An optimal curriculum for training in endoscopic ultrasound: a summarized evidence-based literature systematic review

Background and Objectives: Endoscopic ultrasound (EUS) training is strongly correlated with procedure quality and improved patient outcomes. However, EUS fellowship curricula and the environment in which training should take place are not well defined. A well-structured training curriculum should aim to establish a universally accepted competence framework before endosonographers are allowed to start independent practice. This systematic review seeks to identify the essential components of an EUS training curriculum, determine the optimal environment for this training, and highlight gaps and inconsistencies in current guidelines. Material and Methods: A comprehensive literature review was performed using different databases (PubMed, Science Direct, Cochrane library, Directory of Open Access Journals, and Google Scholar) using Mesh methodology for keyword search in the field of EUS training and following PRISMA guidelines. Inclusion criteria were review articles, original research articles, international societal guidelines, book chapters, and expert consensus addressing EUS educational aspects published in the last two decades (January 2002–August 2023) in peer-reviewed journals in English. Results: A total of 49 papers were included according to the inclusion criteria in the 20-year period range, from which 31 assessed diagnostic EUS curricula content and 19 any aspect of the therapeutic EUS curricula. The requisites, duration, and/or competence demonstration strategies were addressed in 28 publications, whereas 15 referred to the adequate environment for EUS training. Overall, there was a consensus on the need for a structured, formal EUS curriculum along with standardized and properly supervised training and assessment to ensure competence. Conclusion: The establishment of a structured EUS fellowship curricula should aim to produce competent practitioners, thereby ensuring safe and effective patient-care, uniformly and at the international level. While there is general agreement in the literature on the major aspects of a training curriculum, which we synthesize here, the ideal EUS training context deserves further study and better definition.