The Liver Transplant Anesthesiology Fellowship Training Paradigm Across the United States: Looking for the Next Steps in Quality Education

Background: Liver transplant anesthesia is a growing nonaccredited subspecialty. Although educational milestones and core competencies for training are published, there is a lack of research into how training is delivered to prepare fellows for independent practice.

Methods: In September 2020, the fellowship directors at all 19 training programs across the United States known to the Society for the Advancement of Transplant Anesthesia (SATA) were surveyed regarding their programs' educational management processes.

Results: A total of 17 fellowship directors responded to more than 70% of survey questions (89%). Few programs had a sequential learning plan that built knowledge and skill sets over time. Learning was primarily based on teaching during clinical care of patients while training time varied between programs. No directors were trained in curriculum development, but most (9/11 respondents) expressed interest in additional education if time was allotted for this task. Even with these challenges, respondents had few problems originating fellowship programs.

Conclusions: Liver transplant anesthesia fellowships had few common educational management processes that allowed for meaningful comparison of educational products between centers. This suggests that trainees are likely to have a wide variability in knowledge and skills that can affect the quality of care delivered. We suggest that national support for fellowship training may help to promote a more ordered yet flexible process at training programs that will improve subsequent patient care.

Keywords: fellowships; graduate medical education; liver transplant anesthesia; medical education.