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Perceptions of gastroenterology fellows regarding ERCP competency and training
Thomas Kowalski1, Thirumaleshwar Kanchana, Surakit Pungpapong
1Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Gastrointestinal Endoscopy
|October 7, 2003
Summary
Many graduating gastroenterology fellows lack adequate endoscopic retrograde cholangiopancreatography (ERCP) training, performing fewer procedures than recommended for competence. Most fellows still plan to perform ERCP independently post-training despite insufficient procedural experience.
Area of Science:
- Gastroenterology
- Medical Education
- Surgical Training
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) training in the U.S. may be insufficient.
- Many training programs lack adequate procedure exposure for fellow competence.
Purpose of the Study:
- To assess the adequacy of ERCP training for graduating fellows.
- To determine the number of procedures required for ERCP competence.
Main Methods:
- A survey was sent to graduating gastroenterology fellows.
- The survey assessed training programs, personal ERCP experience, and post-training plans.
Main Results:
- Graduating fellows performed a median of 140 ERCPs and 35 sphincterotomies.
- Only 36% of fellows met competence benchmarks for ERCP and cannulation success.
- 160-200 ERCPs are suggested as necessary for competence.
Conclusions:
- Most graduating fellows do not achieve adequate ERCP success rates during training.
- Despite inadequate training, a majority intend to perform ERCP unsupervised.