Training in Laser Bronchoscopy and Proposals for Credentialling: Proposals to Improve Training and the Ongoing Practice of Laser Bronchoscopy (Part 1)
At the present time, in my opinion, there are enough physicians in the United States who have completed continuing medical education courses in laser bronchoscopy and are applying what they have learned in their practices. Centers which have offered two- to three-day laser bronchoscopy courses should strongly consider discontinuing this type of course, as we have done.
Hospitals where laser bronchoscopies are done should, through their laser and credentialling committees, annually review the experience of physicians performing laser bronchoscopy. This should include the development of caseload criteria to renew a physicians privileges to continue laser bronchoscopy, as well as a critical review of benefit to the patients and the complications incurred.
Professional societies, such as the American College of Chest Physicians, should develop and publish guidelines for training and competency in laser bronchoscopy, much as they did for endoscopy and fiberoptic bronchoscopy. While organizations such as the American Board of Internal Medicine have not sought to dictate the number of times a procedure must be done to assure competency, they have indicated a desire that procedures should be applied for the patients benefit. Others have suggested a probationary period (three to six months) under the supervision of a trained laser-experienced bronchoscopist in order to acquire the necessary experience in the performance of laser procedures.