UW General Surgery Technical and Professional Skills

Endoscopy

The UW Surgery Endoscopy Curriculum is designed to meet the requirements of the American Board of Surgery Flexible Endoscopy Curriculum (http://www.absurgery.org/xfer/abs-fec.pdf). This includes didactic content from the Fundamentals of Surgical Endoscopy (FES) as well as your GI rotation and additional endoscopic experience on other clinical rotations including Surgery O, Surgery S, NWH, and the VA.

Fundamentals of Endoscopic Surgery (FES)

FES is a program developed by SAGES (Society of Gastrointestinal and Endoscopic Surgeons) and adopted by the American College of Surgeons.  It is a validated program in endoscopic simulation and will form the core of your endoscopic skills training. Certification (both with a cognitive test and skills test) is considered a ‘high stakes exam’ due to its rigorous validation and is required for Board Certification by the American Board of Surgery (ABS). You will need to pass both tests before February of your R4 year in order to have a completed application for ABS Certification (mailed in April of your Chief year).

Fundamentals of Endoscopic Surgery has two parts: a didactic module (FEC) and technical skills training. The FES exam has a national pass rate of 80% (of examinees pass), so it is strongly recommended that you study for this certification examination.

R1

Complete ABS Flex Endo Curriculum Level I (Cognitive) – Basic understanding of GI diseases and endoscopic GI anatomy

R2

Complete ABS Flex Endo Curriculum Level II (Cognitive) – The cognitive milestones in this level focus on understanding flexible endoscope function, including setup, troubleshooting, and maintenance of the equipment.

  • SCORE Esophagogastroduodenoscopy Module (http://www.surgicalcore.org/modulecontent/130707)
    • Endoscopic history
    • Endoscope structure
    • Advancements in imaging technology
    • Equipment setup, technology, and EGD technique
  • SCORE Colonoscopy
    • Instrumentation
    • Advanced imaging
    • Technique
  • Fundamentals of Endoscopic Surgery (http://www.fundamentals-didactics.com)
    • Module 1: Technology
      • Characteristics of Endoscopes
      • Equipment Setup
      • Troubleshooting
      • Equipment Care
    • Module 4: Upper Gastrointestinal Endoscopy
      • Indications
      • Preparation
      • Diagnostic EGD
      • Complications
    • Module 5: Lower Gastrointestinal Endoscopy
      • Indications
      • Preparation

Complete ABS Flex Endo Curriculum Level III (Cognitive) – Indications and contraindications of upper and lower flexible endoscopy, periprocedural patient management

  • SCORE Esophagogastroduodenoscopy Module (http://www.surgicalcore.org/modulecontent/130707)
    • Basic upper endoscopy
    • Indications
    • Contraindications
    • Assessment and monitoring
    • Technique of upper endoscopy
    • Complications of EGD
    • Diagnostic upper endoscopy
    • Indications
    • Patient preparation
    • Performance of diagnostic EGD with normal anatomy
    • Postoperative stomach anatomy
    • Tissue sampling techniques
  • SCORE Colonoscopy Module (http://www.surgicalcore.org/modulecontent/130830)
    • Steps of procedure
    • Therapy during colonoscopy
  • SCORE Enteral Access
    • PEG
  • FES (http://www.fesdidactic.org)
    • Module 2: Patient Preparation
      • Informed Consent
      • Anesthesia Risk Assessment
      • Bowel Preparation
      • Prophylactic Antibiotic Therapy
      • Management of Anticoagulation
    • Module 3: Sedation and Analgesia
      • Conscious Sedation
      • Medications
      • Recovery
      • Alternative Sedation
      • Small Caliber Endoscopy
    • Module 6: Performing Lower GI Procedures
      • Diagnostic Colonoscopy
      • Rigid Endoscopy
      • Lower GI Endoscopy
      • Important Considerations
    • Module 10: Tissue Removal
      • Resective Techniques
      • Sampling Techniques
      • Ablative Techniques
    • Module 11: Enteral Access
      • Preparation
      • Indications
      • PEG
      • Procedures with PEJ
      • Replacement
      • Complications

R3

Complete ABS Flex Endo Curriculum Level IV (Cognitive & Skills)

  1. SCORE Therapeutic Endoscopy: http://www.surgicalcore.org/videoplayer/510000088
    1. Bleeding
      1. Variceal
      2. Nonvariceal
    2. Neoplasms
      1. Upper GI
      2. Colon
    3. Strictures
      1. Esophageal
      2. Duodenal
      3. Colonic
  1. FES (http://www.fundamentals-didactics.com)
    1. Module 7: Lower GI Anatomy, Pathology, and Complications
      1. Pathology Recognition
      2. Complications
    2. Module 9: Hemostasis
      1. Non-thermal Techniques
      2. Thermal Techniques

Complete ABS Flex Endo Curriculum Level V (Cognitive & Skills)

  1. SCORE ERCP module http://www.surgicalcore.org/chapter/25204#25218
  2. FES http://www.fundamentals-didactics.com
    1. Module 8: Didactic Endoscopic Retrograde Cholangiopancreatography (ERCP)
      1. Indications
      2. Preparation
      3. Performance of ERCP
      4. Complications
      5. Pathology Recognition
    2. Module 12: Endoscopic Therapies
      1.  Dilation
      2. Foreign Body Removal
      3. Transgastric Laparoendoscopy
      4. Choledochoscopy
      5. Intraoperative Endoscopy
      6. Tumor Localization

Global Assessment of Gastrointestinal and Endoscopic Skills (GAGES):

GAGES is a validated technical skills exam.  You will submit your upper and lower GAGES scores to the ABS with your Board application packet.

R4 and R5

Review the Endoscopy Skills Curriculum for the R3 Level