About FEES

Flexible endoscopic evaluation of swallowing (FEES) is one of the most commonly chosen methods for the objective assessment of swallowing. Today, FEES has been successfully applied to diverse patient populations and disease patterns. The aims of FEES are to identify pathological movement patterns, assess the effectiveness and safety of swallowing, determine suitable food consistencies or forms of nutrition and guide the use of therapeutic manoeuvres for each patient.

1. The definition of quality standards and systematic procedures, designed to guarantee the consistent performance of FEES throughout Europe. In the long run, the intended standardization of terminology, examination algorithms and interpretation of results will not only facilitate professional communication within a given hospital but will also contribute to the optimization of understanding between the various sites involved in the treatment of an individual patient over time, e.g. acute clinic, rehabilitation clinic, outpatient care.                                                              
2. A formal accreditation program leading to a valorization of FEES as an independent, clinically relevant and sought after qualification                             
3. To provide a clear pathway to regulate the use of FEES by several professional domains, inside a multidisciplinary team, as practised in other parts of the world and even in other disciplines.

The ESSD FEES accreditation program is divided into two stages: the FEES certificate and the FEES instructor certificate.

Figure 1 gives an overview of the educational steps leading to the FEES certificate and FEES instructor certificate.

The diagnostics and therapy of swallowing disorders are relevant to many disciplines. This training curriculum is therefore open to all clinicians with an interest in this topic. It also offers health care professionals the opportunity to acquire qualifications in the area of instrumental dysphagia assessment and to expand their range of activities. Attention should explicitly be drawn to the fact that the present curriculum addresses neurogenic and geriatric OD. Therefore, neither the diagnostics of structural changes in the mouth and throat (e.g. tumors or anatomical variants) nor the examination of swallowing disorders due to such ailments (e.g. structural changes after surgery or irradiation) are dealt with in detail in this training program and patients with any of these disorders should be referred to an otorhinolaryngologist or a phoniatrician.

The following prerequisites have been defined for qualification in the area of FEES within this curriculum and will be reviewed by the ESSD:

• Two years of clinical practice focused on the care of neurological or geriatric patients is required for doctors and health care professionals. Three months of this period shall be completed in a neurological or geriatric department or a facility involving the care of these patients, such as dysphagia or FEES units.
• Along with the acquisition of the FEES certificate, the following requirements specific to each professional group must be fulfilled in order to attain the status of a FEES instructor: allied health professionals must be in possession of at least five years of experience in the area of diagnostics and therapy of neurogenic, geriatric OD. Physicians must have acquired a specialist title.

The following two groups may apply for the ESSD FEES certificate or the ESSD FEES instructor certificate upon individual application:

• Holders of similar certificates issued from other societies
• Professions that include the training of FEES and management of swallowing disorders, such as otorhinolaryngologists and phoniatricians

All respective decisions will be taken by the ESSD.

Please use the following links to apply for the ESSD FEES Certificate or the ESSD FEES Instructor Certificate.

• ESSD FEES Certificate - Click here. 
• ESSD FEES Instructor Certificate - Click here

Download here.

This curriculum encourages the performance of FEES by a team of physicians and allied health care professionals. It is the conviction of the ESSD that, within the FEES team, tasks should be assigned flexibly, taking into account the training level of each person involved. However, it is essential to note that the FEES certificate described here does not overrule national regulations.

Therefore, holders of either the FEES certificate or the FEES instructor certificate do not automatically acquire the right to carry out FEES in their home countries, as this depends on national regulations. What the ESSD accredits are the skills and the knowledge to perform FEES. Whether, and under which conditions, non-medical professionals are allowed to do FEES, is defined by country-specific legal regulations. Therefore, it is suggested that professionals interested in this education should carefully check the regulations of their home countries before registering.

Link to full paper here.