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Clinical Training
Although clinical assignments are flexible, the program is designed in one-month blocks as follows:
- Esophageal Clinic
For 24 weeks you will spend mornings in the Esophageal Clinic seeing patients under the direct supervision of the consulting staff member. You will provide esophageal consultation for Saint Marys Hospital (SHM) inpatients that have been seen by the GI Service. Your Esophageal Clinic rotation will be mentored by senior esophagologists. Attendance in the OR will provide the opportunity to observe fundoplications, esophagectomy and Heller myotomy.
- Motility testing
For four weeks you will spend mornings in the SMH Endoscopy Unit instructed by the lead motility GI assistant, learning the techniques of esophageal manometry and pH testing. You will interpret all 24-hour pH and esophageal motility studies done that day, then present your interpretation to the staff person reading tracings.
- Esophageal Motility Interpretation Sessions
You will also actively participate in the Interactive Esophageal Motility Interpretation Sessions, which meets once per month, to review challenging motility and 24-hour pH studies. While in Esophageal Clinic you'll be encouraged to read all motility and 24-hour pH tracings that day and review them with the staff to gain one-on-one experience with interpretation over the entire year.
- Cervical dysphagia testing
For four weeks you will spend mornings learning the techniques of evaluating proximal esophageal function. This will be done with the Department of Radiology for two weeks, the Department of Otolaryngology for one week and the Department of Physical and Medical Rehabilitation for one week.
- GI Pathology
For two weeks you will spend mornings reviewing GI Pathology slides from the esophagus, stomach, small intestine and colon and discuss their interpretation with GI pathology staff.
- Bleeding Team
The opportunity exists for you to participate on the Bleeding Team on Tuesdays and Wednesdays. This activity will provide experience with sclerotherapy, band ligation, and thermal therapy, such as gold probe and Bicap. Weekend coverage will also be encouraged on an "ad hoc" basis.
- Additional skills training
Eight weeks on upper endoscopy and four to eight weeks on the complex endoscopy list will provide you with training opportunities for the following:
- Attend all achalasia dilatations until you have successfully performed at least 10.
- Attend all Botox injections until you have successfully performed at least 10.
- Attend esophageal laser and stent placements when you are assigned to the Endoscopy Unit.
- You will have the opportunity to learn and observe endoscopic ultrasound and photodynamic therapy.
- Opportunity will be provided to observe and potentially participate in the use of the BARD Endoscopic Suturing Device, the NDO Plicator device, the Swain capsule and other novel therapeutic esophageal interventions at the Institute Hills Animal Laborator
Education
As an advanced esophagus fellow, you will help to coordinate and attend the monthly Esophageal Interest Group meeting. You assist in teaching clinical fellows assigned in the esophageal rotation.
You will also be expected to actively participate in the Interactive Esophageal Motility Interpretation Sessions, the GI Outcomes Journal Club and the GI Fellows Journal Club.
Research Training
Several members of the Interest Group are actively involved in esophageal research. These programs are quite vibrant and they too span the spectrum of esophageal disease. Interest Group members are actively investigating the pathophysiology of cervical dysphagia, the epidemiology and pathophysiology of gastroesophageal reflux disease, and esophageal function. The research program in Barrett's is especially strong and addresses basic pathophysiology, genetics, epidemiology, and advanced diagnostic and therapeutic techniques.
During the first month of training, you will meet with each member of the Esophageal Interest Group involved in research and who has been approved for mentorship privileges by the GI Division. You are also encouraged to contact those individuals prior to starting the fellowship.
You will have 50 percent time over the course of the year (i.e. 47 weeks) to participate in research. You are expected to complete at least one major research project. Participation in several smaller projects is also encouraged.
You must demonstrate skills in the design, conduct, analysis and reporting of results of a research study. Courses in these topics are offered at Mayo Graduate School and Health Services Research at no cost throughout the year. Candidates particularly interested in study design and outcomes methodology may pursue a masters degree program in clinical epidemiology and biostatistics also at no charge.
You will be encouraged to embark on diagnostic and therapeutic endoscopy research projects. The Developmental Endoscopy Unit (DEU) will be available to you providing there is sufficient staff coverage.
To learn more about Clinical Research Training at Mayo Clinic.
Teaching Opportunities
Opportunities are available for teaching rotating residents and medical students.
Evaluation
To ensure that you acquire adequate knowledge and develop your technical skills, your performance will be monitored carefully during the course of your program training. You will be evaluated formally by your supervising faculty member after each clinical rotation and will meet with the program director to review these evaluations. In addition, you will regularly evaluate the faculty to ensure that your educational needs are being met.
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