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. 2025 Aug 16.
doi: 10.1007/s13304-025-02362-3. Online ahead of print.

Education and training of surgical residents in upper gastrointestinal surgery: a European survey

Călin Popa  1 , Diana Schlanger  2 , Alberto Aiolfi  3 , Moustafa Elshafei  4 , Dimitrios Theodorou  5 , Ognjan Skrobic  6 , Aleksandar Simic  6 , Suzanne Gisberz  7   8 , Davide Bona  3 , Luigi Bonavina  9 ; Education Training in Foregut Surgery (ETFS) European Collaborative Group; Emanuele Abate, Ahmed Abdelsamad, Florin Achim, Rita Alfieri, Andrea Balla, Yves Borbely, Nicholas Boyle, Giuseppe Brisinda, Piero Giovanni Bruni, Waqas T Butt, Matteo Calì, Giacomo Calini, Valentin Calu, Francesco Cammarata, Giampiero Campanelli, Carlo Castoro, Marta Cavalli, Alexandros Chamzin, Mircea Chirica, Serge Chooklin, Nicola Cillara, Michael de Cillia, Sandra Cristina, Fabrizio D'Acapito, Elke Van Daele, Giorgio Dalmonte, Verdi Daunia, Sara De Bernardi, Viorel Dejeu, Lieven Depypere, Octavian Enciu, Félix Ferraz, Gilberto Martinho Santos Figueiredo, Edoardo Forcignanó, José Freire, Uberto Fumagalli, Francesca Gatti, Mircea Gheorghe, Andrei Cristian Ghioldiş, Mario Giuffrida, Ines Gockel, Ewen A Griffiths, Peter Grimminger, Caroline Gronnier, Christian Gutschow, Anis Hasnaoui, Till Heidsiek, Mark Ivo van Berge Henegouwen, Sandra Hilário, Petre Hoara, Argyrios Ioannidis, Orestis Ioannidis, Stylianos Kapiris, Clive Kelty, Dagmar Kollmann, Dimitris Korkolis, Ivan Kristo, Stylianos Kykalos, André Lázaro, Thorsten Lehmann, Jonathan Levy, John Lipham, Francesca Lombardo, Michele Manara, Luigi Marano, Sheraz Markar, Manuel Mega, Stefan Monig, Emanuele Morandi, Francesk Mulita, Beat Peter Muller, Martina Novia, Fabio Massimo Oddi, Matthias Paireder, Roberto Peltrini, Enrico Pinotti, Mauro Podda, Razvan Popescu, Dragos Predescu, Elisa Reitano, Martin Riegler, Riccardo Rosati, Dimitrios Schizas, Francisco Schlottmann, Sebastian Schoppmann, Galyna Shabat, Natalia Sipitco, Maria Sotiropoulou, Giovanni Domenico Tebala, Flavio Tirelli, Elena Adelina Toma, Tania Triantafyllou, Yener Uzunoglu, Hanne Vanommeslaeghe, Milan Veselinović, Wah Yang, Jörg Zehetner
Affiliations

Education and training of surgical residents in upper gastrointestinal surgery: a European survey

Călin Popa et al. Updates Surg. .

Abstract

Educating and training young surgeons is a complex challenge that requires a structured pathway. Upper gastrointestinal (UGI) surgery is becoming a highly attractive subspecialty, yet it is not universally recognized. Currently, there are no standardized guidelines or curricula for UGI surgical training across Europe and a wide disparity among countries remains. This study aims to focus on the current European landscape from the perspective of both trainees and trainers, and to provide a foundation for developing effective guidelines for education and training of surgical residents. We conducted a cross-sectional survey study with targeted questions about various aspects of managing patients with UGI diseases, including preoperative investigations, surgical interventions, interventional endoscopy, and postoperative follow-up. We also assessed the availability of training resources and extracurricular activities. Distinct questionnaires were distributed independently to trainees and trainers. The overall response rate was 35.6%. Most trainees and trainers recognized the need for dedicated courses in UGI surgery and emphasized the importance of learning through video materials. The survey revealed that surgeons are often unfamiliar with UGI endoscopy and functional esophageal function studies. We analyzed residents' direct involvement in three surgical procedures: anti-reflux surgery, gastrectomy, and esophagectomy. Residents expressed a lack of confidence in executing certain surgical steps. Both trainers and residents expressed preference for extracurricular, hands-on courses focused on UGI surgery but reported insufficient opportunities for such training. This survey highlights significant gaps and limitations of UGI training for surgical residents in Europe. Efforts toward standardization and development of specific guidelines and recommendations are required to enhance education in UGI surgery.

Keywords: Esophagectomy; Fundoplication; Gastrectomy; Medical education; Surgical training; Upper gastrointestinal surgery.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical approval: All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent to participate: Informed consent from all participants was obtained. Consent for publication: All authors approved the publication of the manuscript in the Journal.

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