Xiong Xin, Barkun Alan N, Waschke Kevin, Martel Myriam
Division of Gastroenterology, McGill University Health Centre, McGill University, Montréal, Québec, Canada.
Can J Gastroenterol. 2013;27(5):267-72. doi: 10.1155/2013/186284.
To determine the current status of core and advanced adult gastroenterology training in Canada.
A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed.
All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery.
Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula.
确定加拿大成人胃肠病学核心及进阶培训的现状。
向14位经认可的成人胃肠病学住院医师培训项目主任发放了一份包含20个与核心及进阶内镜培训相关问题的调查问卷。对于连续变量，分析中位数和范围；对于分类变量，分析百分比及相关的95%置信区间。
所有14个项目都对调查做出了回应。核心培训学员的中位数为6名（范围为4至16名）。胃镜检查、结肠镜检查、经皮内镜下胃造口术和乙状结肠镜检查的操作量中位数（范围）分别为400例（150至1000例）、325例（200至1500例）、15例（0至250例）和60例（25至300例）。13个项目中的11个（84.6%）在其课程中使用了内镜模拟器。14个项目中的8个（57%）提供结构化的进阶内镜培训奖学金。大多数（88%）提供内镜逆行胰胆管造影术（ERCP）和内镜超声检查的联合培训。进阶内镜奖学金每年提供的职位中位数为1个（范围为1至3个）。ERCP、内镜超声检查和内镜黏膜切除术的操作量中位数（范围）分别为325例（200至750例）、250例（80至400例）和20例（10至63例）。目前没有项目提供内镜黏膜下剥离术或经自然腔道内镜手术的培训。
大多数经认可的加拿大成人胃肠病学项目在核心培训期间达到了加拿大胃肠病学协会推荐的最低操作要求。然而，进阶培训的经验存在更大差异。需要进一步研究来验证和规范胃肠病学课程中使用的评估工具。
