Could doing an advance year hurt?

[GastriqueGraffin]

Is it a real concern to complete an advanced endoscopy year of training only to then find the ideal first job (location, salary, partnership, hours, etc) that is looking for a generalist +/- basic ERCPs?

---

Members don't see this ad.

 

[Scope guy]

Advanced gives significant advantage in my opinion in job search. More and more seniors with ERCP certification are retiring. Many private practices dont want ppl doing EUS coz compensation is less, it takes more time, anaesthesia support, etc. you can always negotiate about building an EUS practice(management should be willing to invest in the equipment). Its not completely waste - it makes you more rounded GI and if you really have the passion to be an advanced endoscopist(which I am not), you should do it regardless of the job proposition. there will be a lot of ERCP need going forward

 

[GastriqueGraffin]

Advanced gives significant advantage in my opinion in job search. More and more seniors with ERCP certification are retiring. Many private practices dont want ppl doing EUS coz compensation is less, it takes more time, anaesthesia support, etc. you can always negotiate about building an EUS practice(management should be willing to invest in the equipment). Its not completely waste - it makes you more rounded GI and if you really have the passion to be an advanced endoscopist(which I am not), you should do it regardless of the job proposition. there will be a lot of ERCP need going forward

I agree with the point about ERCPs but along the lines of EUS not being overly profitable, many programs claim to teach balloon enteroscopies, ESDs, EMRs, RFAs, some also do POEMs, bariatric, and miscellaneous stuff. All of which is cool but if even EUS is something that is not guaranteed to be in a job then how much of that can someone expect to use in private practice?

 

[IM2GI]

Is it a real concern to complete an advanced endoscopy year of training only to then find the ideal first job (location, salary, partnership, hours, etc) that is looking for a generalist +/- basic ERCPs?

What environment do you want to practice? It is increasingly difficult to find a good academic advanced job with enough advanced time. On the same token, most community groups do not want to bother with ESD/POEM/Bariatrics. So while basic ERCP skills are valuable most of the "Advanced general" stuff is not that practical outside of major referral centers or a group that will support those kinds of cases.

 

[GastriqueGraffin]

What environment do you want to practice? It is increasingly difficult to find a good academic advanced job with enough advanced time. On the same token, most community groups do not want to bother with ESD/POEM/Bariatrics. So while basic ERCP skills are valuable most of the "Advanced general" stuff is not that practical outside of major referral centers or a group that will support those kinds of cases.

What if my goal is community private practice in a larger group, in a more desirable city/region? I will not have enough ERCPs in fellowship to be able to do them upon graduation. I would be open to learning anything that I can potentially apply in practice (I actually enjoy it) but don’t want to work in an academic/large tertiary care or learn things I’ll never have a chance to use. How would you recommend someone in my position to proceed?

 

[Scope guy]

What if my goal is community private practice in a larger group, in a more desirable city/region? I will not have enough ERCPs in fellowship to be able to do them upon graduation. I would be open to learning anything that I can potentially apply in practice (I actually enjoy it) but don’t want to work in an academic/large tertiary care or learn things I’ll never have a chance to use. How would you recommend someone in my position to proceed?

You should be ERCP certified at the end of advanced year for sure. If you meant you won’t be certified at end of your 3 year fellowship, then ya that’s very common these days due to MRCP. You can do reasonable size EMR in office practice(upto a couple cm). You can learn bravo, capsule, manometry which are feasible to do in your practice setting. Everything else beyond it is tailor made to certain large practices and academic centers. You need a good surgical backup to do a lot of advanced stuff. From what you are telling, advanced year is not gonna add a whole lot except ERCP and to an extent EMR skills