Raising interest for neurogastroenterology: Bottom-up from the undergraduate medical curriculum?

We would like to thank the authors Advait Upadhyaya et al. for sharing their views on our article “How to raise the interest for neurogastroenterology among young gastroenterologists?”. The medical student's perspective is essential for this topic and should be assessed more carefully. Integration of neurogastroenterology into undergraduate curricula is an important element in raising interest for this area of expertise and eventually improving quality of patient care.

As far as postgraduate training is concerned, the Blue Book (https://www.eubogh.org/blue‐book/) designed by the European Section and Board of Gastroenterology and Hepatology defines the European training program for Gastroenterology and Hepatology. It aims to harmonize the training across European countries. For neurogastroenterology, there is a chapter on “Functional and Motility Disorders of the GI Tract,” but no specific objective on the curriculum for the subspecialty is specified. Only oncology, hepatology, nutrition, and endoscopy are considered subspecialties with specific learning goals. The curriculum presents objectives on performance evaluation, for example, on the number of endoscopies to perform, but there are no objectives on functional testing. There is also a possibility to take the European Specialty Examination in Gastroenterology and Hepatology. Currently, this examination is only mandatory in the Netherlands, Switzerland, and the United Kingdom for trainees in gastroenterology. In addition, since 2018, the American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility have identified the components of neurogastroenterology and motility training. They have divided them into three tiers, from knowledge and training expected for all gastroenterologists to gastroenterologists specialized in neurogastroenterology and motility.

In the future, interest in neurogastroenterology may grow through recognition as a subspecialty as a whole in every country and gastroenterology training curricula, with dedicated specific training objectives for young GI trainees. We should also encourage the fellowship between cities and countries to improve the training in Europe.

Furthermore, when determinants of career choice are assessed, undergraduate training seems particularly important. Teaching and the teacher could have a positive influence or rather discourage students from choosing a specialty. A French study was performed on 484 young gastroenterologists already in training to determine the factors that have influenced their choice for gastroenterology. For most of them, an internship in gastroenterology had a positive influence on their choice, and this factor was much more important than education. These results may be transposed to fellowship in gastroenterology with the choice of their subspecialty. We may encourage exposure to neurogastroenterology and motility both in undergraduate and postgraduate internship and training, early in their medical training.

In conclusion, continuous exposure to neurogastroenterology starting early during undergraduate training and throughout postgraduate training through carefully designed curricula might be a key to promoting neurogastroenterology among young gastroenterologists.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest regarding the content of this manuscript.

AUTHOR CONTRIBUTION

All authors contributed equally in the conception and writing of this editorial.