Ionising radiation as a disincentive to training in ERCP: myths, facts and mitigations

There is a striking disparity in the number of male and female hepatobiliary endoscopists in the UK. Numerous factors influence this, but concerns about radiation exposure are a major issue. This concern is shared by both male and female endoscopists but becomes especially relevant to those of childbearing age. Factors contributing to a lack of information and general lack of clarity about radiation include unpredictable radiation doses, significant variations in radiation safety practice, poor recording and analysis of cumulative doses and lack of data on radiation exposure in endoscopy. Improving education around radiation exposure is essential. The aim of this review is to summarise available evidence and provide guidance in this area. It is hoped this will facilitate the entry of women into radiation-associated endoscopy fields like Endoscopic Retrograde Cholangiopancreatography (ERCP) and improve the diversity of the workforce.