World Endoscopy Organization ERCP Fellowship Program 2020: Experience of a Pakistani doctor

I am a Pakistani gastroenterologist with a special focus on advanced GI procedures, namely endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS). I was lucky enough to be chosen for the WEO ERCP Fellowship Program in 2020. However, the Program was delayed considerably because of the COVID-19 pandemic, and I was finally allowed to attend this comprehensive training opportunity in February 2024 at the Wuhan University Zhongnan Hospital (WUZH), Wuhan, China.

The WEO Fellowship Program offers cutting-edge ERCP training in collaboration with seven prestigious endoscopy centers in China. It was my good fortune to be placed for fellowship training at the Digestive Endoscopy Center of WUZH, Wuhan under the leadership of Professor Qiu Zhao, a renowned figure worldwide in digestive endoscopy.

My training, spanning from February to May 2024, was well structured and thorough, encompassing direct observation of the procedures, followed by hands-on experience of ERCP. I received instructions and guidance on various aspects of ERCP, including safe intubation and navigation of the duodenoscope, selective cannulation, balloon dilation, sphincterotomy, stone removal techniques, stricture dilation, and stent placement. Throughout the training, the emphasis was on avoiding complications such as post-ERCP pancreatitis (PEP) and perforation. Moreover, I polished my skills in interpreting cholangiograms and pancreatograms, essential for effective ERCP.

The Digestive Endoscopy Center of the WUZH is a great place for endoscopy trainees, having around 16 operation rooms.  The Center is equipped with advanced endoscopes including DSA, the laser confocal endoscope, Olympus 290 machines, Fuji 7000 machines, Pentax ultrasound endoscopes, etc. Dr. Zhao’s team is capable of performing almost all the comprehensive endoscopic procedures.

In addition to ERCP, I also had the opportunity to observe advanced endoscopic procedures, including diagnostic EUS, therapeutic EUS, EMR, ESD, POEM, and enteroscopy. Throughout this learning journey, I received invaluable support and guidance from Prof. Zhao and his team, particularly Prof. Wang, Dr. Fanndy Wang, and Dr. Shang. Prof. Zhao's approach to patient care and research was truly inspirational for me. He emphasized the importance of personalized medicine and encouraged continuous self-learning and improvement. This WEO fellowship certainly fulfilled my urge for excellence and continuous skill improvement.

I am deeply grateful to Laura Schleser Low at the WEO headquarters for her attentive care and guidance, and thankful to Dr. Lan Liu for all logistical support and communication in China and for making this mission possible. Participating in the WEO Fellowship Program and the hands-on training experience has profoundly impacted my journey in ERCP, and I will always consider this a rewarding experience.

Dr. Kazim Abbas Virk