Insufficient Job Control among Gastroenterology Trainees: Time to Focus on the Science

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Clin Endosc. 2016;49(5):492-493
Publication date (electronic) : 2016 August 26
doi :
1Department of Gastroenterology, National University Health System, Singapore
2Harvard Macy Institute, Boston, MA, USA
Correspondence: Neel Sharma, Department of Gastroenterology, National University Health System, 1E Kent Ridge Road, 119228, Singapore Tel: +65-91745985, Fax: +65-91745985, E-mail:
Received 2016 July 6; Accepted 2016 July 8.

To the Editor:

Nam et al. [1] undertook a remarkable study highlighting job stress in the field of gastroenterology. Among their findings, they noted that fellows demonstrated insufficient job control in relation to more senior professorial colleagues [1].

The field of gastroenterology has been slow to catch up with advances in medical education. Hence, this finding is not a surprise. When we look into the science of learning and, more specifically, masterful learning, various facets are essential. Schumacher et al. [2] described several including team relatedness, autonomy, and personalized learning. Even today, trainees demonstrate a lack of team relatedness and autonomy. If we as educators are true to ourselves, can we honestly admit to imparting these elements to junior members? Often, there is still a “them vs. us” culture, which hinders progression in the field [3]. Furthermore, we all are aware that individuals during training achieve competency at different rates. We should recognize, therefore, the importance of personalized learning where content is tailored appropriately to needs of the individual in question and more specifically on areas they are less aware of. An additional facet of masterful learning is that of feedback—and, more importantly, the nature of feedback, delivered in a non-judgmental manner in a safe learning environment with the additional opportunity to give feedback to seniors.

If we continue to fall behind on the science of learning, we will continue to read studies that highlight job issues.


Conflicts of Interest: The author has no financial conflicts of interest.


1. Nam SJ, Chun HJ, Moon JS, et al. Job stress and job satisfaction among health-care workers of endoscopy units in Korea. Clin Endosc 2016;49:266–272.
2. Schumacher DJ, Englander R, Carraccio C. Developing the master learner: applying learning theory to the learner, the teacher, and the learning environment. Acad Med 2013;88:1635–1645.
3. Limb M. “Them and us” attitude hinders trainees’ leadership development [Internet]. London: BMJ Careers; c2014. [updated 2015 Dec 3; cited 2016 Aug 20]. Available from:

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