6 Copyright © 2016 Korean Society of Gastrointestinal Endoscopy COMMENTARY

Competence in colonoscopy procedures is a critical com-ponent for gastroenterology fellowship training programs. However, not only specific measures of colonoscopy compe-tence but also a precisely structured curriculum is lacking. The approach to determine whether a trainee has achieved competence in colonoscopy procedures remains debatable. With respect to technical competence, successful learning has been defined as the ability to intubate the cecum sufficiently.1 Therefore, a common approach has been to establish a thresh-old number of procedures required to achieve a cecal intuba-tion rate of ≥90%.2 On the other hand, the adenoma detection rate (ADR) may be a reflection of clinical competence.3 As we know, ADR is considered as the primary measure of the quality of mucosal inspection and the single most important quality measure in colonoscopy.1 One issue regarding ADR i