GI Unit Leadership: Shaping a High-Performing Endoscopy Unit (On-Demand) | February 2026-ASGE guideline

ASGE guideline_privileging credentialing proctoring

Pdf Summary

The American Society for Gastrointestinal Endoscopy (ASGE) Standards of Practice Committee has developed comprehensive guidelines for privileging, credentialing, and proctoring clinicians performing gastrointestinal (GI) endoscopy. The aim is to promote high-quality patient care and safety by establishing a standardized framework to evaluate endoscopist competency across all major endoscopic procedures.<br /><br />Key principles include documenting adequate training and cognitive and technical competence specific to each endoscopic procedure or skill set before granting privileges. Competency should be assessed with objective criteria and direct observation rather than relying solely on a minimum number of performed procedures, though threshold procedure volumes are suggested as a baseline. For example, competency assessment is recommended after 130 esophagogastroduodenoscopies (EGDs), 275 colonoscopies, 200 ERCPs, and 225 endoscopic ultrasound procedures.<br /><br />Separate credentialing is required for major therapeutic techniques such as endoscopic mucosal resection, endoscopic submucosal dissection, ablative therapies, enteral stent placements, and deep enteroscopy. The guidelines stress that minor skill acquisition may be accomplished via focused courses and practical exposure, while major new skills require formal training, preceptorship with experienced instructors, and documentation of competency.<br /><br />Proctoring—independent assessment by a credentialed endoscopist—is recommended particularly for applicants seeking new privileges, staff undergoing recredentialing, or those flagged for quality concerns. Proctors observe technical skills and patient management without direct intervention unless patient safety is compromised.<br /><br />Recredentialing processes, ideally every 2–3 years, must include ongoing quality monitoring, performance data review, continued education, and mechanisms for remediation if competency declines.<br /><br />The guidelines emphasize uniform credentialing standards across specialties and institutions, proposing that quality improvement efforts and adherence to surveillance protocols contribute to reducing adverse outcomes, such as postcolonoscopy colorectal cancer. The document highlights the importance of a culture of quality, continuous learning, and objective competency assessments to ensure safe and effective GI endoscopy practice.

Keywords

ASGE

gastrointestinal endoscopy

credentialing

privileging

proctoring

competency assessment

endoscopic procedures

quality assurance

recredentialing

patient safety