The utilization of flexible sigmoidoscopy by family practitioners after residency training

Flexible sigmoidoscopy is routinely performed by family practice physicians, most of whom receive training in postgraduate education programs. The aim of this study was to assess the utilization of flexible sigmoidoscopy by family practitioners who received training during residency.

Family practitioners who underwent training in flexible sigmoidoscopy during their residency were contacted by phone or mail and polled regarding their current use of flexible sigmoidoscopy and assessment of their previous training.

Forty-two graduates were contacted; 76% were certified (according to our predefined criteria) during training and 74% were currently performing flexible sigmoidoscopy. Of those who were certified, 87% were currently using flexible sigmoidoscopy compared with 45% of those who did not receive certification (p = 0.02). Training during the last year of residency was more likely to be associated with current use of flexible sigmoidoscopy than earlier training (69% vs. 30%, p = 0.03). Certification was associated with more procedures during training (24.3 +/- 1.7 vs. 16.6 +/- 3.1, p < 0.05). Current users performed a mean of 4.3 +/- 0.75 procedures/month; most reached 40 cm in depth of insertion and completed the procedure in 17.2 +/- 1.2 minutes. Of patients undergoing flexible sigmoidoscopy, 13% were ultimately referred for colonoscopy. Most practitioners considered their training useful and only 9.6% had obtained additional training outside residency.

Most family practitioners certified in flexible sigmoidoscopy during residency performed the procedure in their practices. Depth of insertion and time for completion of the procedure seem to be adequate.