Pediatric Gastroenterology, Hepatology, and Nutrition Training in the Asia-Pacific Region: An International Survey of Training Centers

Abstract

Purpose: Published data on pediatric gastroenterology, hepatology, and nutrition (PGHN) training centers in the Asia-Pacific region are limited. This study aimed to evaluate the infrastructure, resources, and training opportunities in PGHN centers across the region to inform future development of training programs. Methods: We conducted an international multicenter, cross-sectional survey among Asia-Pacific nations between August 2023 and July 2024. Results: A total of 43 responses were received from 11 countries. Most centers (58.1%) operated with ≤3 specialists, and trainees in these centers were less likely to receive formal supervision or participate in research. Procedural exposure varied significantly: although endoscopy was widely available, 50% of centers reported fewer than 100 colonoscopies performed annually. Access to training in specialized procedures was limited (pH/ impedance, 48.8%; high-resolution manometry, 34.9%; intestinal ultrasound, 41.9%), with radiologists performing most liver biopsies and intestinal ultrasounds in many centers. Conclusion: This first comprehensive survey of PGHN training in the Asia-Pacific region identified considerable variations, with key challenges in training infrastructure and procedural exposure. Most centers operate with limited specialist numbers, impacting supervision and research opportunities, and many struggle to meet international volume-based training requirements for essential procedures. Enhanced regional collaboration and alternative training approaches may help address these gaps.