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Rotations

Fellows are encouraged to arrange for away rotations based on their interests. 

Consult Services

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Fellows are assigned to consult services at 3 different sites throughout their training, all located in Worcester, MA. They serve as first call for consults placed by different services (ICU, ER, Medicine, Surgery, Neurology, etc.) on patients with varying gastrointestinal, hepatic and pancreaticobiliary issues. They build on their growing experience as they learn to multitask and prioritize tasks throughout the day, form differentials based on the available clinical data, relay their thoughts and plans via notes, assist and perform procedures on patients they have seen, run rounds with the Attending and other trainees, arrange for follow up in the outpatient setting and help coordinate care for our patients with their families and other physicians. Always supervised, fellows are nevertheless expected to act more independently as they progress through the years and to serve as teachers and professional role models for newer learners.

First year fellows are primarily assigned to General GI or Liver Consult/Transplant service at the primary university based site, at the University Campus. Second year fellows essentially run the combined General GI and Liver Consult service at Memorial Campus, which is the smaller campus located 2 miles away from the medical school. All fellows provide consult services at Saint Vincent’s Hospital, which provides for a more traditional community-based hospital experience.  Since we implemented a X + Y schedule for the University Campus based consult services, senior fellows divide up service requirements when first year fellows are off service during the Y week.

Biliary Service

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All senior fellows are assigned to inpatient and outpatient blocks designed to allow for exposure to advanced endoscopic procedures, such as ERCP and EUS. Inpatient biliary service includes coordinating care with the primary consult teams, scheduling advanced procedures and then joining the advanced endoscopist to assist and perform these procedures. Despite the presence of a dedicated Advanced Endoscopy Fellow a year, general GI fellows have ample opportunity to learn about this complicated group of patients and start to develop basic skills involved with these highly specialized and evolving procedures.

Endoscopy

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All first year fellows are assigned a mandatory outpatient endoscopy block within their first three months of training. Fellows are expected to learn how to assess and consent a patient for common endoscopic procedures such as diagnostic EGD or screening colonoscopy. Fellows learn how to anticipate difficult cases, evaluate for factors that can affect the interventions, and provide post-procedure recommendations and follow up based on the findings and pathology.  They of course, are expected to also perform the procedures under the guidance of an Attending physician. 

Research

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Fellows are scheduled for a research block during their first year, and more blocks are dedicated to research by their third year. Requirements for clinical, quality improvement and patient safety projects, presentations and publications are set from the beginning of training and progress is marked through quarterly meetings and at biannual performance reviews. Fellows are encouraged to work with various Attendings but also encouraged to develop their own projects.  Research blocks are designed to allow for minimum clinic responsibilities so research efforts can be prioritized. This block also allows another time to be able to perform more procedures, but the primary objective is to produce meaningful research. 

Clinics

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As a large referral center, UMass GI is able to provide subspecialized care within the field of Gastroenterology and as trainees in the affiliated fellowship program, fellows have the opportunity to follow patients in various clinics.  General GI and General Liver Continuity clinics provide the core outpatient continuity experience.  In addition, fellows are assigned to IBD, Pancreas and Urgent GI Care Clinics. They have the opportunity to work with the Transplant Hepatologists to work in Liver Transplant based clinics.  As newer services, such as bariatric endoscopy, are introduced, fellows can anticipate working in these clinics to learn from these patients.  Fellows are assigned to clinics while on certain service blocks - never when providing the consult service at University Campus - and during non-service rotations.

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