Background and study aims: Endoscopic submucosal dissection (ESD) enables curative resection of superficial gastrointestinal neoplasia but requires structured training. Although European Society of Gastrointestinal Endoscopy (ESGE)/American Society for Gastrointestinal Endoscopy (ASGE) curricula exist, real-world practices and barriers remain unclear. Methods: We conducted an anonymous web-based survey (April–July 2025) with 55 items assessing training opportunities, barriers, curriculum adherence, and quality metrics, stratified by role and annual ESD volume. Results: We received 288 responses (137 trainees, 151 trainers) from 39 countries across five geographic macro-areas. Nearly half (47.2%) had undertaken structured training, but only 46.5% fulfilled ESGE/ASGE curricula, with marked variation by center volume (69.6% in high-volume vs 26.8% in low-volume, P Conclusions: This international survey reveals substantial disparities in ESD training and calls for coordinated efforts to improve access to structured curricula, mentorship, and affordable training models.
Giulio et al. (Mon,) studied this question.