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Curriculum

The Advanced Endoscopy Fellowship Program provides intense EUS and ERCP training with the goal of developing future leaders in the field.

The program can be tailored to meet individual needs, allowing greater emphasis on either EUS or ERCP to facilitate research efforts.

In addition, you will actively participate as a member of our GI Bleeding Team Service and in the interpretation of capsule endoscopy. Exposure to other advanced procedures such as EMR and luminal stenting is made available depending on your needs and existing opportunities.

An animal lab is available in which you may design and perform animal studies, and acquire basic skills and enhanced exposure to new and advanced endoscopic techniques. A complete text and video library is available to augment teaching.

Clinical Training

Upon completion of the Advanced Endoscopy Fellowship, you should be able to:

  • Utilize EUS and ERCP to diagnose and manage patients with a variety of GI disorders.
  • Identify the unique features of dedicated echoendoscopes, catheter probes, and EUS and ERCP accessories.
  • Identify normal and abnormal EUS and ERCP anatomy.
  • Establish the T, N, and M stage for luminal tumors and pancreatic cancer.
  • Differentiate the various types of cystic pancreatic tumors
  • Identify the utility of EUS for evaluating patients with chronic pancreatitis including autoimmune pancreatitis.
  • Differentiate the various subepithelial mass lesions.
  • Assess the N stage for lung cancer.
  • Integrate EUS into the care of patients with inflammatory bowel disease.
  • Demonstrate proper technique for EUS guided biopsy (FNA, Trucut).
  • Demonstrate proper technique for selective biliary and pancreatic cannulation, endoscopic sphincterotomy, pre-cut sphincterotomy, and needle-knife sphincterotomy.
  • Recognize the technical aspects and role of interventional EUS and ERCP procedures including, but not limited to, stone retrieval, cyst drainage, stent insertion and retrieval, removal of migrated stents, rendezvous procedures, pseudocyst drainage, celiac plexus block and neurolysis, duodenal and other luminal stenting, and endoscopic ampullectomy.
  • Begin the process of overseeing and teaching these skills and techniques to other GI fellows.
  • Integrate proper reimbursement and billing into their practice.

Didactic Training

In addition to hands-on performance of these techniques, the curriculum includes a series of didactic lectures. These lectures are provided by the EUS and ERCP staff, other GI and Non-GI physicians who utilize these techniques, radiologists, oncologists, and conferences directed by advanced fellows.

Conferences

In addition to the weekly GI divisional and research conferences, there are separate endoscopy conferences and meetings. As an advanced fellow, you will be responsible for presenting at several of these forums and for the coordination of intermittent advanced endoscopy meetings.

Research Training

Regular and structured meeting are held between fellows and identified mentors to design and conduct research protocols. Fellows also work with other members of the GI Division with diverse skills and investigative backgrounds. Research projects are further developed and implemented in one of our varied GI Subspecialty Clinics and Interest Groups.

You will have dedicated blocks of time for work on mutually agreed upon research projects. The development of at least one prospective EUS-based and/or ERCP-basedstudy is required. It is expected that you will also complete one retrospective study and one review article. You will be encouraged to initiate the planning and dialogue of at least one of these studies prior to beginning the fellowship program.

The advanced fellow is expected to enroll patients who are undergoing procedures into already-approved clinical protocols in which you are involved.

Publications and Presentations

It is anticipated that each of the prospective studies developed will generate results and information suitable for publication in a major GI subspecialty journal. Two additional critical manuscripts are expected. These may include a major subject review, case report (limited to one only) or a retrospective review. The development of abstracts for at least two of the major national GI meetings (DDW week: AGA/ASGE; fall ACG) also is anticipated.

Teaching Opportunities

Opportunities are available for teaching rotating Gastroenterology fellows in the endoscopy suites and residents and fellows during conferences and while covering the Bleeding Team.

Evaluation

To ensure you gain proficiency and develop the corresponding technical skills, your performance is monitored throughout this program. You are formally evaluated by your supervising faculty member following the completion of each clinical rotation; and then meet accordingly with the program director to review these evaluations. In addition, you regularly evaluate the faculty to ensure your educational goals are being met.

Call Frequency

Advanced Endoscopy fellows are infrequently on call. The primary call responsibility during this fellowship is related to the GI Bleeding Team coverage since this service is primarily covered by GI fellows, the Advanced Endoscopy fellows typically cover a few days per month each, on average.

You will have responsibility for disposition of outpatients cared for in the endoscopy suites. If you want to be involved in emergency and/or weekend ERCP procedures, this is possible, but not required. However, you will be expected to keep a page on in the evening to field calls from patients who may have complications or questions, so that these issues can be managed by phone and/or triaged appropriately. Such calls are not usual.

Moonlighting

One year is spent on focused training and research, therefore moonlighting is generally not allowed.

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