4 WORLD GASTROENTEROLOGY NEWS OCTOBER 2014 Editorial | Expert Point of View | Gastro 2015: AGW/WGO | WDHD News | WGO & WGOF News | WGO Global Guidelines | Calendar of Events faculty with new studies on how to teach. The other educational program, the WGO’s Training Centers (8), are where high quality endoscopy training is provided. An interesting effort is the collaboration with several societies in the USA and Europe in order to provide professors and mentors for several Training Centers. It is worth mentioning that the Ankara Training Center in Turkey (9) has developed a mentorship program with the AGA that will provide some competen-cies other than the endoscopic skills for their trainees. Most of basic techniques are covered in the TTT programs and the development of the TTT in Spanish had provided a new opportunity for some non-English speaking members; this idea may be replicated in other languages to make this available for a larger group. Endoscopic skills are part of the competencies but a special consider-ation is the lack of quality standards for the different procedures, not only the common procedures such as gastroscopy or colonoscopy but also because of the development of several new procedures like endoscopic ultra-sound and endoscopic mucosal resec-tion require a good training program for the gastroenterologist to become proficient. The quality standards begin with numbers provided by the dif-ferent societies, mostly without large research to back them up, so they are usually quite different from one another (Table 3) (10). In the past few years there have been some initiatives to improve qual-ity measures. A series of instruments have been designed to evaluate the quality of colonoscopy. This started with only cecal intubation rates but then polyp detection rates and patient comfort were added. The UK has published its first large colonoscopy audit last year and they also have a Joint Advisory Group on GI Endos-copy (11) which has recently provided information from their e-portfolio of trainees that say they achieved their learning curves at a larger numbers than the one set from their national society (12). There are some instru-ments to measure colonoscopy as-sessment like the Mayo Colonoscopy Skills Assessment Tool or the Gastro-intestinal Endoscopy Competency Assessment Tool from Toronto (13, 14). All these are ongoing efforts on establishing ways to evaluate proce-dure skills, and the WGO may play a role in giving standards for most countries, especially in those countries that may not be able to perform their own research. Critical appraisal, statistics and knowledge translation are very important and probably could be taught better. There is much research showing that many different groups of physicians lack the understanding of basic statistics. This may impact patient care if misinterpretation af-fects understanding patients needing screening and the risks of both screen-ing and performing different invasive and non-invasive tests (15). In summary, the WGO has provided several tools to improve gas-troenterology training worldwide and continues to help improve training among its members, but it also has a unique position to perform research such as systematic reviews on educa- EPAs for Gastroenterology - USA (2014) Manage common acid peptic related problems Manage common functional gastrointestinal disorders Manage common gastrointestinal motility disorders Manage liver diseases Manage complications of cirrhosis Perform upper and lower endoscopic evaluation of the luminal gastrointestinal tract for screening, diagnosis, and intervention Perform endoscopic procedures for the evaluation and management of gastrointestinal bleeding Manage biliary disorders Manage pancreatic diseases Manage common GI infections in non-immunosuppressed and immunocompromised populations Identify and manage patients with noninfectious GI luminal disease Manage common GI and liver malignancies, and associated extraintestinal cancers Assess nutritional status and develop and implement nutritional therapies in health and disease Table 3. Requirements of procedure for trainees WGO (2007) ASGE (2012) EBG (2012) BSG (2004) Peru (2002) Upper Endos-copy 100 130 200 200 50 Control of nonvariceal UGI bleeding 20 25 30 - - Control of variceal UGI bleeding 15 20 - - - Colonoscopy 100 200 200 200 50 Polypectomy 20 30 50 - 20 Upper Endos-copy 10 15 15 - 20
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