CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(03): E268-E275
DOI: 10.1055/a-2017-3827
Original article

Who will excel in advanced endoscopy? A study assessing the criteria and perceptions of experts with regard to selection of ERCP and EUS trainees

Sara Campos
1   Champalimaud Foundation, Gastroenterology department, Digestive Unit, Lisbon, Portugal
2   Université Libre de Bruxelles, Brussels, Belgium
Jacques Devière
1   Champalimaud Foundation, Gastroenterology department, Digestive Unit, Lisbon, Portugal
2   Université Libre de Bruxelles, Brussels, Belgium
3   Gastroenterology, Hepatopancreatology and Digestive Oncology department, Erasme Hospital, Belgium
Marianna Arvanitakis
2   Université Libre de Bruxelles, Brussels, Belgium
3   Gastroenterology, Hepatopancreatology and Digestive Oncology department, Erasme Hospital, Belgium
› Author Affiliations


Background and study aims Training program directors (TPDs) and experts play a crucial role in selecting ERCP/EUS trainees and determining the workforce in endoscopy. Additionally, prospective trainees should know what TPDs/experts expect from them. Nonetheless, the criteria and perceptions used in this selection have not been clarified. The aim of this study was to identify TPD/expert values/beliefs regarding personal attributes needed for selecting trainees that can excel and those which may lead to disqualification; compare perspectives between TPDs/experts and trainees regarding the selection process and critical trainee characteristics; and investigate the general approach and satisfaction regarding current application process for ERCP/EUS training.

Methods We conducted a web-based survey to collect general opinion and data regarding the application process and trainee selection and disqualification from training. European TPDs/experts and trainees were invited to participate.

Results Thirty-six TPDs/experts and 25 trainees from 18 countries responded. The application process is mainly driven by individual request (86.1 %). Almost half of TPDs/experts felt only moderately (38.9 %) to slightly (8.3 %) satisfied with the current application process. TPDs/experts value a diversity of trainee characteristics, but mainly traits such as “honesty,” “being a team player,” and “self-awareness” (72.2 % each). Technical skills ranked seventh as considered “extremely important.” “Disregard for patient welfare” and “lack of work ethic” were the most common reasons for disqualification. TPDs/experts and trainees agreed in most questions.

Conclusions This survey outlines trainee selection criteria for ERCP/EUS training. Non-technical skills are the most valued by TPDs/experts. While knowledge and technical expertise are clearly important, understanding that professional attitudes are highly regarded may help direct the application process more effectively.

Supplementary material

Publication History

Received: 24 June 2022

Accepted after revision: 17 November 2022

Article published online:
23 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Johnson G, Webster G, Boškoski I. et al. Curriculum for ERCP and endoscopic ultrasound training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2021; 53: 1071-1087
  • 2 Kochman ML. Third-tier fellowship training: advantages and program selection. Gastrointest Endosc 2005; 61: 427-428
  • 3 Keswani RN, Qumseya BJ, O’Dwyer LC. et al. Association between endoscopist and center endoscopic retrograde cholangiopancreatography volume with procedure success and adverse outcomes: a systematic review and meta-analysis. Clin Gastroenterol Hepatol 2017; 15: 1866-1875.e3
  • 4 Gibson KS, Muffly TM, Penick E. et al. Factors used by program directors to select obstetrics and gynecology fellows. Obstet Gynecol 2012; 119: 119-124
  • 5 Grabowski G, Walker JW. Orthopaedic Fellowship selection criteria: a survey of fellowship directors. J Bone Joint Surgery 2013; 95: e154
  • 6 Benzon HA, De Oliveira GS, Jagannathan N. et al. Selection of subspecialty fellows in anesthesia for pediatric anesthesia: a national survey of program directors in the United States. Paediatr Anaesth 2015; 25: 487-491
  • 7 Shantha JG, Shulman B, Gonzalez M. et al. American Society of Ophthalmic Plastic and Reconstructive Surgery Fellowship Survey: Fellows Selection Criteria for Training Programs. Ophthal Plastic Reconstruct Surgery 2013; 29: 428-430
  • 8 Nies MS, Bollinger AJ, Cassidy C. et al. Factors used by program directors to select hand surgery fellows. J Hand Surgery 2014; 39: 2285-2288.e5
  • 9 Dijkhuizen K, Bustraan J, van den Bogaard MED. et al. Values and beliefs on trainee selection: What counts in the eye of the selector? A qualitative study exploring the program director’s perspective. Medical Teacher 2020; 42: 1179-1186
  • 10 Anderson J, Lockett M. Training in therapeutic endoscopy: meeting present and future challenges. Frontline Gastroenterol 2019; 10: 135-140
  • 11 Selber JC, Tong W, Koshy J. et al. Correlation between trainee candidate selection criteria and subsequent performance. J American Coll Surgeons 2014; 219: 951-957
  • 12 Lieberman D. How to select a mentor as a trainee and junior faculty. Gastroenterology 2016; 151: 17-19
  • 13 Jovanovic I, Mönkemüller K. Quality in endoscopy training—the endoscopic retrograde cholangiopancreatography case. Ann Transl Med 2018; 6: 264-264
  • 14 Flin R, Maran N. Identifying and training non-technical skills for teams in acute medicine. Qual Saf Health Care 2004; 13: i80-84
  • 15 Helmreich RL, Merritt AC, Wilhelm JA. The evolution of Crew Resource Management training in commercial aviation. Int J Aviat Psychol 1999; 9: 19-32
  • 16 Flin R, Patey R, Glavin R. et al. Anaesthetists’ non-technical skills. Br J Anaesth 2010; 105: 38-44
  • 17 McCulloch P, Mishra A, Handa A. et al. The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care 2009; 18: 109-115
  • 18 Hitchins CR, Metzner M, Edworthy J. et al. Non-technical skills and gastrointestinal endoscopy: a review of the literature. Frontline Gastroenterol 2018; 9: 129-134
  • 19 Ravindran S, Thomas-Gibson S, Murray S. et al. Improving safety and reducing error in endoscopy: simulation training in human factors. Frontline Gastroenterol 2019; 10: 160-166
  • 20 Siau K, Dunckley P, Feeney M. et al. ERCP assessment tool: evidence of validity and competency development during training. Endoscopy 2019; 51: 1017-1026
  • 21 Wood M. Maintaining and fostering the future success of academic anesthesia: recruiting and training the next generation of academic anesthesiologists. Anesth Analg 2013; 116: 1-3