179 Endoscopy Practice Amongst UGI Consultant Surgeons in the United Kingdom & Northern Ireland: A National Survey

Abstract Aim The national endoscopy scene is led by gastroenterologists. Upper Gastrointestinal (UGI) surgeon’s endoscopy training has mirrored the medical equivalent with clear endpoints for accreditation. However, a crisis is looming with workforce challenges, especially for advanced procedures. Our survey interrogated the current expertise of consultant UGI surgeons as well as training opportunities in therapeutic endoscopy. Method We conducted a national 30-question survey disseminated through AUGIS mailing group to UGI consultant surgeons. The process is ongoing and we present a collation from the initial 40 responses. Results The replies spanned 17 deaneries; 53% were benign UGI surgeons with two thirds appointed post-2010. Majority felt that competence in diagnostic and therapeutic endoscopy is essential for benign UGI and OG surgeons but not HPB surgeons. All respondents performed UGI endoscopy - 80% JAG accredited and 50% certified trainers. 68% had a weekly session, but only 35% offered a weekly training list. 75% performed over 100 OGDs yearly and 63% supervised fewer than 100 training OGDs. 85% performed therapeutic endoscopy: 75% - dilatations and stents, 63% - PEG, 33% - haemostasis, 13% - ERCP and 8% - EUS. 40% desired further training in therapeutic endoscopy, with a third experienced discouragement. 63% felt surgeons deserved equal opportunities for training in ERCP/EUS, and majority felt funding of fellowships focusing through provision of service colonoscopy lists discriminated against UGI surgeons. Conclusions The potential for advanced endoscopy delivered by UGI surgeons remains untapped, and despite a willingness, opportunities are limited. We suggest a better national endoscopy strategy of collaboration and parity may avert the crisis.