Fellowship Training Program
The first year trainee is taught the basic elements of consultative gastroenterology, as well as how to use endoscopy as an extension of the physical examination. During six months at Georgetown University Hospital, the objectives are focused on the management of patients with inflammatory bowel disease and patients requiring advanced endoscopic intervention (both diagnostic-EUS, and therapeutic- ERCP, large polyps, stents, etc). The first year fellow also will develop skill in the care of patients with colorectal neoplasia and in recognizing the GI side effects of chemotherapy agents. In addition, first year trainees are exposed to Liver Transplantation with those patients admitted for pre-transplant evaluation or management of complications. In the first year of training, fellows are responsible for selecting a topic and beginning their fellowship research project.
Six months of the first year are spent at the Washington, D.C. Department of Veterans Affairs Medical Center (VAMC). Goals specific to the VAMC include an emphasis on clinical nutrition and a focus on liver disease. In addition to Continuity Clinics held at the VAMC, there is a weekly clinic specifically for liver disease.
In the second year, the responsibilities are increased. Fellows serve in an intermediate supervisory role, providing an immediate educational role model for first year trainees, coordinating rounds and conferences. Although all procedures are supervised, the second year trainee begins to perform more advanced endoscopic procedures and serves as a member of the response team to emergency cases.
Fellows typically will spend four months at the VAMC, four months at Georgetown working with inpatients or on the endoscopy service, and up to four months on electives. Fellows also work on their research projects and, perhaps, prepare them for presentation.
Fellows are required to spend four months at the VAMC and at least four months working with the Endoscopy Service at Georgetown. This includes the possibility of working with advanced endoscopic ultrasound. In this capacity, as opposed to earlier 'exposure' to this technique, the fellow has hands-on training. Faculty expertise in EUS is available, and the trainee is involved in pre-procedure evaluation and post-procedure management. Depending on the fellow's goals, training in advanced endoscopic and manometric techniques is available. The fellow also is able to see outpatients being evaluated for liver transplant, to follow patients after transplant and to manage hospitalized patients on this service.
Third year trainees at GUH are given progressive responsibility for coordinating conferences and patient selection for presentation. They work with first year fellows and attendings to prepare for conference presentation at regular conferences and the City wide GI conference. Fellows also are encouraged to prepare posters or manuscripts based on their research findings.