Year: 2026
Type: article
Abstract: BACKGROUND & AIMS: Hepatology is experiencing major shifts in disease etiologies and is raising demand for multidisciplinary care. However, a globally harmonized framework defining core training content remains lacking. We aimed to develop a globally informed expert consensus framework for the content of core hepatology training, to provide a structured foundation for curriculum development. METHODS: A two-round modified Delphi using the RAND/UCLA Appropriateness Method was conducted. A comprehensive list of curriculum items was developed from international training standards, refined by a steering committee, and rated by a stratified international panel. Consensus was determined using medians and a disagreement index (DI), which classified curriculum items as essential, desirable, or optional. RESULTS: A total of 456 experts completed Round 1, of whom 78.7% also completed Round 2. Consensus was strongest for foundational knowledge and core diagnostic skills, including interpretation of abnormal liver function and liver screening test results, and non-invasive fibrosis assessment (both DI = 0). Management of major liver diseases was consistently prioritized as essential. Procedures with the highest endorsement for independent performance were paracentesis, transient elastography, variceal screening, and endoscopic variceal therapy. Consensus was limited for conventional ultrasonography and advanced interventions, reflecting regional variability in resources and scope of practice. Most experts (79.1%) supported formal training in research methodology, and the median recommended fellowship length was 24 months. Subgroup differences were mainly observed in selected resource-dependent or highly specialized items. CONCLUSIONS: This global consensus offers a priority-stratified outline of core hepatology training content providing a practical foundation for curriculum development and staged implementation across diverse health systems. IMPACT AND IMPLICATIONS: Our study provides a consensus-based, priority-stratified framework for core hepatology training content that may inform curriculum development and local adaptation, given the growing global burden of liver disease and the heterogeneity of training standards. This framework may support curriculum mapping and local adaptation for trainees, program directors, professional societies, and policymakers, including in settings where structured hepatology training pathways are still evolving. In practical terms, these findings may assist educators and institutions in reviewing and refining national curricula and training structures. However, specific implementation decisions, including accreditation requirements and procedural training standards, will need to be adapted to local regulatory and resource contexts. Recognizing that these recommendations are based on expert consensus rather than outcome data and may be variably implementable in resource-limited settings, the next steps are pilot implementation in diverse settings, evaluation of trainee and patient outcomes, and iterative revision, supported by coordinated efforts from societies, governments, and training institutions.
Source: JHEP Reports
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Institutions: First Affiliated Hospital Zhejiang University, State Key Laboratory of Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Charité – Universitätsmedizin Berlin, Chinese University of Hong Kong, Queen Mary University of London, Blizard Institute, McGill University Health Centre, King's College London, Foundation for Liver Research, King's College Hospital, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, NYU Langone Health, New York University, Inserm, Hôpital Beaujon, Army Medical University, Southwest Hospital, Seoul National University, Seoul Metropolitan Government, SNUH SMG-SNU Boramae Medical Center, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Recep Tayyip Erdoğan University, Ministry of Health, Makerere University, Bangladesh Medical University, Aga Khan University, Aga Khan University Hospital, University of Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Karolinska University Hospital, Sahlgrenska University Hospital, Karolinska Institutet, Magna Graecia University, University of Gothenburg, Instituto de Gastroenterología, University of Helsinki, Helsinki University Hospital, Yale University, Minerva Foundation, Saga University, Siriraj Hospital, Mahidol University, Centre Hospitalier Universitaire d'Angers, Université d'Angers, St. Luke's Medical Center, Hanoi Medical University, University of Cape Town, University of Kelaniya, National University of Singapore, National University Hospital, National University Health System, Hospital Médica Sur, Universidad Nacional Autónoma de México, Christchurch Hospital, University of Otago, King Saud University, American University of Beirut Medical Center, Hôpital Mustapha Pacha, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Ministry of Health, Erasmus MC, Federal Ministry of Health, Sultan Qaboos University, University of Ghana, Korle Bu Teaching Hospital, Minia University, University of Bern, University Hospital of Bern, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Iuliu Hațieganu University of Medicine and Pharmacy, Institutul Regional de Gastroenterologie Prof. Dr. Octavian Fodor, Beaumont Hospital, University of Malaya, University of Lisbon, Medical University of Vienna, Post Graduate Institute of Medical Education and Research, National and Kapodistrian University of Athens, University of Antwerp, Antwerp University Hospital, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, University of Southampton, University of Verona, Ospedale Sacro Cuore Don Calabria, The University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Wenzhou Medical University, First Affiliated Hospital of Wenzhou Medical University
Language: English
Subfield: Education
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $4,110
Funders: Yale University, NYU Langone Medical Center, American University of Beirut, Helsingin Yliopisto, Wenzhou Medical University, University of Otago, McGill University, Universidad de Sevilla, University of Bern, Queen Mary University of London, University Hospital Southampton NHS Foundation Trust, Università degli Studi di Milano, McGill University Health Centre, Inselspital, Universitätsspital Bern, York University, National Institute for Health and Care Research, University of Southampton, King's College London, National University of Singapore, Minerva Foundation, Institut National de la Santé et de la Recherche Médicale, National Natural Science Foundation of China, King Saud University, Seoul National University, Universität Wien, Karolinska Institutet, Mahidol University, Sultan Qaboos University, Universiti Malaya, Zhejiang University, Chinese University of Hong Kong, National and Kapodistrian University of Athens, University of Ghana, Universidad Nacional Autónoma de México, Sahlgrenska Universitetssjukhuset, Göteborgs Universitet, Universidade de Lisboa, Medizinische Universität Wien, Universitas Indonesia, Università degli Studi di Verona, University of Cape Town, Universiteit Antwerpen, Universidade Federal do Rio de Janeiro, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Southwest Hospital, University of Kelaniya, National University Health System, Army Medical University, Minia University, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, National Science and Technology Major Project, NYU Grossman School of Medicine, College of Medicine, Seoul National University, Sahlgrenska Akademin, College of Medicine, King Saud University, National Major Science and Technology Projects of China, Faculty of Medicine Siriraj Hospital, Mahidol University, Faculty of Medicine and Health, University of Sydney
OpenAlex ID: W7167825385