General medical training in gastroenterology: views from specialist trainees on the challenges of dual accreditation

Abstract

Higher specialist training in general internal medicine (GIM) and the medical specialties has been subject to many changes and increasing subspecialisation in recent years. The 'Shape of Training' review proposes 'broad-based specialty training', shortening of training by one year, and subspecialisation to be undertaken after the certifi cate of specialty training is obtained. All higher level gastroenterology trainees based in the UK were invited to complete an online survey between July and September 2012 to assess their experience of gastroenterology and GIM training. Overall, 72.7% of trainees expressed satisfaction with their training in gastroenterology but signifi cantly fewer (43.5%) expressed satisfaction with their training in GIM. Satisfaction with gastroenterology training thus is good, but satisfaction with GIM training is lower and levels of dissatisfaction have increased signifi cantly since 2008. Up to 50% of trainees are not achieving the minimum recommended number of colonoscopy procedures for their stage of training. Experience in GIM is seen as service orientated, with a lack of training opportunities. There is a worrying diffi culty in gaining the minimum required experience in endoscopy. If the length of specialist training is shortened and generalised, training in key core specialist skills such as endoscopy may be compromised further.

Training in pediatric hepatology across Europe: a survey of the National Societies Network (2016-2019) of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition

“…There is reportedly a variety of training opportunities in hepatology in the UK, even for adult specialists [ 9 ], and the Lancet Commission proposed the establishment of dedicated liver centers in district general hospitals to improve training in this important area [ 7 ]. Early identification of training fellows interested in hepatology can provide future specialists with the necessary knowledge, experience and skills to provide the best possible care to patients with hepatobiliary diseases [ 10 , 11 ].…”

Trends in UK endoscopy training in the BSG trainees’ national survey and strategic planning for the future

“…The main difficulties are identified as achieving access to sufficient numbers of cases to achieve timely certification in colonoscopy and to training in therapeutic endoscopy, particularly the management of acute GI bleeding. In the 2012 survey, it was found that 50% of trainees were not achieving the minimum recommended number of colonoscopy procedures for their stage of training;27 therefore, there seems to have been little improvement over the intervening 4-year period.…”

Intercostal chest drain insertion by general physicians: attitudes, experience and implications for training, service and patient safety

“…Such a move would further impact on procedural exposure and experience among trainees. Challenges already exist in developing and maintaining specialty-specific skills for dual-accrediting trainee physicians in the current system 25 26. ICD insertion becoming a specialist-only skill may be the result of junior doctors deciding their training priorities lie elsewhere and, for procedural skills, within their own specialties.…”