“Gastrointestinal Endoscopy: Time for Change”

In the thirty years since the flexible fibreoptic gastroscope was introduced, gastrointestinal (GI) endoscopy has undergone a spectacular evolution. The explosion in technology and an ever-increasing demand for procedures has left us poorly equipped to provide the quantity and quality of endoscopy required now and into the next century. With increasing sophistication, the risks of GI endoscopy have become appreciable, particularly in therapeutic procedures. These risks can only be contained by adequate training and experience. The present system of higher training in gastroenterology serves endoscopy badly: there is no structure for developing a career interest in GI endoscopy. This is a waste of limited financial and human resources. GI endoscopy should be identified as an area of gastroenterology requiring additional training. New teaching tools such as computer simulation may provide opportunities to learn endoscopy without patient involvement. Research in GI endoscopy, which has been neglected, should be actively encouraged.