Schedules
The fellows in the gastroenterology program will all receive training at all facilities. Rotations at other facilities that offer specialty training or expertise not available from either institution will be allowed and encouraged based on the fellows’ interests.
General Overview
The fellows in the gastroenterology program will all receive training at all facilities. Rotations at other facilities that offer specialty training or expertise not available from either institution will be allowed and encouraged based on the fellows’ interest. The three-year fellowship is divided into 51 three to four-weeklong blocks or 17 blocks per year. 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 gastroenterology fellowship training will stress research, advanced therapeutics to include ERCP and endoscopic ultrasound, and motility training. Training in hepatic transplantation, clinical nutrition, and pediatric gastroenterology will also be encouraged. The specific details of the rotations follow. Endoscopic biopsy, cytology, and photographic documentation are also essential.
Fellows examine and treat scheduled and unscheduled patients with a wide variety of common gastrointestinal conditions while on the outpatient clinic rotation. Fellows will also see more acute emergency patients with more complex problems, requiring interaction with surgical and radiology departments at all facilities. By their nature, each facility will have different patient populations and consultative experiences, allowing the fellow to learn how to manage inpatients in various settings/practice patterns, which is our goal. Patients are followed for their active problems or referred back to the primary physician. When appropriate, long-term follow-up will be continued through the fellow’s continuity clinic. Fellows will perform GI endoscopic procedures on such patients after a determination is made that such procedures are required. The second-year fellow will begin to be exposed to motility, as well as some advanced diagnostic and therapeutic procedures, during this rotation. Third-year fellows will focus on assessments of patients requiring more advanced procedures, and emphasis will be placed on following those patients into the procedure area.
During inpatient consult rotations, fellows consult on patients with gastrointestinal problems at all sites, depending upon assignment, hospitalized in various inpatient wards, including general medicine, surgical, pediatric wards, and various intensive care units throughout all institutions. The fellow evaluates patients and advises primary care and specialty services physicians of his diagnostic impressions, recommended diagnostic tests and appropriate therapy. The trainee also performs endoscopic procedures or other GI procedures generated by such patient contacts, under the direct supervision of the attending staff.
Fellows will be exposed to research activities by designing a clinical or basic science research protocol, which would then be submitted for approval by the Institutional Review Board and Human Use Sub-Committees of the respective institutions, either Upstate or the Syracuse VA. Once the protocols have been approved, fellows will then conduct the study under the supervision of a staff gastroenterologist in cooperation with other members of facilities where appropriate. Fellows will be taught how to analyze data and apply statistical techniques to interpret such data. A manuscript will then be prepared, which will be submitted to satisfy the fellowship program graduation requirements. Preparation of a publishable piece of investigation, either clinical or basic science, is required for graduation. At the end of each Research rotation, the fellows will be required to submit a Research form to the fellowship coordinator, signed by their mentor, outlining what they’ve worked on.
Mentor/Fellow Meeting Schedule:
- 2 months BEFORE Scheduled Rotation: Fellows are REQUIRED to meet with their mentor at least 2 months before their Research block is scheduled to begin to come up with a proposal. Failure to do so will result in that block will be changed to Outpatient.
- 1st Day of Scheduled Research Block: Fellow must meet with their mentor on the first day of their Research block to go over their plan for the block, how they will spend their time, what they plan to accomplish, etc.
- By End of Research Block: Fellows must submit a report to their mentor and the fellowship coordinator no later than the final day of their scheduled research block. Failure to do so will result in their next Research block being changed to Outpatient.
First-Year Fellows
First-year fellows will be expected to develop a hypothesis 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.
Second-Year Fellows
The second year will be expected to complete virtually all of their data collection in conjunction with their staff and in preparation for manuscript preparation, presentation, etc.
Third-Year Fellows
The third-year fellow will be expected to prepare a manuscript in publishable format in conjunction with their staff. This will be reviewed by the collective teaching faculty for adequacy and will be reviewed during a monthly research meeting or journal club.
Fellows are supervised while seeing and performing procedures on more acute emergency patients with their attending and triaging and determining acuity and level of care needs. They will see patients with attendings caring for more complex problems requiring therapeutic intervention, such as with ERCP, in order to experience the unique outpatient aspects of those types of patients. The fellow will be allowed to assess patients needing the majority of motility and pH studies in conjunction with the attending staff.
During the gastroenterology procedure block, our primary aim is to equip fellows with comprehensive skills and knowledge essential for proficient practice in the field. Through a dynamic and immersive learning experience, fellows will engage in a diverse range of gastroenterology procedures, including endoscopies, colonoscopies, and therapeutic interventions. This will happen at both the university hospital and the VA hospital.
Objectives encompass developing proficiency in patient evaluation, procedural techniques, and diagnostic acumen. Fellows will refine their abilities to perform accurate assessments, make informed decisions, and execute procedures with precision while prioritizing patient comfort and safety. Furthermore, the procedure block aims to cultivate effective communication within interdisciplinary teams, honing fellows' capacity to collaborate, present cases, and provide concise post-procedural assessments. This block will help the fellows choose the areas of their career interest and also areas where they need additional training and participate in the same. By the culmination of this block, fellows will have not only attained technical excellence but also a deepened understanding of the holistic care that defines outstanding gastroenterological practice.
