The organisation and needs of young sections belonging to UEG National Societies: Results of a Europe-wide survey

Abstract

One of the aims of the Young Talent Group (YTG) is to make United European Gastroenterology (UEG) more attractive for young fellows interested in gastroenterology, and to involve them actively in UEG activities, by collaborating with young GI sections (YGIS) across Europe. Therefore, the YTG launched a survey to collect up-to-date information on YGISs belonging to UEG National Societies. The Friends of YTG were chosen as the target population and received a web-based questionnaire concerning their personal information, the structure of YGIS in their respective country, the YGIS’ support mechanisms for young trainees, and ideas on how to improve them. Overall, 24 of 29 Friends answered the survey (83%). Among the Societies surveyed, only half have a young section. Typically, YGIS are supported, but not influenced, by National Societies through several initiatives. Results of the survey suggest that a lack of funding, of harmonised education, and of active roles available within National Societies, were the concerns most prevalent among young fellows. Our survey shows that the development of YGIS is being hindered by organisational, financial, and political issues. The YTG believes that a close collaboration between National Societies, UEG, and the YTG is necessary in order to offer young fellows the most productive and professionally satisfying future possible.

Background and aim

One of the tasks of the United European Gastroenterology (UEG) Young Talent Group (YTG) is to make UEG and UEG Week more attractive for young trainees and specialists in gastroenterology and hepatology, as well as to involve them actively in the activities promoted by UEG. To achieve these goals, the YTG seeks to facilitate exchanges between young physicians and researchers across UEG National Society Member countries and to motivate and train them to become the leaders of tomorrow. ¹

The continuous recruitment of motivated gastroenterologists is crucial not only for UEG, but also for UEG National Societies. Many National Societies have therefore established sections dedicated to young trainees. These ‘Young GI sections’ (YGIS) play a strategic role in facilitating the development and education of young physicians and researchers, by giving them a voice within the National Society, and by making networking possible across geographic regions and research areas of interest.

The YTG strives to promote National YGIS and their activities, as well as to gather young physicians and basic science researchers belonging to UEG member countries with an interest in digestive diseases, to form a proactive and engaged social and professional network.

However, a dynamic and fruitful interaction between YTG and YGIS is currently encumbered by a lack of official data about the YGIS.

Therefore, the YTG is looking to gather up-to-date and detailed information about YGIS throughout UEG National Society member countries, including their structure and organisation.

Methods

Target population of the survey: The Friends of YTG (FYTG)

In order to develop a comprehensive understanding of the YGIS throughout UEG National Society member countries, the FYTG were selected as the target population of this survey. FYTG are young trainees who act as ambassadors of YTG across UEG National Societies, and each of them is appointed for a two-year term by her or his reference National Society. At the beginning of the FYTG project, people in charge of existing YGIS were invited to become ‘Friends’, again in accordance with the respective National Society. In countries without YGIS, the National Societies were asked directly to appoint an FYTG and were encouraged to consider young trainees who had been involved in other UEG activities.

The task of FYTG is to give feedback about UEG activities, as well as to inform UEG about activities promoted by their National Society. They provide information about the needs of the trainees and young gastroenterologists in their countries, and also help to disseminate information about UEG’s Young GI Network initiatives in their own country.

To date, UEG comprises 47 National Societies, 29 of which have appointed an FYTG delegate.

Development and analysis of the web-based survey

The YTG designed a questionnaire to collect information about individual FYTG, the structure and support mechanisms of YGIS in their respective countries, and ideas for how to improve these YGIS.

For the countries without YGIS, the YTG wanted to understand the main barriers for their development and how the YTG could provide help in overcoming them. For countries with a YGIS, YTG wanted to build a database about their structure (including the gender and regional balance within their board), collaborations with their National Society, and the benefits being provided to trainees.

The survey included 48 questions and was enclosed in a web platform and distributed to all FYTG, who were asked to complete it within three weeks. Participants who did not answer by the deadline were contacted through several reminders in order to achieve the highest possible response rate. The complete questionnaire is available as a supplementary file.

All returned questionnaires were transferred to a Microsoft Excel spreadsheet. Means and percentages were calculated for data originating from multiple-choice questions. Answers from open questions were gathered and, when possible, synthesised.

