Endoscopic training during fellowship: A nationwide French study

•What is already known on this subject?.•Evaluation of the quality of training of fellows in endoscopy is essential and competence assessment has mainly been based on a minimum number of procedures needed. In 2016, a French national survey evaluating fellows’ perception of their training showed only 49% and 35% of last-year fellows had reached the threshold of recommended EGD and colonoscopies.•What are the new findings?.•The mean number of weeks fully dedicated to endoscopy training and the mean number of procedures performed by fellows during their training did not differ between 2016 and 2020. However, the access to theoretical courses and simulation-based training was significantly higher in 2020 compared to 2016. The perception of skill acquisition has also gotten better in the last four years.•How might it impact on clinical practice in the foreseeable future?.•These results argue in favor of a higher caseload during fellowship and suggests that theoretical and simulation-based training courses are helpful. A reform is likely warranted in this regard. In France, it is mandatory that gastroenterology fellows have mastered the basic level of endoscopy by the end of training. The aim of this study was to assess improvement in the quality of fellows’ endoscopy training in France during the last four years. All fellows in France in training were eligible for participation. A 21-item questionnaire was sent out. The primary outcome was the completion by fourth year fellows of all the number of procedures recommended. Results were compared with those of a 2016 survey. Two-hundred-and-sixty-five fellows responded to the survey. The participation rate was 47.0%. The mean age was 27.3 ± 1.0 years and 56.4% were female. Access to theoretical courses (63.7% vs. 30.6%, p < 0.001) and simulation-based training (virtual reality simulator: 58.4% vs. 28.2%, p < 0.001, animal models: 29.4% vs. 17.2%, p < 0.001) was significantly higher in 2020. Although the number of procedures did not increase, significantly higher perception of skill acquisition in colonoscopy as well as diminished pressure to advance procedures were noted. Access to theoretical courses and simulation-based training and perceived acquisition of numerous skills has gotten better. However, the quality of training in endoscopy still needs improvement.