Assessment of endoscopic training of general surgery residents in a North American health region.
BACKGROUND
Ensuring competency of trainees is a challenge for residency programs. The American Society for Gastrointestinal Endoscopy (ASGE) recommends that a minimum of 130 EGDs and 140 colonoscopies be performed to assess competency.


OBJECTIVE
We assessed the number of endoscopies performed by surgery and gastroenterology residents during their training. Endoscopy patterns were also assessed for staff gastroenterology specialists and general surgeons in Alberta, Canada.


METHODS
Physician billing data were used to determine endoscopic practice patterns, and the number of endoscopies performed by gastroenterology fellows and surgery residents were obtained.


METHODS
Major teaching hospital.


METHODS
Procedure numbers.


RESULTS
In large cities, the number of colonoscopies performed by gastroenterologists increased ( approximately 2-fold) over the study period (there was minimal change in endoscopy numbers by surgeons). In contrast, in smaller communities, EGDs and colonoscopies by surgeons increased about 2-fold (from approximately 4065 to 7288) and about 4-fold (from approximately 1909 to approximately 7629), respectively (with only a minimal increase in colonoscopies ( approximately 3000), by gastroenterologists. During training, gastroenterology fellows performed significantly more procedures (EGDs, 29 +/- 5.6 by surgery residents vs 363.9 +/- 12.7 by gastroenterology fellows; colonoscopies, 91 +/- 14.2 by surgery residents vs 247.8 +/- 21.6 by gastroenterology fellows).


CONCLUSIONS
All training data are from a single teaching center.


CONCLUSIONS
All gastroenterology fellows, but none of the surgery residents, achieved the minimum number of endoscopic procedures recommended by the ASGE to assess competency. These data suggest that we must reexamine our training programs and/or our methods for evaluating endoscopic competence.
Asfaha
Samuel
S
Division of Gastroenterology, Gastrointestinal Research Group, University of Calgary, Calgary, Alberta, Canada.
Alqahtani
Saleh
S
Hilsden
Robert J
RJ
MacLean
Anthony R
AR
Beck
Paul L
PL
D000416:Alberta; D002983:Clinical Competence; D016099:Endoscopy, Gastrointestinal / Q000592:standards / Q000706:statistics & numerical data*; D013502:General Surgery / Q000193:education*; D007396:Internship and Residency