Intended for healthcare professionals


Basic skills in gastrointestinal endoscopy

BMJ 2011; 343 doi: (Published 11 November 2011) Cite this as: BMJ 2011;343:d7142
  1. Sreedhari Thayalasekaran, locum appointment for training, specialty training year 3, gastroenterology, Royal Berkshire NHS Foundation Trust, Reading, UK
  1. sreethaya{at}

The basic skills in gastrointestinal endoscopy course covers the theoretical and practical aspects of upper gastrointestinal endoscopy and is approved and accredited by the Joint Advisory Group on Gastrointestinal Endoscopy (JAG). It is held in various locations across the country; the JAG Endoscopy Training System website gives specific locations and dates ( I attended the course at the Mersey School of Endoscopy, which is one of the three national endoscopy training centres in England.

The course aims to provide trainees with the skills to perform upper gastrointestinal endoscopy safely. The first two days were spent at the Royal Liverpool Hospital. The third day consisted of hands-on training, with half the delegates at the Royal Liverpool Hospital and the other half at Aintree Hospital. The faculty consisted of three consultants, one nurse endoscopist, and one healthcare assistant.

Who is the course for?

It is for anyone who wants to gain the basic skills to perform endoscopy safely. Delegates on the course included medical and surgical trainees, nurses, interventional radiologists, and general practitioners with a special interest in endoscopy. Individuals had various levels of experience, with some just starting endoscopy and others approaching independent practice. No previous endoscopic experience is necessary, but you must show that you have access to regular endoscopy lists for at least six months after the course. The course is a mandatory requirement for submission to JAG certification for independent practice.

Why did you do it?

I attended this course in March 2011 as a specialist trainee year 3 in gastroenterology, having done endoscopy for eight months. I wanted the opportunity to receive detailed feedback on my technique and areas for improvement. I believed that the course offered such an experience.

What is the course’s structure?

The course is delivered over three days. The first day is spent discussing topics in small group tutorials. A video on how to gain consent is also shown.

On the second day we practised skills on models and the simulator and learnt about blind spots, with a brief review of anatomy.

The third day involved endoscopies on patients and completing assessments; detailed feedback was given.

Lunch is provided as well as tea and coffee throughout each day.

Topics included:

  • Unit planning and operation

  • Informed consent

  • Indications and contraindications

  • Complications

  • Sedation

  • Antibiotic prophylaxis and anticoagulation

  • Scope design, function, troubleshooting, and decontamination

  • Introduction to accessories and biopsy techniques

  • Safety and decontamination

  • Diathermy—basics and safety

  • Complications—prevention and management.

How much does it cost?

The course costs £850. You have to register on the JAG Endoscopy Training System website and then book a course online. To be accepted on the course you need to provide:

  • The completed application form

  • A letter of support from your educational supervisor affirming that the course is appropriate for you and that you have a dedicated training list and will be continuing to train in upper gastrointestinal endoscopy for at least six months

  • A copy of your General Medical Council or Nursing and Midwifery Council certificate

  • A copy of your hepatitis B status

  • Evidence of your current contract.

A certificate of attendance is given, and trainers log your attendance on the JAG eportfolio. Trainers also complete DOPS (directly observed procedural skills) on your eportfolio on the third day after watching you do endoscopies on patients.

How much effort did it entail?

It is mandatory to attend the three consecutive days, which start at 8 30 am and finish at 5 pm. A pre-course booklet is sent to all delegates for preliminary background reading. This is useful, as a lot of the information discussed during the course is in the booklet.

Was it worth it?

Definitely. The range of topics covered through discussion, demonstrations, hands-on practice, and feedback was invaluable. There was plenty of opportunity to ask questions throughout the course and to receive hands-on practice under direct supervision. The faculty members were excellent in giving individual feedback on areas for improvement. My understanding and confidence were greater at the end of the course.

Would you recommend it?

Yes, I would recommend it to trainees in endoscopy as early on in their training as possible. The course gives trainees just starting out greater confidence, knowledge, and skills to perform endoscopies while enabling experienced trainees to perfect their technique. The trainers were all highly skilled, enthusiastic, and knowledgeable and focused on specific learning objectives for each delegate.

Further information

For further information email rlb-tr.MSE{at}


  • Competing interests: None declared.

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