Shape of Training Review: an impact assessment for UK gastroenterology trainees

Abstract

BackgroundPhysician training in the UK is undergoing considerable change due to the implementation of recommendations made in the Shape of Training Review. In particular, higher specialty training (HST), including gastroenterology, will be shortened from 5 to 4 years. This will also incorporate general internal medicine (GIM) training. There is concern among gastroenterologists regarding how high-quality gastroenterology training will be delivered in 4 years.MethodsThe 2018 British Society of Gastroenterology (BSG) trainees’ survey results were used to examine the potential impact of a 4-year HST period on achieving key competencies in gastroenterology.Results291 (49.4%) gastroenterology trainees responded. Satisfaction with gastroenterology training was high (79.6% respondents), and self-reported confidence in hepatology training was also high (84% senior respondents). However, only half (51.1%) of the respondents achieved complete colonoscopy certification by their final year of training. Comparison with the 2014 BSG trainees’ survey demonstrated that the number of endoscopy procedures achieved by trainees has reduced in sigmoidoscopy (p=0.006) and colonoscopy (p<0.001). The proportion of time spent in GIM training has increased since the last survey, with 81.8% of the respondents spending more than 25% of their time in GIM. GIM training was reported to be a key barrier to adequate gastroenterology and endoscopy training.ConclusionThese data indicate significant barriers to delivering gastroenterology and endoscopy training within the current 5-year programme. Novel strategies will be required to improve the rate of progression in endoscopy training, in particular if high-quality gastroenterology HST training is to be delivered in 4 years.

The Impact of COVID-19 on Gastrointestinal Endoscopy Training in the United Kingdom

“… 4 The effects of COVID-19 are projected to persist until 2022, 5 coinciding with UK Shape of Training reforms aimed at reducing specialty training from 5 to 4 years. 6 This combination is likely to render minimum procedure numbers unattainable for many trainees. In response, the BSG is actively engaging in multistakeholder dialogue to discuss possible solutions:…”

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“…4 Traditionally, this was already challenging; half of gastroenterology trainees surveyed in 2018 lacked accreditation in colonoscopy as they approached CCT. 5 There also exists a disparity between mandatory CCT requirements and the range of endoscopic skills that should equip a trainee for their consultant jobs. Biswas et al report low levels of confidence in one quarter of senior specialist trainees when asked about endoscopic management of gastrointestinal (GI) bleeding; the effect of COVID-19 on endoscopy training is likely to compound this further.…”

Endoscopy training in the UK pre-COVID–19 environment: a multidisciplinary survey of endoscopy training and the experience of reciprocal feedback

“…There is no formal accreditation for the role of endoscopy trainer other than attendance at the courses, hence previous surveys have shown wide variation in quality of training. 11–13 …”