The Accreditation in Endoscopy Society of Pakistan: The Case for Training Standards

As the need for quality assurance in the provision of endoscopy services was felt increasingly across the globe, various training assessment and accreditations bodies such as the Joint Advisory Group (JAG) in the United Kingdom were established. JAG introduced JAG Endoscopic Training System (JETS), an e-port-folio and accredited endoscopy courses. Its remit also included standardization and accreditation of endos-copy facilities. Together, these measures redefined the landscape of endoscopy training and practice standards in the UK and beyond. In Pakistan, post-graduate trainees learn to perform endoscopy during their fellowship in gastroenterology, where an “apprentice-mentor" method is used with no agreed national standard for evaluation. This review article used databases, published literature, endoscopic guidelines and a large number of research journals to find out the latest evidence for evolution in endoscopic training procedures and emphasises the need of developing a national agency for endoscopy training, certification and accreditation in Pakistan. The comparison of different training techniques suggests that the incorporation of simulation based training in the early phases of endoscopic training along with mandatory patient-based training is a good combination. The training should involve deliberate practice with gradual acquirement of needed skills, based on teaching, feedback and debriefing and contextual learning. In view of the need for quality assurance, Pakistan should establish an inter-agency training and accreditation group. The group's aims would be to formulate a curriculum, give accreditation to mandatory courses, provide an e-portfolio for performance evaluation and establish a means of assessment and certification. The mandatory training courses should be standardised, should involve innovative learning techniques and be independent of clinical discipline of the trainee. Continuous professional development should be