Patients:  Inclusion Criteria:  Adult age 45 and above Undergoing a colonoscopy performed by a gastroenterology fellow Willingness and ability to provide informed consent  Exclusion Criteria:  History of not tolerating prior colonoscopies well or difficult colonoscopies (e.g. high sedative requirement) Undergoing a diagnostic colonoscopy for inflammatory bowel disease or other known inflammatory/infectious process  An individual who meets any of the following criteria during the colonoscopy will be excluded from participation in this study:  Colonoscopy without polyps Polyps not removed in entirety Polyps with indeterminate size  An individual who meets any of the following criteria after the colonoscopy will be excluded from participation in this study:  1. Hyperplastic or non-adenomatous polyps on pathology report  Fellows  Inclusion Criteria:  NYU gastroenterology fellow Willingness and ability to provide informed consent  Exclusion Criteria:  1. Not deemed to be medically trained and ready to perform a colonoscopy by supervising gastroenterology attending