FES exam outcomes in year two of a proficiency-based endoscopic skills curriculum

Background: FES certification is required to sit for the ABS Qualifying Exam. Previous work demonstrated a 40% FES pass rate for residents with standard clinical endoscopy training. After implementing a proficiency-based simulation curriculum, our FES pass rate increased to 87%. The purpose of this study was to monitor the success of our curriculum in its second year. We also hypothesized that residents who took the FES exam within 30 days of their clinical endoscopy rotation would have superior pass rates to residents who waited longer. Methods: PGY4 residents (N = 12) underwent flexible endoscopy training including a 1 month clinical rotation plus proficiency-based simulation training using bench-top models (Trus, Operation Targeting Task) and a virtual reality task on the GI Mentor. Residents that passed FES on their first attempt were compared to residents that did not pass based on number of endoscopies logged, hours spent practicing on simulators, and time elapsed between completing their endoscopy rotation and taking the FES exam. FES total scores and section scores were compared to historical controls. Results: Nine residents (75%) passed FES on their first attempt. Overall, 80% of residents who tested within 30 days of their endoscopy rotation (n = 5) passed FES while 71% of residents who waited longer (n = 7) passed FES (p = non-significant). Residents that passed FES were not significantly different from residents who did not pass based on number of endoscopies logged or hours spent practicing on simulators. Compared to historical controls, scores on loop reduction improved significantly with the new curriculum. Conclusions: FES pass rates decreased during the second year of our curriculum. Based on other literature, our trainees would benefit from higher volumes of endoscopy and/or a more robust proficiency-based simulation curriculum. Scheduling the FES exam in the month following the endoscopy rotation did not significantly improve pass rates.