The landscape of advanced endoscopy continues to evolve as new technologies and techniques become available. Although postgraduate advanced endoscopy fellowships have traditionally centered on ERCP and diagnostic EUS, the breadth of training has increased over the years in response to the ever-growing demand for therapeutic endoscopy. The increasing diversity and complexity of emerging endoscopic techniques accompanied by the shift in focus toward competency-based medical education requires innovative changes to the curriculum that will ensure adequate training yet without compromising best patient practices. The purpose of this review is to highlight the expansive array of advanced endoscopic procedures and the challenges of both defining and measuring competence during training. All authors are interventional endoscopists at their respective institutions performing these complex procedures, as well as training fellows in these techniques. We share our perspectives based on our experience navigating through these issues at our institutions and discuss strategies to standardize training and how to potentially incorporate these measures in the process of credentialing and privileging in endoscopy.

随着新技术和新技术的出现，高级内窥镜的前景继续发展。尽管研究生的高级内窥镜研究奖学金传统上一直以ERCP和诊断性EUS为中心，但随着对治疗性内窥镜需求的不断增长，多年来培训的广度有所增加。新兴的内窥镜技术的多样性和复杂性的增加，以及对基于能力的医学教育的关注的转移，要求对课程进行创新性的改革，以确保在不损害最佳患者实践的情况下进行适当的培训。这篇综述的目的是强调先进的内窥镜检查程序的广泛应用以及在培训过程中定义和衡量能力的挑战。所有作者都是在各自机构中执行这些复杂程序的介入性内镜专家，并对这些技术进行了培训。我们根据在机构中处理这些问题的经验分享我们的观点，并讨论标准化培训的策略以及如何在内窥镜检查的资格和特权过程中潜在地纳入这些措施。