Gastroenterology Training Programs Research Articles

Objective Evaluation of Endoscopy Skills during Training

To evaluate the number of supervised gastrointestinal endoscopic procedures required to achieve initial competency using a simple objective grading system. Prospective, cross-sectional study. A gastroenterology and surgical training program at a large, university-affiliated county hospital. Seven gastroenterology fellows and five fourth-year surgery residents. Trainees were graded postprocedure using a microcomputer program. Grading criteria for esophagogastroduodenoscopy included entering the esophagus (esophageal intubation), traversing the pylorus into the duodenum, and recognizing whether the upper gastrointestinal tract was abnormal. Criteria for colonoscopy were traversing the splenic flexure, intubating the cecum, and recognizing whether the colon was abnormal. When presented with a case mix representative of practice, esophageal intubation did not reach 90% until more than 100 procedures had been done. Cecal intubation remained at only 84% after 100 procedures. More than 100 supervised upper gastrointestinal endoscopies or colonoscopies are necessary to achieve technical competence in gastrointestinal endoscopy.

Training and third-tier certification in gastroenterology

Third-tier certification for specific areas of gastroenterology, most notably advanced endoscopic skills, is not required at this time. Strict criteria for training and the awarding of credentials in specialized areas must be strictly adhered to by program directors in accredited gastroenterology training programs.

Analysis of Academic Training Programs in Gastroenterology for the 10-Year Period 1957 to 1967

A comprehensive analysis has been made of the gastroenterology training programs supported by the National Institute of Arthritis and Metabolic Diseases. The analysis covers the development and present extent of the program over a 10-year period and includes information on 61 individual programs and 657 trainees. Utilizing information obtained on the present career activities of 489 former trainees, the efficacy of these programs has also been examined. Findings in each of these areas are discussed and attention is given to the impact of recent limitations in funds on the further development of the program. Finally, future needs in the support of research training as anticipated from the results of this analysis and the discussion of the advisory committees are presented. The information obtained in this manner will be extremely useful to the National Institute of Arthritis and Metabolic Diseases for planning future policy regarding its training programs and, hopefully, will have a salutory effect on the academic discipline of gastroenterology.