Colonoscopy was historically a dual certification pathway process, but following an evidence review
in 2022, JAG colonoscopy certification is now awarded following a single pathway process.
Note – even after achieving full certification, JAG recommends that all endoscopists should continue
to seek further training on dedicated training lists as part of their ongoing personal development.
Certification application criteria
The certification criteria is shown in the table below. The previous three months of data that are
recorded on the JETS e-portfolio will be used to calculate the procedural data.
*>200 if certified in flexible sigmoidoscopy
**Excludes rectal/rectosigmoid hyperplastic polyps
JETS will generate a reflection tool following every 50 procedures that are performed. An action to
complete will appear on the user’s dashboard when a reflection tool has been generated. For further information about reflection tools, refer to the separate reflection tool guidance on the JAG
website.
Once a trainee has met the criteria above, they are required to complete 4 summative DOPS forms.
The summative DOPS must be completed within 1 month. The applicant must score ‘competent for
independent practice’ for all 4 summative DOPS.
Once completed, the portfolio needs to be reviewed and signed off by the trainee’s training lead.
Once approved locally, it will need to be approved by the JETS national assessors.
Further information
Polypectomy
Trainees will be expected to have been assessed in their polypectomy skills. When a polyp is
identified, the trainer should join the trainee, observe/train on polypectomy followed by the
completion of a DOPyS. A DOPyS is a DOPS form created specifically to assess polypectomy. It can be
found in the DOPS sections of the JETS e-portfolio. DOPyS can be completed during either flexible
sigmoidoscopies or colonoscopies.
In order to be fully certified, a candidate must demonstrate they can satisfactorily remove a
minimum of two stalked polyp, two cold snare, and two small sessile lesion/EMR all of level 1. They
must also demonstrate they can satisfactorily remove a minimum of two stalked polyp, two cold
snare, and two small sessile lesion/EMR all of level 2.
DOPyS level are calculated using the SMSA scale. This uses size, morphology, site and access as a rating scale to calculate the level. Four polyp SMSA levels are available, Level 1 (4–5 points), Level 2 (6–9 points), Level 3 (10–12 points) and Level 4 (>12 point)
Points are awarded as follows (points for each are shown in brackets):
Size: <10mm (1), 10-19mm (3), 20-29mm (5), 30-39mm (7), >40mm (9)
Morphology: Pedunculated (1), Sessile (2) Flat (3)
Size: Left (1), Right (2)
Access: Easy (1), Difficult (3)
Numbers
The minimum number of procedures for each trainee applying for colonoscopy certification is 280. If
a trainee is already certified in flexible sigmoidoscopy, then the required number of colonoscopy
procedures is 200.
All common pathology and unusual anatomy may not be encountered with lower procedural
experience. If an application is to be submitted with less than the stipulated minimum number of
procedures, the applicant is required to contact the JAG office (askjag@rcp.ac.uk) providing a reason
for the lower number. This must be submitted by both the trainee and a trainer. The JETS assessors
may then seek additional evidence of competence
The summative assessment process is supported by the JETS e-Portfolio. The ‘certification’ tab on the
trainee’s dashboard will open a summary screen that displays the trainee’s status.
Submit 4 summative DOPS
The arrangements for a summative assessment are:
• Minimum of two different assessors
• Minimum of two cases
• Minimum of four DOPS (observations and judgments)
• No assessor is the primary endoscopic trainer
• Within a month
So this could result in the four DOPS being completed as:
• 2 x 2 process simultaneously = 2 assessors over 2 cases
• 2 x 2 process sequentially = 2 assessors over 4 cases
• 2 x 1 x 1 process = 3 assessors over 4 cases
• 1 x 1 x1 x 1 process = 4 assessors over 4 cases
or a variation on the above.
Sign off by local training lead
The Trust’s Training Lead will review the trainee’s e-Portfolio. If approved it will then be sent via JETS
to the JAG office.
Pay certification fee to JAG
The current certification fee is £70 per modality.
Your e-portfolio will be updated to show you when payment has been received. We estimate it will
take two weeks from receipt of payment to a certificate being issued. A PDF version of the certificate
will be emailed to you so please ensure your email is kept up to date.
Portfolio is assessed by assessor
The JAG office will send your portfolio to the appropriate regional lead to judge whether or not the
criteria have been fulfilled. If they approve your application a certificate will be issued
If they reject your application, the trainee will be informed. The assessor will provide a reason as to
why the portfolio has not been approved.
If they request further info, you will receive an email asking you to provide further info. Most likely
this will be an additional procedure or DOPS via JETS. Contact askjag@rcp.ac.uk if you would like to
submit further evidence.
Lifetime procedure count
These numbers are not to be used as a barrier to application for JAG Certification. The numbers
outlined above are to be used as a guide to trainees, trainers and the JAG Office as the approximate
numbers of procedures that most trainees will have achieved by the time they apply for JAG
Certification, and at which stage the trainee should have gained sufficient experience to be able to
independently make appropriate decisions about patient care and follow up after endoscopy. It is
recognised that individual trainees, through many different factors, learn practical skills at different
rates. It is therefore the eligibility criteria as stated above, not numbers of procedures, that define
when a trainee is ready or not for application