The current state of colonoscopy training in family medicine residency programs

Background and Objectives: The US Preventive Services Task Force has recommended that all adults ages 50 and over be screened for colorectal cancer Colonoscopy is the most accurate screening procedure, but the feasibility of colonoscopy as a screening tool is limited by the number of physicians trained to perform it. This study determined the current state of colonoscopy training in US family medicine residency programs. Methods: We surveyed program directors of all Accreditation Council for Graduate Medical Education-approved family medicine residency programs regarding colonoscopy training. Results: The response rate was 94% (426 of 455). Forty-eight percent (n=201) of directors reported that their program offered colonoscopy training, but only 18% (n=75) of all respondents had actually trained one or more residents to do colonoscopies. Nationally, the mean number of colonoscopies performed per resident was 42.6 +/- 3.9. Regional differences were reported; residents trained in the western United States performed a mean of 69.8 +/- 12.8 colonoscopies per resident. Gastroenterologists in hospital-based gastroenterology suites trained approximately 75% of family medicine residents. Fifteen percent (n=64) of directors reported that 133 (4%) of their July 2002 graduates sought credentials to perform colonoscopy. Conclusions: Only a minority of family medicine graduates seek credentials to perform colonoscopy, and significant regional differences in training exist.