Gastrointestinal endoscopy training in general surgery residency: what has changed since 2009?

The Residency Review Committee for Surgery increased the endoscopy requirement for general surgery residents graduating in 2009 and thereafter. These changes led to the release of a position paper from 4 major gastroenterology societies claiming that the brief exposure of general surgery residents to endoscopy is not sufficient to gain competency. The societies also stated that these increased requirements will place an undue burden on gastroenterologists to supervise surgical residents in endoscopy training.

We designed a retrospective study to see if general surgery residents at our university-based training program were able to meet the 2009 requirements, and if reliance on nonsurgical faculty has increased. The case logs of all general surgery residents graduating from our institution during seven consecutive years were reviewed.

All endoscopic procedures were carried out at our main university hospital and at our two affiliated university hospitals. Residents spend two thirds of the year at the main campus and the remaining time at the affiliates.

We found that our surgical residents have met the new Accreditation Council for Graduate Medical Education requirements. In our program, surgeons continue to provide most of the resident supervision for endoscopic procedures. Although there was an initial increased utilization of nonsurgical faculty for upper endoscopy, reliance on nonsurgical faculty for endoscopy training has declined every year since the guidelines were revised.

It is possible for general surgery residents to meet the new Accreditation Council for Graduate Medical Education requirements in endoscopy without placing an undue burden on gastroenterologists.