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Training in advanced bilio-pancreatic endoscopy.

Claudio G DE Angelis1, Stefano Rizza2,3, Felice Rizzi2

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Summary

Demand for expert biliopancreatic endoscopists is rising due to complex endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) procedures. Standardized training and validated skill assessments are crucial for advanced biliopancreatic endoscopy competence.

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Medical Education

Background:

  • Clinical applications of ERCP and EUS are expanding, leading to more complex procedures.
  • Increased complexity of ERCP and EUS raises the demand for specialized biliopancreatic endoscopists.
  • Existing postgraduate fellowships aim to meet this demand, but standardization is lacking.

Purpose of the Study:

  • To address the need for standardized training and competence assessment in advanced biliopancreatic endoscopy.
  • To highlight the necessity of specialized training beyond general gastroenterology fellowships.
  • To discuss regional differences in advanced biliopancreatic endoscopy training.

Main Methods:

  • Review of current training practices and challenges in advanced biliopancreatic endoscopy.
  • Analysis of the scope of training required for ERCP and EUS competency.
  • Discussion of the need for revised training guidelines and assessment tools.

Main Results:

  • Competency in ERCP and EUS often requires 1-2 years of training beyond standard GI fellowship.
  • Significant regional differences exist in advanced biliopancreatic endoscopy training approaches.
  • Self-teaching ERCP and EUS without supervision is not advisable.

Conclusions:

  • There is a critical need to revise current training guidelines for advanced biliopancreatic endoscopists.
  • Establishing a standardized curriculum and universally validated skill assessment tools is essential.
  • Implementing consistent, targeted feedback mechanisms will ensure trainee competence.