About the GI Fellowship Program
The first year is chiefly devoted to clinical training, divided evenly between UMMHC and Worcester Medical Center. At UMMHC, the first-year fellow, working closely with attending physicians, is chiefly responsible for organizing the combined inpatient and Hospital consult service of the Division. Since throughout the year there is often a medical student and/or resident taking elective training in the Division, the fellow also plays a key role in teaching and organizing the activities of these persons. While rotating at Worcester Medical Center, the first year fellows' responsibilities are similar to those at UMMHC with a slightly greater emphasis on ambulatory care. There is a one-half day outpatient clinic for 1st year fellows throughout the first year.
Consultation Services: At UMMHC, we have two services: The general GI service, including especially gastrointestinal and pancreatic diseases and the liver service, which works closely with the multidisciplinary Liver transplantation service. The fellows assume reponsibility for the initial patient evaluations. The fellow then reviews all recommendations with our consultation team, including the attending physician,and contacts the consulting service. In recent years, approximately 15,500 patients have been admitted annually to the University of Massachusetts Hospital's 416 beds. Typically, there are about 10 inpatients under the care of the DDN Service's at one time, an average of 20 new consults are seen per week, and 1500 endoscopy and other procedures performed per year at UMMC. Nearly all of these activities have been the responsibility of the first-year fellows, working in a team with a medical student, a medical resident, and an attending physician.
Research Proposal: During the first six months of the first year, each fellow has a two-month block of time during which he/she is responsible for developing a research project and proposal. The latter is to be in a form appropriate for submission to NIH for competitive funding of a National Research Service Award or to other funding agencies (e.g. The American Digestive Health Foundation, The American College of Gastroenterology). Examples of recent research projects which our fellows developed or participated in include (1) Analysis of cryoglobulinemia and auto-immune markers in chronic hepatitis C; (2) A controlled trial of consensus interferon for therapy of chronic hepatitis C; (3) The clinical impact of endoscopic ultrasound; (4) Characterization of preneoplastic molecular defects in colonic cells obtained from colonoscopy preps; (5) The expression of the DCT-1 (divalent cation transporter -1) gene in duodenal mucosae of subjects with HLA-linked heredity hemochromatosis, compared with controls; (6) Investigationof the role of iron in pathogeneis of non-alcoholic steatohepatitic (NASH) and possible benefits of iron reduction for therapy of NASH; and (7) Usefulness of clarithromyium for therapy of Chron's disease or gama linolemi acid for therapy of ulcerative colitis.
Years 2 and 3:
The schedule for these years is more flexible and depends upon the needs and interests of the fellows. Those primarily interested in clinical practice and scholarship will spend approximately 14 months chiefly doing advanced procedures (e.g., Endoscopic ultrasound, enteroscopy, ERCP, PEG, polypectomies) and outpatient clinics, and 3-5 months on the inpatient and outpatient Liver Service and 5-7 months mainly doing research and scholarly activities. Fellows primarily interested in laboratory-based research activities will have the option of spending from 14-20 months primarily doing research, with proportionately less time doing procedures and attending clinics. Clinic: Approximately 7,000 patients are seen annually in the outpatient Gastroenterology Clinic. The second year fellow spends two mornings per week seeing patients in the Clinic under the supervision of a DDN attending. One morning per week is dedicated to new patient visits with the other being reserved for follow-up visits. The attending will personally confirm the fellow's findings and discuss the patient's management plan with the fellow. Electives: Fellows may choose to take up to three months of electives in their third year. These may include electives at UMASS or other academic centers, and may be in pediatric gastroenterology, GI surgery, radiology, pathology, or liver transplantation. Approximately four months of inpatient consultation and procedures are done in the second year at the Memorial Campus.
Fellows are evaluated by attending faculty on a quarterly basis. This is done via a computerized database. There is ample opportunity for verbal feedback in addition to the E-Value database.