Endoscopic ultrasound and clinical competence

The last few years have seen substantial growth in technology, research, and performance of endoscopic ultrasound. Unfortunately, opportunities for training in EUS have not kept pace with this growth. To improve the breadth and quality of training in EUS, resources will need to be channeled in two directions. One is the development of endoscopic ultrasound training programs in academic centers. These would provide the expertise and the number of patients necessary to train selected GI fellows in EUS. The second direction is toward development of systems for retraining of physicians already in practice. We believe that this would require the development of EUS simulation systems combined with a short, intense, hands-on training in centers of excellence. How fast these training systems will develop is dependent upon market forces. If the information provided by EUS can be proven to reduce costs and if the results improved patient's quality of life, the development of training programs for EUS would accelerate markedly.