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

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download