Assessment of training in pancreatology and biliary diseases during gastroenterology residency: A national survey by AEG-AESPANC.

Abstract

Introduction: Biliopancreatic diseases are prevalent, complex, and associated with significant morbidity and mortality. Despite their clinical importance, training in these conditions remains poorly defined across Europe. We aimed to assess self-perceived knowledge in biliopancreatic diseases among gastroenterology trainees and early-career specialists, and to identify training-related factors associated with higher competence.

Patients and methods: A nationwide cross-sectional online survey was conducted among final-year residents and specialists completing residency between 2018 and 2024 under the auspices of the Spanish Association of Gastroenterology (AEG) and the Spanish Association of Pancreatology (AESPANC). Participants reported demographics and training characteristics. General self-perceived knowledge was rated on a 0-10 scale, and knowledge of 45 pancreatic and biliary conditions was assessed using a 5-point Likert scale.

Results: Of 216 respondents (60.5% women; mean age 32.3 years), 28.8% were residents and 71.2% specialists. Median general knowledge scores were 7/10 for both pancreatic and biliary diseases. Highest competence was reported in common conditions (acute pancreatitis, biliary colic, cholecystitis, cholangitis), lowest scores were observed for chronic pancreatitis, autoimmune pancreatitis, cystic fibrosis, pancreatic cystic lesions, and benign biliary disorders. Factors associated with higher self-perceived knowledge included presence of pancreatology specialists, larger case volumes, outpatient clinic exposure, participation in multidisciplinary committees, structured teaching, and formal competency assessment.

Conclusions: Training in biliopancreatic diseases among gastroenterology trainees in Spain is heterogeneous, with significant gaps in clinically relevant domains. Structured clinical exposure, mentorship, formal evaluation, and targeted teaching are key factors. These findings highlight the need to standardise and strengthen pancreatology training pathways to improve patient care.