Evolution of gastroenterology training.

There have been rapid developments in gastroenterology (GE) over the last decade. Up until the late 1980s, GE-training was incorporated in Internal Medicine training. The introduction of endoscopy has necessitated the need for additional training. Around the world different national boards have developed their own curricula which will be discussed in this paper. Emphasis will be placed on the curriculum recently introduced in The Netherlands. The internal medicine component has become a two-year requirement (Common Trunk) and the duration of training in GE has been extended to four years. Because of the growing complexity of GE, there are now four subspecialties: Interventional Endoscopy, Neuromotility, Oncology and Hepatology that trainees can choose from. These subspecialties each have predefined specific requirements. The World Gastroenterology Organization has drawn up a standard curriculum which can be of help to the boards in different countries. The curriculum emphasizes the knowledge and skill components. The curriculum also defines the training recommendations, the requirements of training facilities and competence evaluation of fellows and facilities, while less is said about research, finance and the number of gastroenterologists required. In the coming decades the curriculum will need to be revised continuously. Personalization of the curriculum will be the next challenge for the years to come.