Comparison of short term vs long term training in endoscopy in prospect to need for repeat endoscopy difference in findings and results- An Indian Scenario- single center observation

Aims To Compare short term vs long term training in endoscopy in prospect to need for repeat endoscopy. To compare difference in findings and results. Do we need a structured training program governed by a committee of state medical council?

Methods Data was collected prospectively from September 2019 till July 2023. The patients undergoing or referred for repeat endoscopy were included. Demographic data, clinical data, endoscopic equipment used and the training of primary endoscopist whether short term or long term were recorded. The outcome of repeat endoscopy was recorded in terms of correct diagnosis, technical success and improvement in patients clinical condition. All the procedures were performed by a consultant endoscopist with long term training and experience of more than 7 years in a high volume center.

A training, anywhere from 4 days to 30 days was considered as short term and more than 1-2 years in gastroenterology institute with large volume was considered as long term training

Results Total 33 patients were studied (n=34). Female – 11. Male- 23. Median age- 28 years. GI bleed without finding cause or failure of procedure- 09 patients. Alarm symptoms (dysphagia and weight loss) and inconclusive findings- 13 patients. Non alarming but persistent symptoms- 10 patients. Jaundice with failed ERCP- 02 patients.

Short term training- 22 (Surgeons and physicians). Long term training- 12 ( DNB and DM Gastroenterologists)

Scope used- Olympus 130 series- 01, 140 series- 08, 150 series- 16, 180 series- 01, 260 series- 01. 170 series-04. 190 series- 03

Repeat endoscopy for missed or incorrect diagnosis and failed procedure was observed more with short term training (64%) with use of lower version scopes (47%) whereas wrong technique and advanced procedure was the major cause for failure in long term training. Technical success rate- 100%, Correct diagnosis and favorable outcome was achieved on repeat endoscopy in all 33 patients.

Conclusions short term training is not at all helpful even in the basic diagnostic procedures, it may help for the maintenance and further increasing skills in case of trained endoscopist. Short term training also adds extra cost and morbidity to the patient. Even for long term training in case of DNB/DM gastroenterologists, a further training in advanced therapeutic endoscopy for a duration of one or two year at high volume center is necessary before embarking on a independent private practice for the well-being of patients. A multicenter study may throw more light on this issue. India doesn’t have such structured training and protocols as compared to other regions abroad. Establishment of such standards and practice of GI endoscopy endorsed by all the society, state medical council and MCI is the need of an hour. [1]

Conflicts of interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Saraswat VA, Tandon RK.. Gastrointestinal endoscopy training in India. Indian J Gastroenterol 1999; 18 (04) 167-73 PMID: 10531720

Publication History

Article published online:
15 April 2024