Canadian credentialing guidelines for colonoscopy.

1Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, South Carolina, USA; 2Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia; 3Division of Gastroenterology, University of Western Ontario, London; 4St Joseph’s Health Centre, Toronto; 5Division of Gastroenterology, McMaster University, Hamilton, Ontario; 6Division of Gastroenterology, McGill University, Montreal, Quebec Correspondence: Dr David Armstrong, Division of Gastroenterology, Health Sciences Centre 2F55, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario L8N 3Z5. Telephone 905-521-2100 ext 76404, fax 905-523-6048, e-mail [email protected] Received for publication September 6, 2007. Accepted September 7, 2007 Aseries of credentialing guidelines for gastrointestinal endoscopic procedures performed in the management of adult patients has been developed by the Canadian Association of Gastroenterology (CAG) Endoscopy Committee, approved by the Clinical Affairs Committee, and reviewed and endorsed by the Executive Board. In the present article, the CAG suggests specific guidelines for credentialing colonoscopy. It is intended to be read in conjunction with the introductory article that outlines the principles of credentialing (1). The CAG does not credential individuals for colonoscopy; that is the responsibility of the endoscopist’s local institution or facility. The purpose of these guidelines is to provide a framework that will allow organizations to assess the training and competence of applicants to perform colonoscopy as part of the credentialing process for the granting of privileges. Colonoscopy is performed to visualize the colonic mucosa, and can be both a diagnostic and therapeutic procedure; it requires the passage of a specialized endoscope – a colonoscope – via the anus or a colostomy to the cecum and, in some cases, to the terminal ileum. The purpose of the procedure is to document any abnormalities, to take biopsies and perform photographic documentation when appropriate, to remove polyps, or to perform therapy such as stricture dilation or hemostasis, if necessary, while minimizing procedure-related risks such as excessive sedation, cardiorespiratory compromise, bleeding and colonic perforation.