Colonoscopy training in South Africa - in crisis? - Response

We thank Professor Thomson for his highly insightful letter to our manuscript "Procedures most frequently performed by South African-trained general surgeons - implications for training and assessment"¹ and the opportunity it creates to further discuss this important issue. Our data shows that colonoscopy is an important procedure for general surgeons to learn and to perform competently, considering the real-life practices and expectation of general surgeons in the current healthcare system. The data also suggests that there may be enough supervised colonoscopies during training to allow for reliable workplace-based assessment of trainees' competence in performing the procedure. However, it does not tell us whether enough cases are done during training to actually achieve competence.