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The best of times and the worst of times: Sustaining the future of academic GI

Bethesda, MD (Feb. 1, 2008) Academic gastroenterology divisions face severe challenges from political and economic influences. These divisions must adapt to changing health care needs in order to successfully maintain their research and educational missions, according to a report released by the American Gastroenterological Association (AGA) Institutes Future Trends Committee. The report, The Best of Times and the Worst of Times: Sustaining the Future of Academic Gastroenterology in the United States, was developed from a consensus conference held in March 2007 and published in Gastroenterology, the official journal of the AGA Institute.

The AGA Institute convened the conference to address the challenges faced by the academic gastroenterology (GI) community, including political and economic pressures causing financial hardship, workforce shortages, and erosion of research and teaching support. It focused on exploring the nature of these challenges and approaches that will help to ensure these divisions can continue to pursue their research and educational missions in the coming years.

While academic GI divisions train the majority of GI specialists in the U.S., these divisions are challenged by increasing service demands, decreasing revenues, difficulty recruiting and retaining faculty, and changing needs of fellows.

Academic GI divisions play an extremely important role in moving the field forward, but their ability to meet their educational and research missions is increasingly challenged by many political and economic factors, according to Timothy C. Wang, MD, AGAF, chair of the AGA Institute Future Trends Committee and Chief, Division of Digestive and Liver Diseases, Columbia University. GI divisions will need to adapt to the changing nature of the health care economy and capitalize on those changes to maximize their future success, aided in part by the leadership of the AGA Institute.

Based on presentations at the conference, the Committee developed several conclusions to help guide gastroenterologists in their practices:

  • GI divisions may need to be run more like businesses, and division leaders may need formal training in leadership skills and business practices.

  • GI fellowship training will need to be modified for trainees seeking academic or practice careers, including more technical skill-specific programs. Programs may identify synergies with other medicine fellowships and collaborate to more efficiently deliver training applicable to all fellows, such as quality, ethics and research standards.

  • Divisions will need to focus on improving faculty retention and workforce issues, such as work hours and debt levels, by using new technologies and flexible policies to meet staff and divisional needs. Directors need to place special emphasis on hiring a diverse faculty, including women and minorities, and cultivate promising young professionals through development of research opportunities and community outreach.

  • The AGA Institute should continue to support these divisions by properly educating and training members, advocating for greater federal funding, fostering career tracks for researchers and professional educators, and encouraging interest in and helping reduce potential barriers among students and trainees to careers in academic gastroenterology.

Through the ongoing charge of the Future Trends Committee, the AGA Institute is playing an integral role in helping academic divisions navigate the changing demands of the health care community. They should consider the conclusions of this report to determine changes in their division that will help improve their research output, staff retention and overall health care quality, said Dr. Wang.

The AGA Institute is firmly committed to supporting the academic GI community and is already taking steps to help facilitate many of these changes. The recommendations of the Future Trends Committee will help guide the AGA Institute in prioritizing its areas of focus and strategic planning of valuable training, education and policy programs.


Contact: Aimee Frank
American Gastroenterological Association

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