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Twitter debate: should upper gastrointestinal bleeding training and certification be formalised?
  1. Vivek Chand Goodoory1,2,
  2. Allan John Morris3,
  3. Andrew M Veitch4
  1. 1 Leeds Institute of Medical Research at St. James’s, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2 Leeds Institute of Biomedical & Clinical Sciences, University of Leeds, Leeds, UK
  3. 3 Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
  4. 4 Gastroenterology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  1. Correspondence to Dr Vivek Chand Goodoory, Leeds Institute of Medical Research at St. James’s, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK; vivek.goodoory1{at}

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With recent recommendations from the Joint Advisory Group (JAG) in Gastrointestinal Endoscopy for training and certification in oesophagogastroscopy,1 flexible sigmoidoscopy2 and colonoscopy,3 this #FGDebate discussed a controversial topic on whether training and certification for upper gastrointestinal bleeding should also be formalised. We were joined by an expert panel consisting of AJM and AMV who are both consultant gastroenterologists with an interest in interventional endoscopy and senior authors of the British Society of Gastroenterology (BSG)-led multisociety consensus care bundle for the early clinical management of acute upper gastrointestinal bleeding (AUGIB).4 This article will summarise and expand on the main discussion points generated from the #FGDebate.

The rationale for a formal certification process

AUGIB is a common medical emergency in the UK with an estimated incidence of 134 per 100 000 individuals, roughly equating to one acute presentation every 6 min and approximately 25 000 annual inpatient hospital admissions.5 Mortality rate following AUGIB remains high at approximately 10% with several nationwide audits revealing suboptimal quality of care.6 7 The 2015 UK National Confidential Enquiry into Patient Outcome and Death (NCEPOD) audit again demonstrated the suboptimal care for those with AUGIB, including poor or unacceptable endoscopic management in 12% of patients.8 Gastroenterologists in the UK are typically expected to undertake periendoscopic and endoscopic management of AUGIB. Despite no formal recommendation from the NCEPOD report on training, the latest curriculum for gastroenterology training published in 2022 highlights the importance for trainees to be able to independently manage patients with AUGIB by the end of their training.9 However, trainees still do not require a formal demonstration …

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  • X @VivekGoodoory, @andymveitch

  • Correction notice This article has been corrected since it published Online First. The first author's name has been amended.

  • Contributors VCG wrote the main draft of the manuscript. AJM and AMV reviewed and edited the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests VCG is a trainee associate editor for Frontline Gastroenterology.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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