Provision of ERCP services and training in the United Kingdom

Background and Study Aims: A rising demand for hands-on training in endosco pic retrograde cholangiopancreatography (ERCP) has coincided with a need fo r increased scrutiny of outcomes (clinical governance) and the development of less invasive methods of pancreaticobiliary imaging. We surveyed the cur rent provision of ERCP facilities and training throughout the United Kingdo m. Methods: Questionnaires were sent to senior endoscopists in 252 acute hospi tals and to 500 trainees in gastroenterology. Results: Completed forms were returned from 180 hospitals (a 71% response r ate) and from 233 trainees (a 47% response rate). A median of 210 ERCPs per year are carried out at each centre (range 40-1000), under the supervision of 345 senior endoscopists. ERCP training had been started by 163 trainees (70%), of whom 42 (26%) had been given one or fewer procedures to start pe r week, Trainees rated their training as excellent (25%), good (28%), adequ ate (24%) or inadequate (22%); 193 (83%) perceived that they needed trainin g in ERCP to ensure that future career opportunities were not denied to the m. Conclusions: Some centres have insufficient capacity for training in ERCP, Some form of preselection for both trainers and trainees may be required to ensure that quality is maintained. Gastroenterology training programmes sh ould move away from encouraging all trainees to learn ERCP, and should prom ote the acquisition of alternative skills.