All YTG members had access to the survey results, which were presented at the National Societies Forum meeting in January 2017.

Results

General data and personal information for FYTG

Overall, 24 of 29 (83%) FYTGs answered the survey, including delegates from countries highlighted in Figure 1.

Figure 1.

Friends of Young Talent Group (YTG) who answered the survey.

The mean age of the FYTG was 34 years old (28–44 years), and 18 of them (75%) were males.

Fourteen (58%) were fully trained gastroenterologists, while seven (29%) were trainees. At the time of the survey, the majority of FYTG (14 of 24, 58%) had spent four to six years of postgraduate training in gastroenterology. In most cases, the FYTG worked as physicians in academic hospitals (19 of 24, 79%), and had attended, or were attending, research training as PhDs or postdoctoral fellows (20 of 24, 84%).

Structure of YGIS

YGIS were present in only 12 of 24 (50%) UEG National Societies; in two countries (Italy and Ireland) there was an additional independent Young GI society besides the YGIS connected to their National Society.

The YGIS were structured in a variety of ways (Table 1). To be a part of the YGIS and to benefit from its advantages, a cut-off time for being considered a trainee existed in four of the 12 (33%) YGIS, while in one case even young gastroenterologists could apply up to three years after their specialisation. Furthermore, an age limit of 35–40 years was enforced in four of the 12 YGIS. Three (25%) sections did not impose professional or age limitations on membership. Board members of the YGIS were appointed in different ways, including: direct election at a meeting of the section or of the National Society (three of 12, 25%), others by open calls launched by the YGIS (five of 12, 42%), or appointment by the National Society (two of 12, 17%). Some boards were formed by trainee delegates from the GI training schools (1 of 12, 8%). Two of the 12 sections (17%), did not have a governing board.

Table 1.

Structure of Young GI sections.

Criteria for being a part of the Young GI group	Professional cut-off for defining ‘trainee’	33%
	YGIS with less than three years GI specialisation	8%
	Age limit of 35–40 years	33%
	No professional or age limit imposed	25%
Ways to appoint board members of YGIS	Direct election at the meeting of the YGIS or the National Society	25%
	Open call launched by the YGIS	42%
	By the National Society	17%
	By trainee delegates of the GI training schools	8%
	A governing board does not exist	17%
Gender representation	Well-balanced	40%
Regional representation	Almost equally balanced	80%

GI: gastrointestinal; YGIS: young GI sections.

The gender and regional composition of the YGIS governing boards was well balanced in four of 10 (40%) sections, whereas a slight or strong male predominance was present in the remainder. Regional representation in the YGIS governing boards was equally, or almost equally, balanced among regions in eight out of 10 (80%) cases, while the remaining two were either poorly balanced or difficult to assess because of the small size of the country in question.

However, only a minority of the YGIS insisted on a regional and gender balance when appointing their board members: Both parameters are evaluated in three of 10 (30%) sections, while regional balance is insisted on in only 20% of cases.

YGIS appeared to be in touch with their trainees through different communication channels, including; mailing lists and newsletters (83%), national meetings (75%), section website (50%), social media (50%), and social and educational events (42%).

Relationships between YGIS and the National Societies

The National Society had the final decision in all actions of the YGIS in eight out of 12 (66%) sections, while only three (25%) sections were autonomous.

Nine out of 12 (75%) sections reported their activity periodically to their National Society; four (33%) of these National Societies reserved a seat for delegates from the YGIS on their own governing board.

Overall, the 24 National Societies surveyed provided different types of financial support for young trainees (independently, or in coordination with the YGIS, when present), including: reduced fees for subscription and participation in national congresses (15 of 24, 62%); travel grants to national meetings (12 of 24, 50%); free educational events (12 of 24%); travel grants to international meetings (six of 24, 25%); visiting fellowships (eight of 24, 33%); and awards for young trainees (eight of 24, 33%). According to FYTG, two National Societies (8%) did not support young trainees.

More than one-third (five of 12) of the YGIS were actively involved in education issues and in the development of the curriculum for the training programme in gastroenterology and hepatology, with the reference society or with another institution that was in charge of it.

Finally, about half (13 of 24) of FYTG believed that their reference societies had a good or excellent awareness of the initiatives for, and concerns of, young trainees in Europe.

