• ENDOSCOPY

Accreditation standards from the Joint Advisory Group (JAG) on gastrointestinal (GI) endoscopy require endoscopists to obtain JAG certification prior to performing procedures independently.1 This process includes trainees completing a JAG certified procedure-specific basic skills course, which widens knowledge base, provides simulation work and patient-facing training procedures. This is led by specialist training faculty within JAG certified endoscopy regional training centres (RTCs). Endoscopy training is then completed within the trainees’ base endoscopy units through a process of acquisition of minimal procedure numbers, attainment of relevant key performance indicators (KPI) and formative and summative assessments. Since the establishment of JAG in 1994 and the JAG Endoscopy Training System in 2011, the benefit of a standardised certification process and maintenance of nationally set quality standards during the early post-certification period of independent practice and beyond has been demonstrated.2 Large-scale national audits demonstrate attendance at JAG-based courses result in improvement in KPIs including adenoma detection rates, polyp retrieval and biopsy practice.3 The current portfolio of JAG endoscopy courses comprises 10 types of basic skills courses, 9 skills improvement courses and 4 endoscopy trainer courses.4 While these courses are essential for trainees and trainers to develop and maintain high-quality patient care, there are a number of financial considerations that should be taken into account (table 1).

The mandatory JAG basic skills gastroscopy course runs as a 2-day course. Day 1 combines interactive lecture-based teaching with trainer facilitated sessions on scope handling, endoscopy ergonomics and training on upper GI simulation models. The second day is patient facing hands-on sessions, which take place across two endoscopy rooms. To optimise learning, endoscopy lists are reduced from 44 patients to 30 patients across two …