Published online Jul 21, 2019. doi: 10.3748/wjg.v25.i27.3468
Peer-review started: February 27, 2019
First decision: May 9, 2019
Revised: May 16, 2019
Accepted: June 23, 2019
Article in press: June 23, 2019
Published online: July 21, 2019
Processing time: 142 Days and 20.8 Hours
Core tip: An additional, optional year of endoscopic-retrograde-cholangiopancreatography (ERCP) training was added because of limited ERCP exposure during standard-three-year-gastrointestinal-fellowships and its greater endoscopic technical difficulty. Yet, many graduates from standard-three-year-fellowships intensely pursue ERCP privileges despite inadequate numbers of ERCPs, or low successful duct cannulation rates. Hospital credentialing committees have sometimes disregarded recommended ERCP credentialing guidelines. Consequently, some gastroenterologists learn ERCP “on the job”, after completing standard GI fellowships, during unsupervised practice. National, mandatory, standards for ERCP are advocated, including number (≥ 200-250) of performed ERCPs, and ≥ 85%-90% successful cannulation rate. An independent entity should oversee ERCP credentialing to prevent politicking within hospital committees.