Rolling out the first batch of DM (Hepatology) fellows: Will it be considered as a red letter day in the history of Indian Gastroenterology.

Hepatology as a discipline is now well established. Most tertiary care centres in developed nations have hepatology as a distinct discipline. In India, PGIMER in Chandigarh and IPGMER at Kolkata have separate departments of hepatology. In India, a dedicated institute for heptobiliary sciences the ‘Institute of Liver and Biliary Sciences (ILBS)’ has been established in New Delhi. International journals with high impact factors namely ‘Hepatology’, ‘Journal of Hepatology’, ‘Liver International’ publish research work related exclusively to the subspeciality of Hepatology. India has many successful liver transplant centres in many regions. All the above events indicate a global explosion in knowledge of various liver diseases. In the past 3 decades, knowledge in liver diseases in India has also increased exponentially leading to identification of liver disorders predominantly seen in Indian subcontinent. Examples of such diseases would include vascular diseases of liver (NCPF, EHPVO, and HVOTO) hepatitis E virus associated liver problems, parasitic liver and biliary tract diseases. Over and above the burden of other global liver diseases such as alcoholic liver disease NAFLD, HBV & HCV associated liver disorders, drug induced liver injury (DILI) disorders are increasing in this country. By now, the in-depth understanding of etio-pathogenesis of these diseases coupled with novel diagnostic assays, and therapeutic interventions based on modern technologies in physics, biotechnology, bioinformatics and pharmacodynamics has resulted in creation of a the multidimensional subspeciality of hepatology. The subsequent creation of dedicated manpower to use and improve these aspects in hepatology is a natural event. Therefore, few tertiary care centre with adequate infrastructure in hepatology have already started (PGIMER, ILBS) separate training programs for hepatology. A few other centres are in the process of creating (CMC, Vellore: IPGMER, Kolkata) dedicated DM course in the discipline of hepatology. Indeed, the first batch of DM fellows in hepatology have already been trained, evaluated and have been certified as dedicated hepatologists in December 2010 at PGIMER, Chandigarh. This initiates the process of rolling out well trained doctors with DM qualification in hepatology resulting in creation of dedicated man power to resolve issues and improve understanding & therapy in liver disease in India. I think it is a welcome step and definite progress for the discipline, because, it is likely to improve care of patients with liver disease, understanding liver diseases specific for the Indian subcontinent (Tropical hepatology) and refining/modifying approaches to suit Indian patients. I hope that creation of such training centres for the subspeciality of hepatology will gradually get incorporated in many more tertiary care centers and contribute to manpower minfrastructure existing in this country.