At present, most endoscopy training during fellowship is based on the apprenticeship method, wherein trainees learn directly through patient cases in the endoscopy unit. In this method, trainees need to perform a high volume of cases and undergo a long training period to achieve competency. For example, it takes approximately 250 upper endoscopies before trainees attain minimum competence1 and 450 colonoscopies to achieve an adenoma miss rate of less than 25%.2 Unfortunately, many trainees may never reach this number of procedures during their fellowship.