Attitudes and Expectations of the 2006 Incoming GI Fellowship Class Towards Advanced Endoscopic Training (AET)

Abstract

Background: Rapid technological advancements in endoscopic procedures such as ERCP and EUS have transformed GI practice and training. However, training in these procedures is demanding, and fellowship opportunities are limited. This study aimed to assess attitudes and expectations of the 2006 incoming GI fellowship class towards AET. Methods: A 23 question survey assessing interest in AET was developed and tested on 20 GI fellows and internal medicine residents interested in GI at our institution. Ambiguous questions were modified and the survey was then administered at the ASGE-sponsored First Year Fellows' Endoscopy Course, which was attended by 298 of 415 (72%) 1 st year fellows from accredited GI fellowship programs throughout the United States. Results: Responses were obtained from 252 (85%) of attendees. 183 (73%) expressed interest in AET, 50 (20%) were unsure, and 19 (8%) were not interested. Reasons for interest included “to be a complete gastroenterologist” (72%), marketability (51%), interest in pancreaticobiliary disease (54%), interest in technology (54%), and interest in endoscopic research (21%). Among those interested in AET, 138 (77%) desired both EUS and ERCP training, and 132 (73%) rated access to AET during a 3 year fellowship as important to their fellowship program choice; 114 (64%) and 124 (71%) were not sure of or underestimated the number of ERCPs and EUSs, respectively, required to meet competency guidelines; 62 (34%) and 75 (43%) were not sure how many ERCPs and EUSs, respectively, are performed at their institution annually. 119 (65%) of those interested do obtain some AET during their three year fellowship, yet 130 (72%) do not expect to be fully trained or are not sure. If not fully trained, 115 (64%) said they would then seek alternative ways to learn (e.g. weekend hands-on courses, videotapes, web-based learning) and eventually practice advanced endoscopic procedures. Conclusions: While interest in AET is high among 1 st year fellows, interest in endoscopic research is low. A majority of these fellows are unsure of the recommended guidelines or how many advanced procedures are performed at their institution. Fellowship training directors should consider educating incoming fellows about AET. Moreover, formally structured AET programs should be created to fully train those committed to AET in order to promote more endoscopic research and limit AET in a non-fellowship format.