Download PDF
CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(04): E551-E560
DOI: 10.1055/a-0839-4476
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Certification of UK gastrointestinal endoscopists and variations between trainee specialties: results from the JETS e-portfolio

Keith Siau
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 2   Department of Endoscopy, Dudley Group Hospitals NHSFT, Dudley, UK
 3   Medical and Dental Sciences, University of Birmingham, Birmingham, UK
,
John T. Anderson
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 4   Department of Gastroenterology, Gloucestershire Hospitals NHSFT, Gloucester, UK
,
Roland Valori
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 4   Department of Gastroenterology, Gloucestershire Hospitals NHSFT, Gloucester, UK
,
Mark Feeney
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 5   Department of Gastroenterology, Torbay and South Devon NHS Foundation Trust, Torquay, UK
,
Neil D. Hawkes
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 6   Department of Gastroenterology, Cwm Taf University Health Board, Llantrisant, UK
,
Gavin Johnson
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 7   Department of Gastroenterology, University College London Hospitals NHSFT, London, UK
,
Brian C. McKaig
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 8   Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
,
Rupert D. Pullan
 9   General and Colorectal Surgery, Torbay and South Devon NHS Foundation Trust, Torquay, UK
,
James Hodson
10   Institute of Translational Medicine, University Hospitals Birmingham, Birmingham, UK
,
Christopher Wells
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
11   Department of Gastroenterology, North Tees and Hartlepool NHS Foundation Trust, Stockton on Tees, UK
,
Siwan Thomas-Gibson
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
12   Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK
13   Imperial College London, London, UK
,
Adam V. Haycock
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
12   Wolfson Unit for Endoscopy, St Mark’s Hospital, London, UK
13   Imperial College London, London, UK
,
Ian L.P. Beales
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
14   Department of Gastroenterology, Norfolk and Norwich University Hospital, Norwich, UK
,
Raphael Broughton
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
,
Paul Dunckley
 1   Joint Advisory Group on Gastrointestinal Endoscopy, Royal College of Physicians, London, UK
 4   Department of Gastroenterology, Gloucestershire Hospitals NHSFT, Gloucester, UK
,
on behalf of the Joint Advisory Group on Gastrointestinal Endoscopy (JAG) › Author Affiliations
Further Information

Publication History

submitted 21 June 2018

accepted after revision 02 January 2019

Publication Date:
04 April 2019 (online)

Also available at
   Permissions and Reprints

Abstract

Introduction In the UK, endoscopy certification is administered by the Joint Advisory Group on Gastrointestinal Endoscopy (JAG). Since 2011, certification for upper and lower gastrointestinal endoscopy has been awarded via a national (JETS) e-portfolio to the main training specialties of: gastroenterology, gastrointestinal surgeons (GS) and non-medical endoscopists (NME). Trends in endoscopy certification and differences between trainee specialties were analyzed.

Methods This prospective UK-wide observational study identified trainees awarded gastroscopy, sigmoidoscopy, colonoscopy (provisional and full) certification between June 2011 – 2017. Trends in certification, procedures and time-to-certification, and key performance indicators (KPIs) in the 3-month pre- and post-certification period were compared between the three main training specialties.

Results Three thousand one hundred fifty-seven endoscopy-related certifications were awarded to 1928 trainees from gastroenterology (52.3 %), GS (28.4 %) and NME (16.5  %) specialties. During the study period, certification numbers increased for all modalities and specialties, particularly NME trainees. For gastroscopy and colonoscopy, procedures-to-certification were lowest for GS (P < 0.001), whereas time-to-certification was consistently shortest in NMEs (P < 0.001). A post-certification reduction in mean cecal intubation rate (95.2 % to 93.8 %, P < 0.001) was observed in colonoscopy, and D2 intubation (97.6 % to 96.2 %, P < 0.001) and J-maneuver (97.3 % to 95.8 %, P < 0.001) in gastroscopy. Overall, average pre- and post-certification KPIs still exceeded national minimum standards. There was an increase in PDR for NMEs after provisional colonoscopy certification but a decrease in PDR for GS trainees after sigmoidoscopy and full colonoscopy certification.

Conclusion Despite variations among trainee specialties, average pre- and post-certification KPIs for certified trainees met national standards, suggesting that JAG certification is a transparent benchmark which adequately safeguards competency in endoscopy training.

Appendix Table 1 – 4