Schedules
Our Gastroenterology fellows will receive training in a broad range of facilities. Rotations at other facilities that offer our learners specialty training or expertise that is not available at our University are encouraged based on each fellow’s individual interests within the field. Our ultimate goal with our Gastroenterology recruitment schedules is to provide our fellows with a well-rounded education that provides them with the knowledge and experience needed to provide patients with top-tier care when practicing within the field.
General Overview
Our three-year fellowship program is divided into 51 3-4 week-long blocks (16-17 blocks per AY). At least 18 months will be devoted entirely to clinical gastroenterology, of which approximately 35% of which will be related to diseases of the liver. The third year of GI fellowship training will stress research, advance therapeutics, including ERCP and endoscopic ultrasound, and motility training. Training in hepatic transplantation, clinical nutrition, and pediatric GI will also be encouraged. All fellows, regardless of level or rotation, will be assessed for ACGME competencies, including patient care, medical knowledge base, practice-based learning, interpersonal and communication skills, professionalism and systems-based learning. Overall clinical acumen and competence will also be assessed. Ongoing assessment of progress will be included in the evaluation process at all levels and at each site.
The OP rotation is designed to help fellows gain expertise in scheduling; determining appropriate follow-up intervals; handling a multitude of common GI problems from both - scientific standpoints and psychosocial considerations – all aiming to develop clinical competence in the field of gastroenterology. As fellows progress, emphasis will allow involvement in more complex cases, requiring advanced diagnostic and therapeutic modalities. All fellows will have the ability to perform a full abdominal exam to evaluate patients. Fellow knowledge of indications and contraindications to medicines, therapeutic plans and endoscopy, will be assessed for competency and to ensure adequate progression. All fellows should understand standard preventative measures, such as colorectal cancer screening and vaccinations.
1st Year fellows: will be evaluated, based on ability to develop a pertinent and coherent differential diagnosis, based on a history and physical. Fellow knowledge of indications and contraindications to medicines, therapeutic plans and endoscopy, will be assessed for competency and to ensure adequate progression. Fellows should be able to assess and triage clinic patients, presenting with typical routine IM/GI symptoms/conditions, including but not limited to: reflux and abnormal liver functions. Fellows will be facile in routine initiation of symptom directed assessment and understand the pharmacology of typical GI medications.
2nd Year Fellows: will be expected to have mastered the development of pertinent and coherent differential diagnosis, based on a history and physical, and will be evaluated on ability to appropriately focus that evaluation on the GI tract. They should also have mastered data integration to form a coherent assessment and plan and be able to synthesize and work through the differential diagnosis, selecting appropriate testing and initial therapy for clinic patients, presenting with typical routine IM/GI symptoms/conditions, including but not limited to: reflux and abnormal liver functions, making follow-up plans and subspecialty consultations, as needed. Fellows will demonstrate the ability to integrate patient information from multiple internal and external sources and determine the pharmacologic interactions of existing medications with planned GI therapeutics. They will be able to work with available systems to initiated disposition plans. They will begin to be exposed to motility and some advanced diagnostic and therapeutic procedures during OP rotations in their 2nd year.
3rd Year Fellows: will have the same expectations as 2nd year fellows, and be evaluated similarly, with more of an emphasis on complex patients and procedures. Fellows will examine and treat scheduled and unscheduled patients, with a wide variety of unusual GI conditions. Fellows are exposed to a truly OP experience with emphasis on the OP experience in a more private practice like arena. They should
During these rotations, fellows consult on patients with GI issues at all sites, depending on assignment, hospitalized in various inpatient wards, including general medicine, surgical, pediatrics & various intensive care units. Fellows evaluate patients and advise primary care and specialty service physicians of diagnostic impressions, recommended diagnostic tests and appropriate therapy. The trainee will also performs endoscopic procedures or other GI procedures, prompted by such patient contacts, under the direct supervision of the attending staff.
1st Year Fellows: are evaluated, based on ability to develop a pertinent and coherent differential diagnosis, based on history and physical, as well as their ability to adequately triage consults. Instruction and assessment will be geared toward their developing knowledge base and clinical experience, with the bulk of this being at UH & the VA. The fellow’s knowledge of indications and contraindications to medicines, therapeutic plans and endoscopy will be assessed for competency and to ensure adequate progression and maturation. Fellows will have the ability to perform full abdominal examinations to evaluate the patient for urgent and routine consults.
2nd Year Fellows: are expected to have mastered the basic ability to develop a pertinent and coherent differential diagnosis, based on history and physical, and will be evaluated on ability to appropriately focus that evaluation on the GI tract, ability to appropriately triage consults, with significantly more proficiency than first years. Their knowledge of indications and contraindications to medicines, therapeutic plans and endoscopy will be assessed for competency to ensure adequate progression. The fellow should begin to master data integration to form coherent assessments and plans and will be expected to begin the transition toward independent IP consultation.
3rd Year Fellows: are expected to have mastered the basic ability to develop a pertinent and coherent differential diagnosis, based on history and physical, and appropriately focus that evaluation on the GI tract, while consistently making appropriate triage decisions and being virtually competent in their knowledge of indications and contraindications to medicines, therapeutic plans and endoscopy. Continued progress toward independent practice is expected, with the bulk of these opportunities occurring at UMU sites. IP staff will assess fellow data integration abilities & ability to form a coherent assessment and plan, which will include appropriate use of ancillary services and assessment of the most medically appropriate venue (i.e. OP/IP.). Fellows will be assessed for ability to transition to independent IP consultation.
Research rotations will focus on acquainting fellows with the scientific method by asking and attempting to answer a question of biomedical importance. It is expected that the research performed will eventually lead to a scientific presentation at a national meeting and a published manuscript.
Fellows will design a clinical or basic science research protocol, which they will submit to the Institutional Review Board (IRB) and Human Use Committee of the respective institutions (UH or VA) for approval. Once the protocols have been approved, fellows will then conduct the study, under core faculty supervision, in cooperation with other contributors. Research rotations will teach fellows about data analytic best practices, and how to apply statistical techniques to interpret such data. A manuscript will then be prepared, which will be submitted to satisfy fellowship program graduation requirements. Preparation of a publishable piece of investigation, either clinical or basic science, is required for graduation.
1st Year Fellows: are expected to develop a hypothesis and complete a research proposal and have it evaluated and approved by the appropriate reviewing board. This will be in conjunction with a staff of the fellow’s choice who agrees to support the project.
2nd Year Fellows: are expected to complete virtually all data collection in conjunction with their staff and in preparation for manuscript preparation, presentation, etc.
3rd Year Fellows: are expected to prepare a manuscript in publishable format in conjunction with their staff. This will be reviewed by teaching faculty for adequacy and will be reviewed during a monthly research meeting or journal club.
Gastroenterology Fellow Recruitment
