Bronchoscopic Training and Practice in Australia and New Zealand Is Inconsistent With Published Society Guidelines

Background: The Australasian practice and training in bronchoscopy has not previously been reported and procedure volumes among Australasian respiratory consultants and trainees are unknown. We surveyed the current practice of flexible bronchoscopy in Australasia and determined adherence to published recommendations. Methods: Adult physician and trainee members of the Thoracic Society of Australia New Zealand (TSANZ) were e-mailed a web-link to an online survey. Survey responses were benchmarked against TSANZ recommendations. Results: The response rate was 42% overall and 78% among trainees. Forty-nine percent of consultants performed less than the recommended 50 procedures per year. Sixty percent of trainees were unlikely to achieve the recommended 200 supervised bronchoscopies during training. Less than 20% of trainees received adequate training in advanced bronchoscopic techniques such as transbronchial lymph node aspiration. The majority of physicians performing such advanced techniques were not performing sufficient numbers to satisfy published recommendations. Conclusions: A large proportion of Australasian bronchoscopists do not meet "numbers-based" recommendations. This empirical data support the 2012 TSANZ interventional guidelines' call to move beyond procedural volume as the sole determinant of technical competence. There is an urgent need to explore alternative means of developing and defining bronchoscopic proficiency.