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lets start with a patient case #FGdebate

We opted to resuscitate the patient and wait until next day GI bleeder slot but further call #FGdebate

#FGdebate agree the important information is the response or otherwise to resuscitation

we opted to endoscope immediately,here are the endoscopic picture #FGdebate Would you treat and how?

Yes I have sympathy for this view however if we dont advocate for certification others will do so? #FGdebate

We opted in the case for dual endoscopic therapy with hemostasis,what next? #FGdebate

For me the crucial thing for the endoscopist is the endoscopy report #FGdebate

remember we have the tools to begin the journey to certification #FGdebate are all trainees logging their activity on JETS?

There is good evidence that use of DOPS improves feedback and performance #FGdebate

we cant go on saying this is too challenging! mortality 8-10% in NVUGIB,and we are focussed on endo and colon sign off?? #FGdebate

I think there will be several components The BSG/JAG Upper GI bleeding course should be mandated,one day course hands on already in several training centres in UK #FGdebate

This is the trainees feedback re self reported competance after the course #FGdebate

Trainees need access to dedicated lists for GI bleeding,this will evolve but needs senior support!#FGdebate

remember in an average hospital with 500 admissions with GI bleed per year only 25% will need endoscopic intervention so we need to ensure trainees get access to dedicated training slots not adhoc out of hours on call!#FGdebate Lets prioritise senior trainees?

here is the current status of trainee competancy and exposure to endotherapy modalities,regional variation and poor performance #FGdebate

Actually if we ensure that trainees are rostered to a daily bleeding list,complete DOPS and attend formal training course this can be achieved #FGdebate

When we consider other complex UGI procedures we know trainees who undergo a formal training course and supervised practised can be signed off for independent EMR after 20 cases,so why not GI Bleeding? #FGdebate

Agreed,this is achievable with limited changes to our existing GI bleed management in UK hospitals and support of the wider GI community #FGdebate

I dont agree that competance in UGIB care is a beaurocratic step, When colon competancy was required pre CCT TPD and clinical directors had to find time to allow trainees to achieve this,however inconvenient for GIM service .Why Not AUGIB?#FGDebate

Yes,otherwise we run the risk of coroners courts etc,If we are on a GIB rota we need to be competant and up to date.Many consultants have realise that with new modalities OTSC,Hemostats etc they need upskilled and have attended our courses #FGdebate