The Gastroenterology fellowship curriculum is structured to provide training in all aspects of the specialty. The first-year fellow spends six months on the Gastroenterology consultation service, three months on the hepatology service, two months dedicated to endoscopy and one month on ambulatory rotation.
During the second year, fellows will spend two months rotating on the Gastroenterology consultation service at Einstein Medical Center Philadelphia, one month on the Hepatology service, two months on the ambulatory rotation, two months dedicated to endoscopy, three months in our suburban venues focusing on motility, esophagology, and inflammatory bowel disease; one month on consultation service at Einstein Medical Center Montgomery; and one month devoted to clinical research.
The third-year fellows spend three months at Einstein Medical Center Montgomery on the GI consult service; two months on ambulatory care; four months on advanced therapeutics and biliary rotations; one month in our suburban venues focusing on motility, esophagology, and inflammatory bowel disease ; one month of ambulatory hepatology; and an elective month. The third year is flexible and is structured to allow the fellow to focus on her or his area of interest while cementing their endoscopic and clinical skills in preparation for autonomous practice.
On the Gastroenterology consult service, fellows will encounter a wide array of patients with common and very complex problems that will foster independent thinking, clinical judgment, and progressive improvement in procedural skills. In addition, the faculty will develop a culture on learning and scholarship that will foster a mindset of lifelong continuing education.
Fellows rotating on the Hepatology service will acquire expertise in the evaluation and management on chronic disease, pre-liver transplant evaluation as well as post-transplant care. The fellows are expected to formulate expansive differential diagnoses, create an evidence-based plan for diagnostic studies and management. There are daily teaching rounds on the hepatology service that include the fellow on the hepatology rotation, at least two internal medicine house staff members, and nurses.
The ambulatory exposure comprises two experiences; GI continuity clinic which is held weekly and proctored by a member of our GI faculty, and the ambulatory rotation in which a fellow will work with one or two attendings very closely in their outpatient and endoscopic practices. Both ambulatory experiences emphasize outpatient evaluation of patients for various GI related complaints, appropriate diagnostic work up and management. Fellows learn to provide effective care in an outpatient setting and develop an understanding on when to refer patients for invasive procedures or hospitalization. Fellows will achieve competence in all aspects of outpatient care, including social and ethical issues, and patient education skills. In addition to the GI continuity clinic, there is a dedicated hepatology continuity clinic in the second year, proctored by a member of our liver faculty.
During the research rotation fellows will acquire the knowledge and skills in proper design of research and quality improvement projects, learn how to properly state a research hypothesis, and formulate a research protocol. Fellows will learn how to properly scrutinize and analyze research papers, acquire the skills to present medical research associated topics utilizing oral presentations with appropriate audiovisual aids, how to write brief abstracts for submission to meetings, and how to write a proper research manuscript for publication. The research experience is structured to assist each fellow to meet these objectives, and to achieve scholarly productivity. A member of our GI faculty supervises the fellowship research experience.
Endoscopy rotations are dedicated to performing endoscopic procedures as well as seeing patients pre-procedurally and following up any post procedure complications. Basic exposure to interventional endoscopy is available in the third year.
Below, the Fellows’ sample schedule is shown, including conferences for the first, and second and third years.
Training occurs mainly at Einstein Medical Center Philadelphia in the first year and at Einstein Medical Center Philadelphia and Einstein Medical Center Montgomery in the second and third years. The Gastroenterology team provides consultative services while the Hepatology team oversees a primary service in a dedicated liver unit. Upper year fellows obtain a feel of independent practice when they rotate through Einstein Medical Center Philadelphia and associated in our suburban Philadelphia venues, supervised by a faculty member but with greater autonomy and freedom.