Upper GI SURGERY - Logbook requirements

The "transferable competency" of UGI Surgery requires assessed and documented numbers for "Knowledge and Skills". Candidates for the qualification must demonstrate skills in each of the above areas of responsibility and be able to present a complete and signed log-book.

The candidates' individual LOG-books have to fulfill the UEMS criteria. In the LOG-book for each item patient's initials (or hospital admission number), type of procedure, date of procedure and approval with signature by independent expert have to be provided.

The individual LOG-books for the categories A, B and C are scrutinized in the Eligibility I process.

The minimal Eligibility requirement for a UEMS UGI Surg qualification is a proved number of 800 credit points for interventions and / or procedures, endoscopies and operations (categories A + B + C).

For each intervention (A) as principle surgeon /endoscopy (B) as principle surgeon or operation (C) performed by the candidate as assistant 1 credit point is given.

For each operation (C) performed by the candidate as principle surgeon (the principle surgeon is the person who performs the majority of the essential steps of the procedure) 2 credit points are given.

At least 50% of the total number of 800 credit points have to achieved as principle surgeon.

This means, that a total of 400 interventions/procedures/endoscopies/operations (categories A + B + C) are the minimum requirement, when they are all performed as principle surgeon.

	Upper GI	Thorax
A.Interventions, Procedures	n=100	n=100

B.Endoscopies	n=365	n=365

C.Operations (total)	n=315	n=315
Thorax	n=80	n=210
Abdomen (major resections)	n=210	n=80
Minimal invasive endoscopical procedures	n=25	n=25

For pragmatic reasons provisional arrangements are provided (see below: "Provisional arrangements") to enhance the qualification until complete European harmonization of surgical training is achieved.

These provisional arrangements allow a range of different compensations to consider various national and/or individual situations.

SOP: Provisional arrangements

Category A and B: The 60% rule

The total number of 280 credit points for the Categories A and B resp. is mandatory. Within the Categories A and B at least 60% (e.g. ex. 36 MDT and 190 gastroduodenoscopies) have to be reached.

Category C: The 75% Rule

The total number of 400 credit points (category C) is mandatory. At least 200 points in cat. 1 B, 1 C and 2 A as principle surgeon. Within each of the 3 subcategories stated under C the particular total number has to be reached at least to 75%. Numeric deficits in one or more subcategories have to be compensated by higher numbers in other groups.

Category A: Interventions & Procedures

If the candidate is not able to present a detailed LOG-book on category A or B "Interventions, Procedures and Endoscopy" a formal confirmation signed by 2 independent experts about the candidates experience in this category may be accepted. In this case the minimum number (n=280 credit points) for category A/B has to be supplemented in category C.

Category B: Flexible Endoscopy

If flexible endoscopy is not performed by the UGI in a specific country, category B may be omitted for the individual candidate. In this case the minimum number (n=220 credit points) for category B has to be supplemented in category C

Catalogue of Interventions, Procedures, Endoscopies & Operations

	Thorax / Upper GI
Category A: Interventions, Procedures (principal surgeon=1)	n=100
Thoracal and abdominal sonographies, inclusive of eFAST, pleural drainage aso	n=15
Teaching experience on specialist level in UGI approved Environment, specialist level (1 hour = 1 credit)	n=15
Approved theoretical and practical courses (one whole course = 3 credits)	n=10
Upper GI MDT presence as chair	n=60

Category B: Endoscopy (principal surgeon=1)	n=365
Flexible esophagogastroduodenoscopy	n=315
EUL / EBUS (attended as assistant)	n=10
Bronchoscopy / ERCP / mediastinal endoscopic procedures (attended as assistant)	n=20
Endoscopic interventions (e.g. polypectomy, sclerotherapy, foreign body removals, dilatation, termal ablation, PEG)	n=20

	Upper GI	Thorax
Category C: Operations (principal surgeon=2, assistant=1)	n=315	N=315
Thorax
Thoracotomy (open and close) (at ex. Oesophageal surgery, re-operations)	N=20	N=20
Oesophagus resections (e.g. oesophagus resection; conduit preparations). At least 40 in patients with malignancies as principle surgeon and 40 transthoracic procedures	N=80	N=80
VATS, diaphragmatic repair, sternotomies, oesophageal disruptions, reflux operations, lung resections aso	N=20	N=130
Abdomen
General abdominal (e.g. Laparotomy/Laparoscopy, re-operations, gastroenteroanastomosis, jejunostomies, bariatric procedures, reflux operations, hiatal hernia, intestinal obstruction)	n=130*	N=20*
Liver, spleen, pancreas (e.g. dissection, organ injury, resection)	n=20	N=20
Large bowel (e.g. colon resection, conduit preparation, colostomy)	n=10	N=10
Abdominal wall (e.g. incisional hernia)	n=10	N=10
Endoscopical procedures
Minimal invasive intraluminal surgery (gastric GIST, EMR, RFA, stents)	N=25	N=25

Procedures done during CCST in surgery or Thoracic Surgery may account

The catalogue may be revised anytime according to UEMS decisions.

Should include 10 reflux operations

LOGBOOK

Lars Bo Svendsen, DMSci
Chairman, MJC Upper GI Surgery

Toni Lerut, MD, PhD
Co- chairman, MJC Upper GI Surgery (thorax)

Philippe Nafteux,MD,PhD
Chairman of he UEMS Board of Upper GI Surgery

Username
Password