Surgical endoscopy training in a university program

Recent directives from the American Board of Surgery requires that applicants become familiar with a variety of endoscopic procedures. The purpose of this report is to review the VA Medical Center's two and a half year experience following the establishment of a surgical endoscopy unit. During the first year, July 1982-June 1983, 212 procedures were performed. These included 64 Colonoscopies (C), 98 Gastroscopies (G), 42 Flexible Sigmoidoscopies (S) and 8 Choledochoscopies (CD). The following year 564 procedures were performed (C-201, G-269, S-86, CD-8). Over the last 6 months 210 procedures were performed (C-98, G-86, S-22, CD-4). Senior surgical residents in their fourth or fifth year of training spent 4 months in the endoscopy service as part of their surgical oncology rotation. Technical and diagnostic competency was achieved in 2 to 4 months. This review indicates that the volume of cases, currently averaging 45 per month, is adequate to train surgical residents and support an independent endoscopy service. The establishment of the unit has also been associated with the development of screening programs for colon and esophageal cancers as well as broader applications of some of the newer indications of fiberoptic endoscopy. Future plans include introduction of variceal sclerotherapy and ERCP.