Recently, the American Society for Gastrointestinal Endoscopy, the American Association for the Study of Liver Diseases, the American College of Gastroenterology, and the American Gastroenterological Association issued a combined position statement in response to the new guidelines from the American Board of Surgery (ABS) requiring a minimum of 50 colonoscopies and 35 upper endoscopic procedures to be performed by a resident to complete a surgical residency.1 These gastroenterologic societies purport to be concerned about the quality of training after such experience and therefore believe that endoscopy should categorically be removed from surgical training and possibly from surgical practice altogether.1 As educators of the next generation of surgeons, we are bewildered by the position of this alliance. We wonder if motives other than competency and patient safety underlie their statement. For critical analysis, one must address 3 intertwined issues: the rationale for this statement, adult learning theory, and endoscopic privileging in clinical practice.
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