Negative withdrawal time: simple and efficient

We read with great interest the study from Bitar et al1 examining colonoscopy quality and efficiency according to level of training. The authors should be lauded for investigating a topic with implications for all gastroenterology training programs as they assess their endoscopy curriculum in the context of placing patient outcomes and colon cancer prevention first. Despite the potential limitations associated with a retrospective study, the primary finding of similar high-quality colonoscopies performed by second-year and third-year fellows in the absence of an attending for the duration of the procedure is noteworthy and reassuring.

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