Challenges in early career for HPB surgeons: an international practice survey

Background: Understanding the needs of early-career surgeons is essential for developing strategies for support. This study examined perceived needs of early-career HPB surgeons worldwide. Methods: A self-administered web-based survey of early career HPB surgeons (aged ≤45 years old or practicing for ≤5 years) was conducted. A questionnaire was developed through items generation and reduction, followed by pilot testing. Quantitative data were reported with descriptive statistics and qualitative responses analysed using open coding. Results: There were 282 respondents. Six main areas of challenges were identified: mentorship opportunities, continued skills acquisition and training, research and collaboration, leadership and career development, clinical knowledge exchange, and accessibility including financial barriers. Specifically, highest rated challenges were ebalancing work and personal life (mean 6.98, SD 2.92), research (mean 6.79, SD 2.50), career development/mentorship (mean 6.70, SD 2.30), networking/collaboration (mean 6.16, SD 2.71), leadership and (mean 6.09, SD 2.53). Rating of research as a challenge was higher in Africa and Central/South America (p = 0.01), and that of leadership was higher in Asia, Oceania, and the Middle East (p = 0.02). Conclusions: This survey highlights the multiple challenges faced by early-career HPB surgeons worldwide. These results provide insights into how to better support early-career HPB surgeons to fully develop their specialty.