Trainees’ Exposure to the Field of Neurogastroenterology and Motility in Internal Medicine and General Surgery Residency Programs

Background: The disorders of neurogastroenterology and motility (NGM) are common, yet studies have shown that medical students have a relative lack of knowledge and confidence in this field, which may lead to poorer patient outcomes. We sought to evaluate whether this is also true of residents during the next stage of medical training. Methods: A questionnaire was developed and sent to internal medicine and general surgery trainees at nine teaching hospitals to assess their exposure to NGM and their comfort with the disorders of NGM versus organic gastrointestinal diseases. Results: A total of 121 trainees completed the questionnaire (mean age 32.7, 33.1% female, 71.9% internal medicine, and 28.1% general surgery). Overall, reported exposure to NGM was low (53.9%), mainly occurred during discussions on rounds, and was more common among surgeons (84.8% vs. 41.5%, p < 0.001). Overall, only 9.1% felt NGM was addressed at a moderate or high level, whereas only 13.3% felt knowledgeable enough to treat patients at a moderate or high level. Comfort with NGM diagnostic testing was also low, especially for anorectal manometry. When asked to rate their comfort with the pathophysiology, diagnosis, and treatment of eight diseases (4 NGM, 4 organic), comfort scores were significantly lower for the NGM disorders across all three domains for the whole population, as well as for internal medicine and surgical trainees individually (all p < 0.003). Conclusions: Exposure to NGM during residency training is low, with trainees often feeling inadequately prepared. This appears to be worse for internal medicine trainees than for general surgery trainees. Strategies to increase exposure and knowledge of NGM during residency training are needed.