EUS training and practice patterns among gastroenterologists completing training since 1993.

Abstract

BACKGROUND: EUS training and practice patterns vary widely. The aim of this study was to assess EUS training methods, volumes, and practice patterns, and to obtain subjective assessment of endoscopic competence from endosonographers. METHODS: A survey was sent to over 1400 U.S. and international gastroenterologists who completed training since 1993. We assessed demographics, whether EUS is performed, how EUS training was obtained, and volume and type of EUS procedures performed in training and at present. Subjective assessment of adequacy of training was also obtained. RESULTS: A total of 157 physicians responded, including 76 EUS performers, of whom 67% completed advanced endoscopy fellowship, 14% were EUS trained during GI fellowship, and 19% learned via other means. EUS performers were subgrouped into those who had and had not completed advanced endoscopy fellowship, and those within and outside of an academic practice. There were significant associations between the number of upper EUS, pancreaticobiliary, and EUS-guided FNAs performed during training (p < 0.001 for all 3 groups) and completion of advanced endoscopy fellowship. Physicians in academic practice performed more EUS and FNAs per month than physicians in other types of practice (p values <0.001 and 0.001, respectively); 93.3% of respondents felt they received adequate instruction in diagnostic EUS, regardless of type of training; 88.9% of EUS performers felt they received adequate instruction in performing FNA. CONCLUSIONS: Most EUS performers are in academic practice. Those with advanced training obtained higher training volumes and perform higher volumes of EUS. The majority of respondents felt well trained regardless of training type and the number of procedures performed during training. This is the first analysis to assess these aspects of EUS training and practice.