Joshua J Weis, MD, Jordan Grubbs, MD, Daniel J Scott, MD, Kareem R Abdelfattah, MD, Abier A Abdelnaby, MD, Deborah Farr, MD, Sara A Hennessy, MD. University of Texas Southwestern Medical Center
Introduction: In 2014, the American Board of Surgery (ABS) introduced the Flexible Endoscopy Curriculum (FEC). The FEC did not alter the minimum defined category case volumes for endoscopy; however, it did introduce specific cognitive and technical milestones for endoscopy training. It also mandated that residents pass the Fundamentals of Endoscopic Skills (FES) exam to qualify for board certification. Since FEC was announced, significant research has been published regarding residents’ success on the FES exam. However, very little is known regarding how FEC has changed the way general surgery programs train their residents in surgical endoscopy. The aim of this study was to quantify changes in flexible endoscopy education at a large academic program in the four years since FEC was published.
Methods: We classified the impact of FEC into four categories: (a) case volume or distribution, (b) clinical rotations, (c) required didactics and simulation exercises, and (d) FES pass rates. For category (a), we reviewed current and historical case logs for all categorical residents from 2013-2018. Mann-Whitney U tests were used to compare endoscopy volumes for each PGY level in 2013-14 to the respective PGY level in 2017-18 with p<0.05 considered significant. For categories (b)-(d), we gathered historical records from the residency coordinator and endoscopy rotation director.
Results: Complete data were available for 60 residents in the 2013-14 academic year and 56 residents in the 2017-18 academic year. Results are summarized in the table below. Median endoscopies performed by PGY2, PGY3, and PGY5 residents all significantly increased during the FEC rollout. Our program’s focus on endoscopy also expanded with increases in endoscopy rotations, didactics, and simulation exercises. These changes translated into significantly increased pass rates on the FES exam from 40% to 100%.
Conclusions: Implementation of FEC at a large academic program led to measureable improvements in clinical experience, program structure, educational programing, and performance on high-stakes assessments related to flexible endoscopy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95230
Program Number: S012
Presentation Session: Education
Presentation Type: Podium