How many colonoscopies should a doctor perform to reach "minimal competency"?
Mayo Clinic researchers say almost twice as many as once was thought -- on average, about 275, according to a study to be shared at the 2011 Digestive Disease Week in Chicago.
"Current recommendations are that 140 procedures should be done before attempting to assess competency, but with no set recommendations on how to assess it," study author Dr. Robert E. Sedlack, a gastroenterologist with the Mayo Clinic in Rochester, Minn., said in a statement. "Our findings suggest that it takes an average of 275 procedures for a gastroenterology fellow to reach minimal cognitive and motor competency."
Mayo Clinic said that while gastroenterology fellows perform around 400 colonoscopies during training, other specialists, such as surgeons and family doctors, could perform many fewer.
In the study, Sedlack and his colleagues assessed 41 Mayo gastroenterology fellows, who performed more than 6,600 procedures from July 2007 through June 2010, on a test called the Mayo Colonoscopy Skills Assessment Tool, or MCSAT.
The test measures how quickly, safely and painlessly the doctors perform intubations and other actions connected with the procedure. Sedlack said the test was the first tool to provide a detailed assessment of trainees' colonoscopy skills.
Mayo Clinic said the American Society for Gastrointestinal Endoscopy was revising its guidelines to call for more procedures during training and to increase the reliance on quantitative tests.
