Training in therapeutic endoscopy: meeting present and future challenges

Area of Science:

• Medical Education
• Gastroenterology
• Surgical Training

Background:

• Current UK medical endoscopy training programs face time constraints, potentially leading to suboptimal skill acquisition and delayed certification.
• Essential procedures like managing gastrointestinal bleeding and polypectomy are often learned through opportunistic experience rather than structured training.
• The reduction of specialty training to four years in 2022 further complicates existing training structures.

Purpose of the Study:

• To propose solutions for enhancing endotherapy training within current UK medical endoscopy programs.
• To address challenges in advanced endotherapy training, including skill selection and accelerated learning pathways.
• To suggest adaptations for future training programs, drawing insights from more established international models.

Main Methods:

• Review of current UK endoscopy training program limitations.
• Analysis of challenges in acquiring competence in therapeutic endoscopy and managing complications.
• Exploration of potential solutions for optimizing advanced endotherapy training and selection processes.

Main Results:

• Identified suboptimal training and certification difficulties due to time pressures and opportunistic learning.
• Proposed strategies for improving endotherapy training, focusing on skill acquisition and accelerated learning.
• Highlighted the need for program adaptation, potentially including dedicated subspecialty training and competitive entry for advanced therapy.

Conclusions:

• UK endoscopy training requires significant adaptation to meet service needs and ensure trainee competence.
• Optimizing advanced endotherapy training necessitates improved selection methods and structured, accelerated learning pathways.
• Future training should incorporate dedicated subspecialty programs, competitive entry, and potentially leverage international best practices and referral networks for complex cases.