field within academic medicine culture.ConclusionGraduates from two QIPS fellowship programmes and their mentors perceive programmatic benefits related to individual career goal attainment and institutional impact. The results and conceptual framework presented here may be useful to other academic medical centres seeking to develop fellowships for advanced physician training programmes in QIPS.