Colorectal trainees in the UK struggle to meet JAG certification standards in colonoscopy by the end of their training.

BACKGROUND Colonoscopy certification in the UK is taken in two parts - provisional and full - mandating lifetime procedure counts of 200 or 300 respectively. The aim of this study was to determine the number of procedures performed by colorectal trainees by the end of training compared with gastroenterology peers and to determine factors associated with achieving the 300-procedure target for full certification. METHODS Dates of entry onto the specialist register were obtained from the GMC (General Medical Council). This list was cross-referenced with procedure counts from the JETS (JAG Endoscopy Training System) database to determine the number of colonoscopies and polypectomies performed during training. Factors associated with achieving 300 procedures were analysed by logistic regression. RESULTS Procedures numbers were obtained for 234 gastroenterology and 148 colorectal surgery trainees. Over the last 5 years, the number of colonoscopies performed during training has declined for colorectal surgery trainees but increased for gastroenterology trainees. Gastroenterology trainees are more likely to achieve provisional and full certification. For trainees completing training in 2017, 19% of colorectal surgery trainees compared with 88% of gastroenterology trainees were able to reach the threshold of 300 procedures for full certification. CONCLUSIONS Colorectal surgery trainees lag behind their gastroenterology counterparts in accruing endoscopy experience. This impacts on the ability of colorectal surgery trainees to achieve certification prior to completion of training. An urgent debate is required to decide what endoscopy training is required of a colorectal surgeon and how a robust training system can be put in place to ensure this is achieved. This article is protected by copyright. All rights reserved