Gastroenterology Fellowship

Curriculum

Digestive health service is primary Gastroenterology and hepatology inpatient service where fellows work with medical students, interns and resident to develop expertise in the diagnosis and management of hospitalized patient with primary luminal or hepatology disease. They round under supervision of two faculty members, one each from luminal and hepatology sections. They manage patients with acute flare up of inflammatory bowel disease, acute and chronic pancreatitis, biliary disorders, gastrointestinal bleeding and decompensated liver disease. Essentially fellows act as a junior attendings; they provide supervision and engage in formal teaching session with other team members.

Luminal Consult Service: On the Luminal Consultation Service, fellows develop expertise in the diagnosis and management of hospitalized patients with various gastrointestinal illnesses and complaints related to the luminal GI tract. Under the supervision of a GI Division faculty member, fellows on the Luminal Consult Service learn these skills by performing consultations requested from other clinical services. During this rotation, fellows see patients with a variety of GI disorders, including upper & lower GI bleeding, inflammatory bowel disease, biliary and pancreatic disorders, dysphagia, abdominal pain, and diarrhea.

Hepatology Consult Service: On the Hepatology Consultation Service, fellows develop expertise in the diagnosis and management of hospitalized patients with liver diseases. Similar to the Luminal Consult Service, fellows perform consultations on hospitalized patients requested by other clinical services. The Hepatology service is staffed by hepatologists. During this rotation, fellows see patients with disorders such as acute liver failure, decompensated liver diseases, hepatic encephalopathy, spontaneous bacterial peritonitis, post-liver transplant complications, abnormal liver enzymes/function tests, and various other conditions.

Endoscopy Rotation: During the Endoscopy Rotation, fellows receive dedicated training in both the cognitive and procedural aspects of endoscopy. Fellows learn the skills needed to perform diagnostic, screening, and surveillance upper endoscopy and colonoscopy, as well as therapeutic aspects of the endoscopy, such as mucosal biopsy, polypectomy, hemostasis, stricture dilation, and gastrostomy tube placement.

Ambulatory Rotation: The Ambulatory Rotation is one of the unique features of our fellowship Program. During the Ambulatory Rotation, fellows spend half-days rotating through our numerous sub-specialty programs, working alongside expert faculty in inflammatory bowel disease, pancreatic disorders, nutrition disorders, advanced endoscopy, viral hepatology, hepatocellular carcinoma and transplant hepatology. Within these clinics, fellows get experience seeing tertiary care referrals while working with renowned experts.

Continuity Clinic: Throughout training, GI fellows longitudinally manage outpatients with various gastrointestinal illnesses in their own continuity clinic. Although continuity clinic is supervised by a GI faculty member, fellows assume the role of primary GI physician for these patients through the course of their illness. In continuity clinic, fellows typically see 2 - 3 new patients and 4 - 6 return patients per session. Fellows will have their continuity clinic either at VCUHS campus or VA campus.

Advanced Endoscopy Rotation: This rotation is designated for senior fellows in VA campus and provides them an exposure to therapeutic procedures like ERCP and EUS. Though our program doesn’t train fellows for ERCP and EUS in traditional three year fellowship, this rotation gives them good insight into therapeutic procedures including indications and technical aspects of advanced procedures.