PTU-010 Exposure to endotherapy for upper gastrointestinal bleeding at the point of gastroscopy certification – is it sufficient?

IntroductionAlthough certification in diagnostic gastroscopy has been established in the UK, there is no formal process for quality assurance (QA) in endotherapy for upper gastrointestinal bleeding (UGIB). Training opportunities are variable, with 11% of gastroenterology ST7s citing inadequate exposure,[1] despite an expectation to independently manage UGIB upon completion of training. Data on endotherapy exposure during endoscopy training is limited. We aimed to assess whether trainees are receiving adequate exposure to endotherapy at the time of gastroscopy certification.MethodTrainees awarded certification in gastroscopy between September 2009–2016 were identified from the national JETS e-Portfolio. Trainee inputs and formative assessments (DOPS) for UGIB therapy, up to their certification date, were analysed. Only trainees with ³200 procedures were included, thereby excluding those who had submitted baseline information which may have contained therapeutic data. Exposure rates from medical endoscopists (physician and surgical trainees) were compared with non-medical endoscopists (NME).Results885 trainee portfolios were analysed (765 medical and 120 NMEs), with a median procedural count of 276 (IQR 124). The median number of therapeutic entries and DOPS were 4 (IQR 11), and 1 (IQR 3) respectively. Overall rates for endotherapy and DOPS were 2.9% and 0.8% per procedure. When stratified by therapy, the median exposure to each therapy was either 0 or 1, with means displayed in Table 1. 25.2% of trainees had no exposure to any type of endotherapy (67.5% of NME and 18.6% of medical endoscopists, p