Training in endoscopic ultrasonography: An Asian perspective

Training of endoscopic ultrasonography (EUS) in Asia faces two major challenges: (i) the ever-increasing demand for skills to handle a growing range of interventional EUS procedures; and (ii) a continual shortage of EUS training programs. As the therapeutic application of EUS continues to expand, the need to train more new endosonographers and upgrade skills of existing ones has become more critical than ever before. A formal fellowship to acquire EUS knowledge and skills in an advanced endoscopy center has always been perceived as the best way of training novices, but such opportunities remain limited in most Asian countries. To keep up with the pace of development in EUS, more short-term EUS programs have been conducted across Asia in recent years. Such programs are generally intensive and may combine didactic lectures, live-case demonstrations, and hands-on training on phantoms, or live animal models for teaching. Although not as rigorous as conventional full-time EUS fellowships, such short-term programs are not necessarily inferior in quality. With courses offered from basic to advanced levels, and at regular intervals, busy practising endoscopists have the flexibility to attend the course that best matches their individual levels of experience, learn at their own pace and acquire EUS knowledge and skills over as many courses as desired. This open-ended progressive learning model is more agile than established fixed-term learning models and is expected to adapt better to future needs.

Survey of endoscopic ultrasonographic practice and training in the Asia-Pacific region

BACKGROUND

Little is known about the current status of endoscopic ultrasonography (EUS) training in the Asia-Pacific region. The aim of the present study was to assess EUS practice and training in the Asia-Pacific region and seek to identify areas where the development of EUS expertise could be further enhanced.

METHODS

A direct mail survey was sent out to 87 practising endosonographers in various parts of the Asia-Pacific region outside of Japan. They were asked to report on their prior training, utilization of EUS, and EUS training in their country.

RESULTS

The respondents (n = 71) were mostly young (median age 40 years), male (97%), practising in academia (36.6%) or public hospitals (50.7%) and fairly experienced (median 5 years) in EUS practices; they had performed a median of 500 procedures in their career. Among them, 49.3% were self-taught. Only 22.5% and 21.1% had undergone formal overseas fellowship lasting >or=6 months, and local gastrointestinal fellowships of various durations, respectively. Fifty-six percent were currently involved in EUS teaching. Most (90%) thought that a formal EUS training fellowship is necessary for acquiring acceptable competence and there should be a minimum number (median 100) of supervised procedures performed and minimum amount of time (median 6 months) spent on training.

CONCLUSIONS

Although EUS practitioners in the Asia-Pacific region were not behind their European or US counterparts in hands-on experience, the lack of formal EUS training programs and opportunities remains an area of concern. For the region to increase EUS utilization, the current shortage of training opportunities needs to be addressed.