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Curriculum

Clinical Training

The curriculum for the Gastroenterology Fellowship varies, depending upon whether you choose the Clinical Scholars Track or NIH-sponsored Track. However, all clinical training includes patient care, procedures, elective rotations, didactic training and teaching opportunities.

Patient Care

Several rotations in ambulatory and inpatient care are mandatory for all fellows. For example, on the gastroenterology hospital service you will serve as a first assistant to the staff and learn how to manage many types of cases - from the straightforward to the complex. GI fellows are expected to serve in a junior faculty-type role, directly supervising and guiding medical residents on the team, together with the staff physician. These resident physicians are responsible for most direct patient care (such as note writing, orders and dismissal summaries), which frees the GI fellow's time for supervision and teaching.

You also will participate in gastrointestinal consultations and perform procedures on hospitalized patients. These experiences will help you learn pragmatic and scholarly approaches to a wide array of inpatient diagnostic and therapeutic gastrointestinal problems. Your assignments will include several specialty areas that are largely hospital based, including nutrition and liver transplantation.

During the outpatient department rotation, you will rotate through most of the subspecialty clinics (e.g., pancreas, motility, IBD) where you will work directly with staff gastroenterologists. In the outpatient practice, the same focus on pragmatic and scholarly approaches to diagnostic and therapeutic gastrointestinal problems exists. In all rotations, the fellow works directly with a supervising staff gastroenterologist.

Procedures

All procedures are performed under the direct supervision of Mayo Clinic staff gastroenterologists. Your procedural training will include upper endoscopy, esophageal dilatation, esophageal and anorectal manometry, esophageal pH readings, small bowel enteroscopy including capsule enteroscopy, paracentesis, percutaneous endoscopic gastrostomy placement, colonoscopy and endoscopic retrograde cholangiopancreatography.

You will extend your endoscopic experience with therapeutic endoscopy, which includes electrocoagulation, hemoclip application, variceal banding and various stenting procedures. You also will have opportunities to learn about gastrointestinal motility, the dynamic assessment of pancreatic, hepatobiliary and gastrointestinal function and other procedures.

Elective Rotations

Several elective rotations are available, including rotations to Mayo Clinic Florida and Mayo Clinic Arizona. You may also spend your elective time pursuing additional clinical or endoscopic experience at smaller private practices near Rochester, within the GI Division, or in other departments (e.g., Surgery, Radiology, Pathology).

Teaching Opportunities

You will have the opportunity to teach Mayo Medical School students, visiting students from other medical schools and medical residents through bedside instruction and formal didactic lectures. At the beginning of the fellowship program, fellows are taught how to give effective presentations, and feedback is provided after most presentations.

Didactic Training

Clinical conferences, seminars, small discussion groups, journal clubs, formal coursework in the Center for Translational Science Activities (CTSA) program and one-on-one instruction are integral parts of the Gastroenterology Fellowship Program. You will work one-to-one with staff gastroenterologists during all aspects of your training. Bedside instruction and other informal teaching methods are also part of the training program.

Conferences

A variety of conferences are held each week in the Division of Gastroenterology. You also may find topics of special interest in other conferences sponsored by the departments of Internal Medicine, Surgery, Oncology, Diagnostic Radiology, and Laboratory Medicine and Pathology. The weekly schedule includes:

  • Monday
    Gastroenterology Research Conference
  • Tuesday
    Core Curriculum for Hospital Residents*
    Core lecture for fellows
    Journal Club
  • Wednesday
    Various interest group conferences*
    Internal Medical Grand Rounds
  • Thursday
    GIH Grand Rounds
  • Friday
    Various interest group conferences*

* Fellows make presentations at these conferences.

Research Training

The Division of Gastroenterology and Hepatology is known internationally for the breadth and depth of its research activities, with expertise in practically every area of these fields. As a result of our research efforts, we have had 1,884 articles/editorials/reviews published by trainees/faculty over the past five years.

Basic science support is provided in physiology, biochemistry and molecular biology, pharmacology, microbiology, genetics, immunology, cell biology, epidemiology, statistics and other areas.

At Mayo, GI fellows' research mentors closely supervise protocol development, the conduct of the study, data analysis and the final manuscript preparation. Critical peer and institutional reviews at each stage help ensure high quality. Most Mayo fellows present their work at national meetings and publish several papers.

The integration of basic and clinical research into practice is one of the division's strengths. Currently, there are 370 active patient-oriented protocols in the Division of Gastroenterology and Hepatology. Some major areas of research include:

  • Barrett's esophagus
  • Celiac disease
  • Chronic liver disease
  • Colorectal cancer (prevention/early detection)
  • Endoscopy (development of new procedures)
  • The enteric neurosciences
  • Inflammatory bowel disease
  • Liver and biliary cancer
  • Liver transplantation
  • Pancreatic cancer
  • Viral hepatitis

Current new initiatives within the division include proteomics and genomics, clinical trials, and obesity.

The divisional research activities are coordinated through the Gastroenterology and Hepatology Research Committee that meets once a month. Research findings are presented at a weekly Research Conference.

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.

Also see:

  • ART602753