Needs and concerns of Young GI fellows, and their possible solutions

The reasons given by 12 FYTG for their National Societies not having a YGIS were: a lack of resources, capabilities, or funding (seven of 12, 58%); a lack of motivated and proactive young trainees (three of 12, 25%); opposition or lack of interest from the National Society (two of 12, 17%); too few GI trainees (three of 12, 25%); and the National Society already being in charge of issues concerning trainees (two of 12, 17%).

Additionally, the FYTG believed that UEG and YTG could support them in organizing a YGIS in many ways, including: strengthening the relationship between the young GI trainees and the reference National Society (five of 12, 42%); by better motivating the young GI trainees (10 of 12, 84%); and promoting shared educational or social events with the reference National Society (10 of 12, 84%).

FYTG identified the following to be the most prominent concerns for GI trainees: lack of motivated and proactive young GI trainees (13 of 24, 54%); lack of structured and harmonised education (11 of 24, 46%); lack of resources/funding/capabilities for education (12 of 24, 50%); lack of adequate job positions for gastroenterologists (eight of 24, 33%); lack of influence on the reference National Society (six of 24, 25%); lack of support from the reference National Society (three of 24, 13%); and an unwillingness among young trainees involved in reference societies to take care of their colleagues’ needs (five of 24, 21%).

FYTG proposed some solutions to improve the conditions for young GI trainees in their respective countries (Table 2), including the improvement of educational programmes, more financial support for young trainees, and increased development of their network and organisation.

Table 2.

Concerns among Young GI Sections and possible solutions.

IMPROVEMENT OF EDUCATIONAL PROGRAMMES	FINANCIAL SUPPORT TO YOUNG GI TRAINEES	NETWORKING AND ORGANISATIONAL ISSUES
○ Harmonisation of educational programmes  ○ National/European curriculum  ○ More space for research activities during training  ○ More integrated training pathways  ○ More hands-on training  ○ Increase of e-learning  ○ Review of trainers by trainees  ○ Better selection process for GI fellows  ○ Better interaction between National Societies and local directors of training schools  ○ Longer GI training	○ More funding for PhD Projects  ○ New jobs for young GI trainees  ○ Higher pay for young GI trainees  ○ Additional research grants for young researchers  ○ More international fellowships  ○ Promotion of participation of young GI trainees in national and international events (reduced fees, cheap travel packages, travel grants)	○ Building a YGIS  ○ Increasing connections between GI trainees and the national societies  ○ Increasing relationships with UEG  ○ Collaboration among countries on young GI issues  ○ Official census of GI fellows  ○ Early identification and support of young talent  ○ Stimulating motivation among young GI trainees  ○ Dedicated young GI sessions at national meetings  ○ Increasing awareness about young GI issues in the national societies

GI: gastrointestinal; YGIS: Young GI sections; UEG: United European Gastroenterology.

FYTG also believed that UEG can support the needs of young gastroenterologists and trainees in their countries by strengthening relationships with their reference National Societies (nine of 24, 37%), by promoting and/or supporting educational/social events together with their reference National Society (14 of 24, 58%), by increasing its educational offers (15 of 24, 65%), and by promoting and supporting the attendance of young GI fellows at UEG Week (19 of 24, 79%).

Finally, FYTG offered suggestions for improving UEG according to the needs of young GI fellows, and these are given in Table 3.

Table 3.

Suggestions from Friends of Young Talent Group (YTG) for improving UEG.

HOW TO IMPROVE UEG ACCORDING TO THE NEEDS OF YOUNG GI TRAINEES

HOW TO IMPROVE COMMUNICATION BETWEEN UEG AND YOUNG GI TRAINEES

○ Stronger connection with EBGH to harmonise education in Europe (UEG Week and UEG courses should be a natural component of EBGH curriculum) ○ Free access to most relevant GI journals ○ Increase visiting fellowships/exchange programs ○ Increase hands-on courses ○ More educational events (including e-learning – itinerant events/shared events with national societies) ○ Dedicated educational activities for inexperienced GI fellows ○ Reduced registration fees/cheap congress packages for UEG week ○ Research/educational grants for non-EU members ○ Train young GIs to be the UEG members of tomorrow ○ Improve communication between young GI fellows and national societies ○ Encourage national societies to have a well-structured YGIS ○ Active involvement of young GIs within UEG events

