J.Jpn. Surg. Soc.. 126(6): 543-547, 2025

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Feature topic

INITIATIVES TO INCREASE HEPATOBILIARY AND PANCREATIC SURGEONS

In recent years, fewer young doctors in Japan are choosing surgical careers, with hepato-pancreato-biliary (HPB) surgery facing particular challenges due to its high technical demands and demanding work environment. The Japanese Society of Hepato-Biliary-Pancreatic Surgery projects that the number of members under age 65 will decline to 80% in 10 years and to just over 50% in 20 years. Long training periods, limited surgical opportunities, and lack of structured mentorship further discourage young doctors. Additionally, long hours and 24/7 responsibility hinder work–life balance, making the field less attractive to newer generations. To reverse this trend, it is essential to build practical, stepwise training systems, introduce shift-based work models, promote task-sharing, and present clear, inspiring role models. At the University of Toyama, efforts such as early operative exposure, fully rotational work schedules, and elimination of harassment have led to more young surgeons, including many women, choosing HPB surgery as a career. Balancing high-level expertise with supportive working conditions is crucial. Continued efforts to improve training and work environments will be key to establishing HPB surgery as a rewarding, desirable specialty for future generations.

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