Current Status and Unmet Needs of EUS Education in Japan: A Nationwide Survey Focusing on Screening EUS, EUS-Guided Sampling, and Interventional EUS

Abstract

Objectives

Endoscopic ultrasound (EUS) plays a central role in the management of pancreaticobiliary diseases. However, EUS training in Japan remains highly dependent on the experience and educational capacity of individual institutions and supervisors, and the nationwide status of EUS education has not been comprehensively evaluated. This study investigated the current status and unmet educational needs of EUS training in Japan through a nationwide survey.

Methods

An anonymous nationwide questionnaire was distributed to 120 institutions performing EUS across Japan through the investigators’ professional network. Institutions routinely performing diagnostic and/or therapeutic EUS were invited to participate in the survey. Survey items included institutional characteristics and educational practices related to screening EUS, EUS-guided sampling, and interventional EUS (I-EUS). Data regarding annual procedure volumes, criteria for trainee initiation, training systems, and educational challenges were collected.

Results

In total, 114 institutions participated. Median annual procedure volumes were 510 for screening EUS, 135 for EUS-guided sampling, and 25 for I-EUS. The number of supervising physicians increased with procedural complexity. Most institutions reported that I-EUS was performed by physicians with >10 years of clinical experience. Criteria for trainee initiation varied substantially among institutions, and no standardized educational pathway was identified. Major challenges included limited case volume, concerns regarding adverse events, and a lack of simulation-based training resources. Only three institutions reported permanent access to dedicated phantom models.

Conclusions

EUS education in Japan remains largely apprenticeship-based, with considerable interinstitutional variability. Standardized curricula, objective competency assessment, and simulation-based training systems are needed to optimize future EUS education.