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Organization of future training in bariatric gastroenterology

Organization of future training in bariatric gastroenterology

作     者:Timothy R Koch Timothy R Shope Christopher J Gostout 

作者机构:Center for Advanced Laparoscopic General and Bariatric SurgeryMed Star Washington Hospital Center and Georgetown University School of Medicine Division of Gastroenterology and HepatologyMayo Clinic 

出 版 物:《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文版))

年 卷 期:2017年第23卷第35期

页      面:6371-6378页

核心收录:

学科分类:1002[医学-临床医学] 10[医学] 

基  金:Ethicon Inc., Somerville, NJ, United States Olympus Medical Systems, Japan 

主  题:Obesity Bariatrics Bariatric surgery Intragastric balloon Endoscopic sleeve gastroplasty Nutrition Endoscopy Training 

摘      要:A world-wide rise in the prevalence of obesity continues. This rise increases the occurrence of, risks of, and costs of treating obesity-related medical conditions. Diet and activity programs are largely inadequate for the long-term treatment of medically-complicated obesity. Physicians who deliver gastrointestinal care after completing traditional training programs, including gastroenterologists and general surgeons, are not uniformly trained in or familiar with available bariatric care. It is certain that gastrointestinal physicians will incorporate new endoscopic methods into their practice for the treatment of individuals with medically-complicated obesity, although the longterm impact of these endoscopic techniques remains under investigation. It is presently unclear whether gastrointestinal physicians will be able to provide or coordinate important allied services in bariatric surgery, endocrinology, nutrition, psychological evaluation and support, and social work. Obtaining longitudinal results examining the effectiveness of this ad hoc approach will likely be difficult, based on prior experience with other endoscopic measures, such as the adenoma detection rates from screening colonoscopy. As a longterm approach, development of a specific curriculum incorporating one year of subspecialty training in bariatrics to the present training of gastrointestinal fellows needs to be reconsidered. This approach should be facilitated by gastrointestinal trainees prior residency training in subspecialties that provide care for individuals with medical complications of obesity, including endocrinology, cardiology, nephrology, and neurology. Such training could incorporate additional rotations with collaborating providers in bariatric surgery, nutrition, and psychiatry. Since such training would be provided in accredited programs, longitudinal studies could be developed to examine the potential impact on accepted measures of care, such as complication rates, outcomes, and costs, in individuals with medically-complicated obesity.

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