VOLUME 54, NO. 6, 2001 GASTROINTESTINAL ENDOSCOPY 811 This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibli- ographies of the identified articles and from recom- mendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for the appropriate use of endoscopy are based on a critical review of the available data and expert consensus. Controlled clinical studies are needed to clarify aspects of this statement and revi- sion may be necessary as new data appear. Clinical considerations may justify a course of action at vari- ance from these recommendations. This document is intended to provide the princi- ples by which credentialing organizations may cre- ate policy and practical guidelines for granting endoscopic ultrasound (EUS) privileges. For infor- mation on credentialing for other endoscopic proce- dures, please refer to “Guidelines for Credentialing and Granting Privileges for Gastrointestinal Endoscopy” (Gastrointest Endosc 1998;48:679-82). DEFINITION OF TERMS Clinical Privileges: Authorization by a local insti- tution to perform a particular procedure or clinical service. Competence: The minimum level of skill, knowl- edge, and/or expertise derived through training and experience, required to safely and proficiently per- form a task or procedure. Credentialing Process: The process of assessing and validating the qualifications of a licensed inde- pendent practitioner to provide patient care. The determination is based on an evaluation of the indi- vidual’s current license, knowledge base, training or experience, current competence, and ability to per- form the procedure or patient care requested. Credentials: Documents provided after successful completion of a period of education or training as an indication of clinical competence. Endoscopic Ultrasound (EUS): A group of related techniques whereby an endoscope is used to place an ultrasound transducer within the gastrointesti- nal lumen to perform ultrasonography of the wall, wall associated lesions, and of structures surround- ing the gastrointestinal tract. Echoendoscope: A device used to perform EUS consisting of a flexible fiberoptic or video endoscope incorporating an ultrasound transducer in its design. Catheter ultrasound probe: A through-the-scope ultrasound device that allows the insertion of a transducer through the working channel of stan- dard endoscopic instruments to perform endolumi- nal ultrasonography. EUS-guided fine needle aspiration (FNA): Use of EUS for real-time guidance of an aspiration needle into a lesion within or adjacent to the GI tract for diagnostic sampling. PRINCIPLES OF INITIAL CREDENTIALING IN EUS 1. Credentials for EUS should be determined inde- pendently from other endoscopic procedures such as colonoscopy, sigmoidoscopy, esophagogastro- duodenoscopy (EGD), endoscopic retrograde cholangiopancreatography (ERCP), or any other endoscopic procedure. 1 2. Competence in EUS requires both cognitive and technical components. 2,3 3. Appropriate documentation should be required in the determination of competence in EUS. This may include the completion of a formal training program (residency or fellowship) or documenta- tion of equivalent training in other settings. Documentation of continued competence should be required for the renewal of EUS privileges. 1,4 4. After the successful completion of EUS training (as detailed in “Guidelines for Training in Endoscopic Ultrasound” Gastrointest Endosc 1999;49:829-33) the trainee: A. Must be able to integrate EUS into the overall clinical evaluation of the patient. B. Should have sound general medical or surgi- cal training. C. Must have completed at least 24 months of a standard GI fellowship (or equivalent) and have documented competence in routine endo- scopic procedures. American Society For Gastrointestinal Endoscopy Guidelines for credentialing and granting privileges for endoscopic ultrasound