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Curriculum

The Division of Gastroenterology and Hepatology offers a three-year, ACGME-accredited training program.

Following the fellowship, trainees will be fully prepared for board-certification in gastroenterology. Learn more:

Program Overview

Endoscopic Training

Rotations

Training Facilities

Didactics

Program overview

The gastroenterology faculty is dedicated to the goal of providing a comprehensive educational environment that fosters the professional development of fellows, thereby enabling them to become proficient gastroenterologists. While the faculty believes that clinical experience is the principal foundation of gastroenterology education, they also believe that a significant portion of the fellow’s education is achieved through lectures, conferences, teaching rounds, research, and an up-to-date comprehension of gastroenterology literature. Therefore, the gastroenterology curriculum is designed to afford fellows the opportunity to attend lectures, conferences, participate in teaching rounds, conduct research and also have sufficient time for review and study of current literature.

The program also stresses the role of gastroenterologists as consultants and the need to establish the skills necessary to communicate effectively with referring physicians. Every aspect of training includes the cultivation of an attitude of skepticism and inquiry and a dedication to continuing education that will remain with the fellows throughout their professional careers. A major contributor to the enhancement of a scholarly attitude is active participation in one or more research projects, ideally followed by presentation of the work at a national meeting and publication of a paper in a peer-reviewed journal.

The field of gastroenterology has been divided into 17 areas in the Gastroenterology Core Curriculum, and into 19 core knowledge areas requiring achievement of competency as defined by the ACGME subspecialty program requirements, encompassing the breadth of knowledge and skills required for the practice of gastroenterology. These areas include not only the traditional curricular content of gastroenterology and hepatology but also associated disciplines such as nutrition, pathology, radiology, surgery, endoscopy, and research.

Fellows will provide care for patients in the hospitals’ intensive care units (including medical, cardiac, surgical, cardiothoracic, neurosurgical, and trauma units), as well as in a variety of outpatient settings where fellows will provide continuity care to ambulatory patients. Fellows will have the opportunity to participate in various subspecialty clinics, including Functional Bowel, IBD, Celiac, and Liver Transplant clinics. A rotation in pediatric gastroenterology is available through an affiliation with Children’s Hospital of Pittsburgh of UPMC.

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Endoscopic training

The faculty in the Division of Gastroenterology perform more than 12,500 procedures annually at these three facilities (including over 4,900 EGDs, 4,400 colonoscopies, 1,800 ERCPs, and 850 EUSs.

The hospitals’ facilities include all up-to-date general endoscopy equipment including scopes with capacity for narrow-band imaging and magnification endoscopy, ERCP and fluoroscopic equipment including sphincter manometry, cholangioscopy, electrohydraulic and laser lithotripsy; also EUS and fine needle aspiration, capsule endoscopy and radiographic equipment with digital video imaging, as well as technology to perform radiofrequency ablation, endoscopic mucosal resection, placement of advanced enteral nutrition devices, and enteral and pancreatico-biliary stenting. A full complement of support services, including anesthesiology, pathology, diagnostic and interventional radiology, surgery, and oncology are available.

Procedural experience in general endoscopic procedures (EGD, colonoscopy) and exposure to advanced procedures (ERCP, EUS) is provided

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Rotations

Fellows in our program will be assigned each year to rotations consisting of 12 blocks of approximately 1 month each at Allegheny General Hospital (AGH) or West Penn Hospital (WPH).

Typical Rotation Schedule

Below is a typical rotation schedule. Individual programs will vary, especially during the third year, according to the fellows' interests:

Year 1

  • AGH Inpatient Consults (6 months)
  • AGH Lab (2 months)
  • WPH Lab (1 month)
  • Nutrition Elective (2 months)
  • WPH Inpatient Consults (1 month)

Year 2

  • AGH Inpatient Consults (3 months)
  • AGH Lab (1 month)
  • WPH Lab (2 months)
  • Inpatient Hepatology (3 months)
  • Electives (Research etc.) (2 months)
  • WPH Inpatient Consults (1 month)

Year 3

  • Advanced Training Electives (ex. advanced endoscopy, IBD, hepatology, nutrition) (9 months)
  • Capsule Endosopy Training (0.5 month)
  • Manometry Training (0.5 month)
  • WPH Inpatient Consults (1 month)
  • Practice Management/Conscious Sedation Training (at Allegheny Valley Hospital) (1 month)

Rotation Descriptions

AGH/WPH Inpatient Consult Floor - All inpatient or emergency room consults received will be evaluated and consultative opinion rendered. Daily attending teaching rounds will be made. The team will generally consist of three fellows (a combination of two 1st and one 2nd year fellows).

