Author: Dr Brian Kirkby FRACS, General Surgeon, NSW, RACS Chair, Surgical Gastrointestinal Endoscopy Committee 

The Royal Australasian College of Surgeons (RACS) has continued to take an active role in advocacy for colonoscopy and endoscopy in 2023, working to deliver activities across a range of government, education and peer support initiatives. 

Colonoscopy roundtable

Safer Care Victoria (SCV) hosted a colonoscopy roundtable at the RACS Melbourne office in March 2023. The meeting was attended by 50 in-person attendees and another 30 joined online. A multidisciplinary meeting that brought together surgeons and physicians, participants discussed a wide range of topics including technology, training, audit, recertification, remuneration and under-performance.

A white paper for government is being developed and the College has provided feedback on a preliminary draft. We anticipate the final report will be released later this year.

Renewal of Endoscopy Skills and Training Program

The Renewal of Endoscopy Skills and Training Program—running since February 2023—is tailored to the individual needs of the endoscopist requiring support for recertification or general up skilling in colonoscopy. The program is currently at capacity with 10 surgeon endoscopists contacting RACS for assistance with recertification or support to improve their colonoscopy skills. 

The program is supported by a faculty of seven endoscopists and the participants have been allocated a mentor, with many also having discussion with a faculty member to better understand what support is needed. On-site visits for those who will benefit from hands-on support were scheduled for September and continues to October. The program will be evaluated towards the end of 2023 but with a waiting list of participants and faculty, it is already evident that this program is addressing an unmet need. This is a strong example of the benefit being part of a supportive and collegiate fellowship.

Train the Colonoscopy Trainer workshop

A Train the Colonoscopy Trainer workshop was held on 31 July at Olympus in Melbourne. Convened by Dr Andrew Luck, FRACS, and Dr Cameron Bell, FRACP, the workshop brought together surgical endoscopists from Australia and Aotearoa New Zealand to up-skill in supervising those who are learning colonoscopy. The workshop was sponsored by Olympus and we are grateful for their support in delivering this training.

Conjoint Committee for Endoscopy training

Access to endoscopy training for surgical Trainees can vary from hospital to hospital and from rotation to rotation. The need for proficiency in a wide range of operative procedures impacts the opportunity for general surgery Trainees to dedicate time to endoscopy in comparison to training in gastroenterology.

Founded on the principle of ‘quality endoscopy by quality endoscopists’, RACS is working towards an agreement with the Royal Australasian College of Physicians (RACP) and the Gastroenterological Society of Australia (GESA) to establish a Conjoint Committee in Endoscopy Training (CCET). This committee will ensure all endoscopists are trained to the same standard regardless of their training pathway. Funded largely by the Gastroenterological Society of Australia, the curriculum is expected in 2025.

Position statements – bowel cancer screening

With the incidence of colorectal cancer in Australia and Aotearoa New Zealand among the highest in the world ⁽¹⁾, early intervention is essential for maximising treatment outcomes and survival ^{(2) (3)}. RACS is working to update its existing position paper to ensure it is underpinned by current evidence and promotes best practice.

Reference

(1) Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021; 71: 209-249. 20210204. DOI: 10.3322/caac.21660.

(2) Australian Institute of Health and Welfare. Colorectal and other digestive tract cancers, https://www.aihw.gov.au/getmedia/892d43f7-ab5d-48fe-9969-129f138687f3/aihw-can-117.pdf.aspx?inline=true (2018).

(3) Bowel Cancer New Zealand. Bowel cancer symptoms and statistics, https://bowelcancernz.org.nz/?wpdmdl=10906 (n.d)