Questionnaire - EBGH
GASTROENTEROLOGY & HEPATOLOGY
CONDITIONS AND DISEASES
COMPETENCIES ACQUIRED
INTERVENTIONAL ENDOSCOPY CURRICULUM
|ENDOSCOPY TRAINING CENTRE: |
|Department: |
|Hospital: |
|GASTROSCOPIES (Diagnostic & Therapeutic): Per Annum |
|COLONOSCOPIES (Diagnostic & Therapeutic): Per Annum |
|ERCP’s: Per Annum |
|ENDOSCOPIC ULTRASOUNDS: Per Annum |
|OTHER ENDOSCOPIC PROCEDURES (List Below): |
| Per Annum |
| Per Annum |
| Per Annum |
| Per Annum |
| Per Annum |
| Per Annum |
|Clinical Supervisor(s): |
|Educational Supervisor(s): |
|Dates Post Acquirement of Basic Endoscopic Competence during which Interventional Endoscopy Training was undertaken: From: _________________ |
|To:__________________ |
| |Number |Formal Competence |
| | |Sign-Off by Supervisor |
| | |Yes/No |
|Stent Placement (Upper/Lower GI) | | |
|ERCP (Total Number) | | |
|ERCP Sphincterotomy (Biliary/Pancreatic) | | |
|ERCP Stent Placement (Plastic/Metal) | | |
|ERCP Gallstone Extraction (Balloon/Dormia ± Lithotrapsy) | | |
|ERCP Rendezvous Procedure | | |
|Percutaneous Transhepatic Cholangiogram | | |
|Muscosal Resection (any GI Organ) | | |
|Muscosal Dissection (any GI Organ) | | |
|Flexible Small Bowel Endoscopy | | |
|Capsule Endoscopy | | |
|Diagnostic and Therapeutic Endosonography (Total Number) | | |
|Endosonography Therapeutic Procedures (Total) | | |
|Endosonography Guided Fine Needle Puncture | | |
|Transluminal Pancreatic Cyst Drainage (EUS Guided) | | |
Other procedures (if any) can be added to the list of competencies
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