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Is Supply Exceeding Demand in Advanced Endoscopy?

Most 2020 fellows reported difficulty finding a job, which may be due to an overabundance of trainees compared to positions available.

Interest in advanced endoscopy training is growing among new gastroenterologists the U.S.

But is the supply of advanced endoscopy trainees exceeding the country’s clinical needs?

A new report from the American Society of Gastrointestinal Endoscopy (ASGE) found a majority (70 percent) of newly trained advanced endoscopists believe their upcoming caseload will predominantly not be endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) procedures.

Rather, after a year of fellowship where most trainees performed more than 300 of each of these procedures, 2020 fellowship graduates estimated less than 50 percent of their first job’s caseload would be considered advanced endoscopy.

“This likely reflects the lack of a clinical need for full-time advanced endoscopists in clinical practice, again suggesting an oversupply of advanced endoscopists in the United States,” the report from ASGE notes.

The ASGE collected fellowship match data between 2012 and 2020 and survey responses from 64 GI endoscopists who completed fellowship in 2020 for its report.

Overall, the society concluded that while interest in a career in advanced endoscopy has been steadily rising since 2012, further assessment is needed to understand the true need for physicians to perform these advanced endoscopy procedures in the future. Approximately half a million ERCPs are performed annually in the U.S., according to current data from the U.S. Food and Drug Administration.  

Key Findings, Trends 

ASGE has provided a fellowship match for advanced endoscopy since 2012. The program remains competitive, with approximately 1.5 applicants for every available position. There were 104 applicants for 63 available positions in 2020, according to the report.

Men comprised a majority of advanced endoscopy matches in 2020, with only 19 percent of accepted fellows being female.

While interest has grown, the number of advanced endoscopy trainees remains a small fraction of gastroenterologists, according to the report. ASGE-sponsored match programs for advanced endoscopy make up only 12 percent of those available for all gastroenterologists through the society.

Most 2020 fellows reported difficulty finding a job, which may be due to an overabundance of trainees compared with available positions. The COVID-19 pandemic was not considered a factor in job search difficulty.

The ASGE report also cited a survey of 41 advanced endoscopists who completed fellowship between 2009 and 2013. Most (78 percent) reported they believed the market for advanced endoscopists was saturated and almost three-quarters said they found it difficult to secure a therapeutic endoscopy position post-fellowship.

Still, 97 percent of those advanced endoscopists would choose the same career path if given the choice to do it again.

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