Training should include formal instruction in:

• The indications and contraindications for each endoscopic procedure
• Obtaining informed consent
• Communicating endoscopic findings and their implications to patients, relatives and carers
• Providing a high standard of written reports and communications with other colleagues
• Communicating bad news, including discussing complications of endoscopy
• The technique of conscious sedation, and the avoidance and management of sedation-related complications
• The skills of endoscopy
• The causes, prevention, recognition, management and avoidance of endoscopy-related complications.

Therapeutic endoscopy should be taught only after adequate skills for diagnostic procedures have been acquired. Procedures should be carried out only under supervision until competence is achieved, and has been formally assessed by the JAG process. JAG is currently developing assessment tools for upper GI therapeutic procedures. Until these tools are developed, responsibility for allowing trainees to perform therapeutic gastroscopy independently is now under the remit of individual endoscopic unit’s governance processes.

Trainees should have wider knowledge of issues related to endoscopy, including surveillance protocols, the implications of findings at endoscopy, and the range of treatment options, or have ready access to such information within the unit.

Educational supervision

Trainees are required to participate in regular endoscopic appraisal as well as supervised training.

They should regularly seek formative assessments that contribute to their portfolio.

They should have a formal summative assessment prior to practising independently as outlined in the JAG Certification Requirements. Use of the specific formative DOPS assessment forms is strongly recommended to provide a portfolio of assessed cases.

The JETS e-portfolio has now “gone live” and a process of roll-out has begun. National coverage is expected in early 2011. Until September 2011, the trainee can choose to use the paper-based certification process. From September 2011, all applications for JAG certification will need to be submitted through the JETS e-portfolio.

Trainees must ensure they have adequate supervision at all times, for procedures that they have not yet gained a certificate of competence in. For trainees, this means a supervisor in the room until Provisional JAG Certification (where applicable), or in the Unit until Full JAG Certification.

Trainees should not undertake independent endoscopy unless formally assessed as competent (JAG Certification) by two assessors.