AGH Hepatology - The 2nd year fellow will see all inpatient hepatology consults, including liver transplant issues, under the supervision of the faculty hepatologist. Attendance at the weekly Liver Transplant clinic is required.

AGH/WPH GI Lab - The fellow will be responsible for performing all scheduled GI lab endoscopic procedures, both inpatient and outpatient.

3rd Year Advanced Endoscopy - Fellows will be responsible for performing inpatient consultations on patients who are felt to potentially require advanced therapeutic endoscopy. The fellow will also be responsible for scheduling and performing the respective procedures and providing post-procedure follow-up care.

Nutrition - The fellow will be exposed to the management of inpatient and outpatient nutritional issues under the direction of medical nutritionist, Dr. Vazquez.

Research - All fellows must complete two scholarly projects prior to the completion of their three year training.

Pathology - Fellows will participate in daily reviews of gross and microscopic pathology specimens with the Pathology attending physician.

Radiology - Exposure to CT Body, and GI Fluoro/MRI will occur. Allowances can be made should the fellow have a specific interest in other areas of radiology (for example, nuclear medicine, interventional radiology).

Pediatrics - This will be located at the Children’s Hospital of Pittsburgh. The rotation will consist of 2 weeks in an outpatient pediatric GI clinic. Longer experiences incorporating in-hospital care are available

Introduction to Advanced Endoscopy - This elective is designed for fellows who might have an interest in pursuing higher level training in advanced therapeutic endoscopy, or who simply wish a more concentrated but limited exposure to these techniques.

Outpatient Endoscopy - The North Shore Endoscopy Center (NSEC) has a high-volume, relatively fast-paced schedule of endoscopic procedures. Participation will give the fellow a closer approximation of a “private practice” model, and should serve to improve efficiency and bolster the fellow’s procedural volumes and experience. This experience will be made available only to senior (2nd and 3rd year) fellows who have already attained substantial experience with basic endoscopic procedures.

Practice Management/Conscious Sedation Training - This will be available to each 3rd year fellow during the early months of the academic year. The fellow will accompany a GI private practitioner through their day-to-day activities, both inpatient and outpatient, clinical and procedural, and also introduce the fellow to administrative issues not encountered elsewhere during their training. Educational focuses will include time and office management, professional billing, interpersonal communication, and practice within a healthcare system. Semi-annual seminars are held to train fellows in the business of medicine.

Fellow Continuity Clinic - Fellows will attend Continuity Clinic an average of 1/2 day/week. Each fellow’s preceptors will change annually to provide exposure to different styles of practice, and different subspecialty foci, ex: IBD, Hepatology, pancreaticobiliary disease.

Intro to Academics - An elective experience for third year fellows to foster teaching skills in the academic arena. Fellows will supervise the GI Consult team, providing guidance and education to junior trainees, to simulate the role of an academic gastroenterologist. Focus is to foster skills in small group teaching and feedback.

Capsule Endoscopy Training - A focused experience provides training to competence in the interpretation of capsule endoscopy.

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Training Facilities

Allegheny General Hospital Campus

Allegheny General Hospital (AGH) located on Pittsburgh’s historic North Side serves as our program’s main inpatient teaching site. This is a (661 beds) quaternary care teaching hospital that supports 20 residency and 23 fellowship training programs.

Federal North professional building houses the GI Division administrative offices and outpatient clinics, as well as an ambulatory outpatient endoscopy center.

West Penn Hospital Campus -

West Penn Hospital (WPH) in Pittsburgh’s Bloomfield neighborhood, approximately fifteen minutes from AGH, houses inpatient facilities and laboratories. 

The S.T.A.R. Center (Simulation, Teaching and Academic Research) Center – located adjacent to WPH, is a nationally recognized state-of-the-art center providing simulation training to students, residents, and fellows.

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Didactic lectures

A comprehensive conference schedule supports the experiential training received by fellows. Conferences occur four days per week.

Core curriculum lecture series

A series of lecture topics intended to introduce the fellows to the literature of gastroenterology and provide an understanding of the pathophysiologic basis for gastrointestinal diseases and a broad range of affiliated topics including research, ethics, and genetics. Topics cover all areas required by the GI Core Curriculum.

 

Monthly lecture series

  • Journal Club
  • Morbidity & Mortality Conference
  • Research Conference
  • Board Review
  • Quality/Safety/Medicolegal conference series
  • GI Cancer Series

Clinicopathologic conferences (CPC’s)

  • Endopath CPC
  • GI/Pathology CPC
  • GI/Radiology CPC
  • Inflammatory Bowel Disease CPC
  • Advanced Endoscopy CPC
  • Hepatology CPC

Bi-Monthly Administrative Conferences

Semi-Annual Career Development/Practice Management Seminars

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