Endoscopy Training

GUIDELINES FOR APPLYING FOR RECOGNITION OF ENDOSCOPY TRAINING

APPLICATION FORMS:

Direct enquires to the Secretariat, Anna Pears, Executive Officer, Royal Australasian College of Physicians.  DDI (04) 460 8126  All applications can now be emailed.

Email anna.pears@racp.org.nz 

Fees

Application of the processing of fees is now $300.00 per category and can be paid by cheque or online, to the  NZ Conjoint Committee Account : 02-0500-0605655-00.  Please include the initials of your first name and your full last name in reference code when making a payment

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

Please forward applications either by email anna.pears@racp.org.nz or if posting please send to:
Secretariat
NZ Conjoint Committee for Recognition of Endoscopy Training
c/- Royal Australasian College of Physicians
PO Box 10-601
WELLINGTON 6043

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 acceptable standards of training in gastrointestinal endoscopic procedures and the maintenance of a register of specialists who have attained these standards.

Purpose

The major purpose of the NZ Conjoint Committee is to provide guidelines relevant to acceptable standards of training in gastrointestinal endoscopic procedures for trainees in Advanced Training Programs.  Once training has commenced, they must record their training according to the guidelines as outlined below, the log books must be supplied and trainees must complete a minimum of experience before they can be assessed by a Supervisor , who will usually be 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 endoscopiests 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

 Information Sheets and Forms

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 are required to perform at least 200 unassisted and complete examinations independently under supervision.  Examinations must include a minimum of 20 emergency or therapeutic procedures (excluding polypectomy).

ERCP

Trainees are required to have previous recognition of training in upper gastrointestinal endoscopy.  Trainees must complate a minimum of 200 unassisted ERCPs in patients with intact papillary sphincters.  Procedures performed must include a minimum of 80 supervised, independently performed sphincterotomies in patients with intact papillary sphincters and a minimum of 60 stents.  Cannulations performed on patients with previous sphincterotomies or stents should be prospectively recorded in the log book to permit assessment of the entire teaching experience.

Colonoscopy

Trainees are required to -

• perform a minimum of 100 unassisted, supervised, complete colonoscopies to the caecum, and preferably the ileum, in patients with intact colons (i.e. with no prior colonic resection;
• perform snare polypectomies on a minimum of 30 patients;
• achieve at least a 90% caecal intubation rate in the 50 cases before completion of training;
• conduct procedures on patients with obstructing cancer or severe colitis must be recorded but are excluded from the calculation of overall intubation rate.

Paediatric Colonoscopy

Trainees are required to -

• perform a minimum of 100 unassisted, supervised, complete colonoscopies in patients with intact colons (i.e. with no prior colonic resection);
• at least 75% of these should be in paediatrict patients;
• achieve at least a 90% caecal intubation rate in the 50 patients before completion of training;
• conduct procedures on patients with obstructing cancer or severe colitis must be recorded but are excluded from the calculation of overall intubation rate.

Cleaning and Disinfection

It is recommended that a minimum of 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 by using the Supervisor's report form uploaded from this site - information/sheets see above).  Two Referees reports are required.

Application

Applications must be lodged on the official form and can be sent by email or courier/post.