Is it feasible for surgical trainees to acquire JAG endoscopy accreditation by CCT? National online survey of UK trainees

BACKGROUND: Higher surgical trainees often struggle to attain endoscopy competencies. We aimed to obtain a national picture of higher surgical trainees' endoscopy experience, highlight barriers to training, and explore potential solutions. METHODS: A 40-point electronic questionnaire was designed and disseminated to higher surgical trainees across the UK. Anonymous responses were collected and recorded from 26/10/2020 to 11/06/2021. RESULTS: A total of 139 higher surgical trainees from 16 out of the 19 regional UK deaneries responded. 75.9% (82/108) had some endoscopy training, and 19.4% (21/108) had no endoscopic training. 27.8% (30/108) had performed over 200 procedures. 77.8% (105/135) were not made aware of endoscopy training requirements by their Training Programme Directors (TPDs). 59.6% (65/109) had no named endoscopy supervisor. Only 49.1% (53/108) felt supported by their endoscopy trainers. Joint Advisory Group on GI Endoscopy (JAG) certification was infrequent, and the highest levels, 14.4% (15/104), were achieved in oesophagogastroduodenoscopy (OGD). Only 55.8% (24/43) of JAG-certified trainees felt competent in that procedure. 50.0% (7/14) of ST8 (final year trainee) respondents were not JAG certified in any procedure. 90.6% (96/106) faced challenges in gaining endoscopy training. The most common obstacles were the COVID-19 pandemic 87.9% (94/107), on-call commitments 80.2% (85/106), lack of allocated endoscopy sessions 80.2% (85/106), insufficient endoscopy training lists 76.4% (81/106), and competition with non-surgical trainees 64.2% (68/106). CONCLUSIONS: Our survey provides detailed evidence of the challenges faced by surgical trainees in gaining endoscopy training. Suggested solutions include allocated endoscopy trainers, dedicated endoscopy-only training blocks, and early guidance about endoscopy training and certification.