Background: Core GI training in Canada is 2 years in length. Little is known about the perceived quality of endoscopy training in Canada, or the opinion of trainees in this matter. Aim: To assess the perceived needs and satisfaction of trainees with regards to the learning of GI endoscopy. Methods: A 17-item survey was posted on the Canadian Association of Gastroenterology (CAG) website in 2003 for 3 months. All trainees enrolled in years 1, 2, or 3 of an accredited GI program in Canada were asked to complete an on-line survey. Responses were recorded in 5-point Likert scales that assessed experience and satisfaction with endoscopic training, the level of confidence achieved in carrying out specific procedures, and preferred methods of learning. Demographic data, procedural numbers were also noted. Subgroup analyses compared pediatric to adult trainees, and looked at year of training. Results: 40 of 93 trainees (43%) responded: 35 adult trainees (43%) and 5 pediatric trainees (38%); 35%, 25%, and 40% in years 1, 2 and 3 respectively. Satisfaction with endoscopic training was moderate (on a 1 to 5 scale, mean 3.4±1.4), with no differences in subgroup analysis. Objectives were unclear (2.8±1.5). Trainees would prefer more teaching about: safety and sedation (3.0±1.3), endoscopy unit management (2.3±1.4), endoscope and accessory design and operation (2.2±1.2), and increased feedback (3.0±1.4), while facilities, case volume, clinical problems, hands-on experience, supervision, teaching of techniques, pathology recognition were felt to be adequate. Trainees felt moderately competent in performing most diagnostic and therapeutic procedures (range of scores 1.5-4.0), with adult and 3rd year trainees being significantly more confident. An introductory course, instructional videotapes, and video clips or still pictures were preferred learning aids. Hemostasis of bleeding lesions with laser, chromoendoscopy, photodynamic therapy, endoscopic mucosal resection, ERCP, EUS, and capsule endoscopy were considered least important to learn during core training. 65% documented procedural numbers, but 73% were unaware of threshold numbers requirements for competency in their programs. Only 8% indicated that 91-100% of procedures were supervised. Conclusion: This survey, that included 43% of Canadian trainees, revealed moderate satisfaction with endoscopic training. Further studies are needed to determine whether the confidence level of trainees correlates with objective assessment of competency.