State of the art lecture: Endoscopic ultrasonography: Training and competence

 

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Endoscopic ultrasonography (EUS) has become an important diagnostic and - recently - also therapeutic tool in gastrointestinal endoscopy, mostly complementary to other primary investigations. Its application in oncology as well as in a variety of benign conditions, the mixture of endoscopy and ultrasound as an imaging technique as well as the complexity of instrument handling to generate adequate visualization have all raised the necessity to define competence and hence design respective training programmes.

The following review shall give an overview on current programmes and the limited evidence of how to define competence and how to organize training. It has to be added that in most other areas of endoscopy with the recent possible exception of colonoscopy, data are scant as well.

Any training and its practical aspects have to be founded on the basis of sound theoretical and clinical knowledge not only of the technique under consideration including its potential complications, but also of the indications of EUS and the incorporation into clinical management of EUS and EUS-FNA as well as associated methods. No training programme whatsoever should only consist of teaching of practical application and technical aspects. Since this is a rather self-evident aspect, this is not dealt with further in the following, also with respect to the fact, that no standardization on the precise content of theoretical teaching exists, but at least clinical evidence can be collected from reviews, metaanalyses and textbooks.

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Prof. Thomas Rösch, M.D.

Central Interdisciplinary Endoscopy Unit

Department of Gastroenterology, Hepatology and Metabolic Diseases

Charité University Hospitals Berlin, Campus Virchow Clinic

Augustenburger Platz 1

13353 Berlin

Germany

Email: Thomas.Roesch@charite.de