Status of a New Model of ERCP Training in China: A Nationwide Survey of Standardized Training for ERCP Procedure (STEP) Programs

Background and Aims: ERCP training should adapt to the rapid development of ERCP technology and indications. China has a large population and vast land area, but ERCP training resources are insufficient. To make effective use of scarce ERCP training resources, the Standardized Training for ERCP Procedure (STEP) program was launched as a pilot trial. We aimed to report the graduation and competence situations and analyze the predictive factors. Methods: This was a prospective multicenter study from Jan 2015 to May 2021 containing 2 stages: the training program stage and the graduate questionnaire survey stage. The graduation and competence rates were investigated and analyzed. Results: In training stage, 146 trainees completed the training, 113 (77.4%) graduated. The gender ratio (men vs. women) was 6.7:1. The mean age was 40.14±4.13 years. In total, 11 trainees failed institutional mentored training phase (IMTP), 18 failed the practice strengthen training phase (PSTP), and 4 failed the comprehensive theoretical test. In the questionnaire survey stage, the response rate was 92%, of which 76.9% (80/104) achieved competence. ERCP cases performed independently in IMTP (OR=1.129, p=0.025) and ERCP volume in training years (OR=1.018, p=0.026) were predictive factors for graduation. Job title (chief doctor) (OR=78.811, p=0.018) and main practice form of PSTP (independently) (OR=17.062, p=0.031) were predictive factors for competence in available graduates. Conclusions: The STEP achieved an acceptable graduation and competence rate. We gained valuable experience in framework organization and multiple assessment checkpoints. Therefore, this standardized training model is suitable for developing countries with rapid progress in ERCP.Funding: NoneDeclaration of Interest: The STEP program was supported by Boston Scientific Corporation. All funds were independently managed by the organization of STEP program, and Boston Scientific Corporation did not involve in the program. All the authors have no financial relationship that can inappropriately influence this study. None of authors was employee of Boston Scientific Corporation.Ethical Approval: Because this study only involves the questionnaire survey of the trainees and withobservational aim, and no patients involved directly in the study, research ethicsapproval was exempted.