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Endoscopy Training

GUIDELINES FOR APPLYING FOR RECOGNITION OF ENDOSCOPY TRAINING

October 2008

Application Forms:

Information sheets and forms

Direct enquiries to the Secretariat,  NZSG at  tamsen.maher@racp.org.nz

**PLEASE NOTE**

From the 20th of October, 2008, old logbooks and application forms will no longer be accepted.  Any information submitted to the NZCC for review must be submitted on the new forms provided via the above link and must be accompanied with the appropriate application fee.

The New Zealand Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy

The Conjoint Committee is a National Body comprising representatives from the New Zealand Society of Gastroenterology, the New Zealand Committees of the Royal Australasian College of Physicians and Royal Australasian College of Surgeons.  The Committee has responsibility for the provision of guidelines relevant to the training in gastrointestinal endoscopic procedures and the maintenance of a register of specialists who have completed an appropriate training program.

Purpose

The major purpose of the NZ Conjoint Committee is to provide guidelines for trainees in Advances Training Programs.  All endoscopists previously recognise by the Australian Conjoint Committee for the Recognition of Endoscopy Training will be included in a file maintained by the NZ Conjoint Committee.  Endoscopists beginning training in gastrointestinal endoscopy should register their training prospectively with the NZ Conjoint Committee. They must record their training according to the guidelines to outlined below and the log books supplied and complete a minimum experience before they can be assessed by a Supervisor recognised by the NZ Conjoint Committee.  Trainees applying for recognition of gastrointestinal training should forward the log books of their experience together with a Supervisor’s report attesting to the candidates competence plus two referee’s reports.

GUIDELINES

The following recommendations are based on current literature data of “Learning Experience.”  Numbers apply only to those procedures performed unassisted, but under supervision.  Logbooks should include both assisted and unassisted procedures.  This includes all attempts both successful and unsuccessful.

Principles

1. Training in gastrointestinal endoscopy should occur in appropriately equipped facilities.
2. Exposure to gastrointestinal endoscopic procedures should be available to all trainees, both physicians and surgeons
3. Training implies an expression of vocational ambition in gastroenterological medicine or gastrointestinal surgery in an Advanced Training Program.
4. Cognitive and interpretive skills combined with a clear understanding of the role of gastrointestinal endoscopy in patient management are as important as technical skills.  This includes attendance at radiological and histological teaching sessions and relevant operations.
5. It is recommended that endosocpists understand the principles and practice of cleaning and disinfection of modern instruments in accordance with current guidelines of cleaning and disinfection.
6. It is recommended that appropriate training in fluoroscopic theory and practice be obtained.
7. The candidate must complete the specified minimum number of procedures under supervision before the supervisor may consider assessing competence.
8. A satisfactory report from the supervisor will be required at the completion of the training program.  The supervisor should attest that the candidate is competent to perform the gastrointestinal endoscopy and specific procedures safely and expeditiously, plus be able to competently integrate indications for gastrointestinal endoscopy and endoscopic findings and therapy into patient management, be able to understand risk factors, recognise and manage complications and be able to recognise personal and procedural limits.
9. The Committee encourages successful applicants to maintain continuing medical education in the field of gastrointestinal endoscopic practice and to regularly audit their own endoscopic practice.
10. The Committee explicitly acknowledges that recognition of training does not attest to an assessment of competency.

SPECIFIC REQUIREMENTS

Log Book

Details of all cases attempted, including those not successfully completed, must be recorded prospectively in the log books provided.  These details include indications complications, degrees of success and time taken.  The time taken is recorded as a guide for the supervisor and is considered to be much less important than the successful completion of a procedure with minimal discomfort for the patient and no complications.

Upper Gastrointestinal Endoscopy

Trainees should perform at least 200 complete examinations independently but with supervision, which should include at least 25 emergency and/or therapeutic procedures.

ERCP

Trainees should have previous recognition of training in upper gastrointestinal endoscopy and complete a total of at least 200 ERCP’s, unassisted, on patients with intact papillary sphincters of which at least a minimum of 80 of these must be sphincterotomies with supervision.  A minimum of 60 stents and/or nasobiliary drains should be inserted during training.
Cannulations performed on patients with previous sphincterotomies or stents should be recorded in the log book but not counted as successful completed ERCP for gaining numbers.

Colonoscopy

Trainees should perform at least 100 unassisted and complete colonoscopies intact colons under supervision (at least to the caecum and preferably into the ileum) including at least 30 snare polypectomies.  A success rate of 85% for intubation of the caecum (and preferable into the ileum) should have been achieved on completion of training.

Cleaning and Disinfection

It is recommended that a minimum if 15 instruments be cleaned under supervision by an experienced endoscopy nurse/technician.  This should be recorded in the log book.

Supervision

The Supervisor should:

• Be recognised by the NZ Conjoint Committee in the particular type of gastrointestinal endoscopy, or be known to be of equivalent standard
• Have personally supervised some of the applicants training
• Attest that the trainee is competent (in a Referee's letter or by using the Supervisor's report form uploaded to this site - information/sheets see above).  Two Referees reports are required.

Application

Applications must be lodged on the official form.  Only original documents will be accepted (no faxed copies).

Fees

Application of the processing of fees is $200.00 per category as from the 10th April 2008.  The forms have now been updated to reflect this change.

The NZ Conjoint Committee meets as required and applicants will be notified within 4 months of their application.

Please forward applications to with a covering letter:

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