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State of Adult Trainee Inflammatory Bowel Disease Education in the United States: A National Survey

Cohen, Benjamin L. MD, MAS; Ha, Christina MD; Ananthakrishnan, Ashwin N. MD; Rieder, Florian MD; Bewtra, Meenakshi MD, MPH, PhD

doi: 10.1097/MIB.0000000000000766
Original Clinical Articles

Background: The fundamentals of inflammatory bowel disease (IBD) education begin during gastroenterology fellowship training. We performed a survey of gastroenterology fellowship program directors (PDs) and trainees with the aim to further examine the current state of IBD training in the United States.

Methods: A 15-question PD survey and 19-question trainee survey was performed using an online platform.

Results: Surveys were completed by 43/161 (27%) PDs and 160 trainees. All trainee years were equally represented. A significant proportion of trainees was unsure or believed that their inpatient (32%) or outpatient (43%) training was inadequate. Only 28% of trainees were satisfied with their current level of IBD exposure during training. Fewer than half the trainees reported comfort in the management of pouch or stoma issues, pregnant patients with IBD, or postoperative management. The proportion of PDs viewing a competency as essential for trainee education strongly correlated with trainee comfort in that area (Pearson's rho = 0.793; P < 0.01). In multivariate logistic regression, monthly IBD didactics was the only variable independently associated with satisfaction with the current level of training (odds ratio, 4.1 95% CI, 1.9–9.0).

Conclusions: Over one-third of participating gastroenterology trainees did not feel “confident” or “mostly comfortable” with their level of IBD training, with varying comfort regarding different competencies in IBD management. These findings suggest that specific areas of IBD training may require additional focus during training and can provide the basis for the development of an IBD core competency curriculum.

*Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York;

Division of Digestive Diseases, Center for Inflammatory Bowel Diseases, The David Geffen School of Medicine at UCLA, Los Angeles, California;

Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;

§Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio;

Department of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania; and

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.

Reprints: Benjamin L. Cohen, MD, MAS, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY 10029 (e-mail:

This study was funded in part from an AGA Academy of Educators Grant and NIH K08 grant # 1 K08 DK084347 to 01, T32DK083251 and P30DK097948.

Benjamin Cohen serves on the advisory boards for AbbVie and Janssen. Christina Ha serves on the advisory board, as a consultant, and on the speaker's bureau for Abbive and as a consultant for Takeda. Ashwin Ananthakrishnan serves on the advisory boards for AbbVie, Exact Sciences, Merck and as research support for Merck and Amgen. Florian Rieder serves on the advisory board for AbbVie. Meenakshi Bewtra has received a research grant from Janssen, has served as a consultant for GlaxoSmithKline and RMEI, and has received a research grant from AbbVie.

Received December 23, 2015

Accepted February 5, 2016

© Crohn's & Colitis Foundation of America, Inc.
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