○ Create YGIS in each country ○ Increase UEG research courses ○ Improve newsletters (including dedicated space for FYTG), Facebook page and social media, social events ○ Placing UEG representatives within boards of national societies ○ Dedicated UEG sessions at national congresses ○ UEG e-learning should be considered among compulsory training activities ○ Increase awareness of the opportunities given by UEG to young GI fellows ○ Dedicated Young GI angle in each national newsletter ○ Teleconferences with all young representative of European societies ○ Dialogue between YTG, NSC, the national society, and its young GI section ○ Participation of UEG representatives in national events/development of common events ○ Greater involvement of young GI fellows in UEG activities

UEG: United European Gastroenterology; EBGH: European Board of Gastroenterology and Hepatology; YGIS: Young GI sections; GI: gastrointestinal; FYTG: Friends of YTG.

Discussion

One of the aims of the National Societies Committee is to promote the idea that every UEG member country should have a YGIS. This aim is strongly supported by the YTG, which could increase the control trainees and young specialists in gastroenterology and hepatology have over their education and future professional opportunities.

We therefore aimed to map the prevalence, structure, and organisation of the YGIS throughout UEG National Society member countries through a web-based survey, as well as to address the main concerns of their trainees. With its high response rate (83%), this survey allowed us to develop a thorough understanding of these topics, while in the process providing us with interesting, and sometimes unexpected, data.

The most relevant finding of our survey is the absence of a YGIS in several European countries. Among the National Societies surveyed, only 50% had a YGIS within its organisation. Lack of resources and capabilities were identified by most of the FYTG (58%) as the main reason for this, followed by a lack of motivated and proactive young fellows. Disappointingly, a lack of interest by the reference National Society, and sometimes even its outright opposition, were described as a barrier to the development of YGIS in a minority of countries.

Additionally, FYTG identified UEG and YTG as possible facilitators in organising a YGIS, by increasing communication and improving relationships with National Societies (including through common events) and by increasing the motivation among young fellows.

A lack of funding for young GI fellows is considered to be one of the most pressing concerns faced by the FYTG. This is unsurprising given that funding dedicated to young physicians has been repeatedly cut in recent years. ²

As at least one of the five non-responding countries has a YGIS (British Society of Gastroenterology Trainee Section), the YTG aims to repeat the survey at a later time and hopes to include newly established YGIS.

Further studies addressing the potential influence of YGIS on scientific and healthcare outcomes are welcomed, as would any that highlight their vital role within National Societies, or which help to increase funding for their development and expansion.

Current YGIS are usually supported by their National Societies through a reduction of subscription fees, provision of travel grants, free educational events, and awards for young fellows. However, some National Societies appear to limit the autonomy and influence of their YGIS by having the final decision in all actions of the YGIS (75%) or by not reserving a seat for delegates from the YGIS on their governing board (66%). Not being granted an active role within the National Societies has also been identified by FYTG as another concern among young fellows.

In light of these findings, UEG and the YTG feel compelled to assist in the process of increasing the number of YGIS across Europe, as well as the opportunities available to those YGIS that already exist.

A final, considerable difficulty faced by young gastroenterologists and trainees is a poorly harmonised education, something most likely the result of under-funding. The European Board of Gastroenterology and Hepatology’s (EBGH) Blue Book describes in detail the ideal training schedule and mandatory educational skills of European fellows in gastroenterology and hepatology. However, recommendations from the EBGH appear to be increasingly hard to follow in all countries, ³ probably because of inadequate resources in postgraduate training centres. Scientific societies should consider taking charge of this issue in order to ensure the quality and harmony of medical training.

Generally speaking, the identification and enhancement of young talent, and connecting it to a positive and friendly professional network, is the key to ensuring a scientific society’s long and prosperous life. Promoting and fostering YGIS appears to be a strategic step for National Societies to make if they wish to achieve this goal. Yet according to the results of our survey, the development and growth of YGIS are sometimes being hindered by organisational, financial, and political barriers.

YTG strongly believe that a close collaboration between National Societies, UEG, and the YTG is necessary if young fellows are to be offered the brightest possible future.