Aimee K Gardner1, Michael B Ujiki2, Brian J Dunkin3. 1University of Texas Southwestern Medical Center, 2Northshore University Health System, 3Houston Methodist Hospital
Introduction: The American Board of Surgery (ABS) has mandated that general surgery (GS) residents complete the Flexible Endoscopy Curriculum, including passing FES. Previous work has shown that up to 30% of graduating GS residents fail the FES exam. Some argue that this is because not all will enter a specialty that requires flexible endoscopy and therefore have not focused on this skill set. The purpose of this study was to investigate if FES pass rates are better in a sample of individuals who have chosen a career in GI surgery and to link FES performance to attitudes and confidence in performing flexible endoscopy.
Methods: Fellows attending the 2016 SAGES Flexible Endoscopy Course were invited to complete the FES manual skills examination. Participants also provided survey responses examining demographics, fellowship type, endoscopy curricula in residency, previous endoscopic case volume, confidence in performing endoscopy, and future practice plans.
Results: Twenty-eight (age: 32.24 ± 3.24; 72% men) fellows completed the FES skills examination. Reported fellowships were MIS/Bariatric (41.4%), MIS (24.1%), Bariatric (13.8%), Flexible Endoscopy (6.9%), Advanced GI (6.9%), and MIS/Bariatric/Flexible Endoscopy (6.9%). Almost half (41.4%) had previously participated in a simulation curricula, with 20.7% completing a didactic endoscopy curriculum. Fellows reported performing an average of 110 ± 109.48 EGDs and 77.44 ± 58.80 colonoscopies. The majority (96.4%) indicated that they will perform endoscopy at least occasionally in practice. Complete FES examination data were available for 25 fellows with an overall pass rate of 60% (60.7% (17/28) received a zero on loop reduction). Previous endoscopy experience did not correlate with overall FES examination scores. However, confidence performing EGDs (r= 0.57, p < 0.01), colonoscopies (r = 0.45, p < 0.05), polypectomy (r = 0.52, p < 0.01) and PEGs (r = 0.46, p < 0.05) did. Additionally, 40% of those individuals who indicated they would implement flexible endoscopy frequently or very frequently (N=15) into practice failed the examination.
Conclusions: These data support existing research suggesting that current flexible endoscopy training in residency may be insufficient for trainees to pass the FES examination, and that failure rates hold true even for this select group of trainees who have chosen a profession in GI surgery and intend to use endoscopy in practice. Interestingly, self-confidence in performing these procedures correlates with FES success. These results suggest that GS residents planning to enter a GI surgery specialty should use more of their elective time honing their endoscopic skills.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80906
Program Number: S062
Presentation Session: Education, Simulation and Assessment
Presentation Type: Podium
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