The creation of a surgical endoscopy training program--is there sufficient clinical material?

The American Board of Surgery now requires surgical training programs to provide instruction in gastrointestinal endoscopy. In order to demonstrate that an independent Surgical Endoscopy Service could generate sufficient patient volume for an endoscopy training program, we reviewed our experience before and after the organization of such a service. In the year before formation of the Surgical Endoscopy Service (1981), surgical endoscopists performed 134 upper gastrointestinal (UGI) endoscopies and 25 colonoscopies for a total of 159 procedures. This represented 17% of the total institutional endoscopies performed. Further analysis indicated that 30.5% of UGI endoscopies and 24% of colonoscopies were performed on patients referred from surgical services. During the first year of the Surgical Endoscopy Service (1982), we performed 322 UGI endoscopies and 102 colonoscopies for a total of 424 procedures. This represented an increase to 36.5% of the total institutional endoscopies. During this time 41% of the UGI endoscopies and 33% of the colonoscopies were performed on patients referred from surgical services. Thus, with the formation of a Surgical Endoscopy Service we were able to dramatically increase our procedure volume and to provide effective gastrointestinal endoscopic training for our residency program. This confirmed our premise that in a typical university training program there is sufficient clinical material to provide training in surgical endoscopy.