The Gastroenterology Fellowship Program at Lankenau Medical Center is a three-year program that provides comprehensive training in the fields of gastroenterology, hepatology, clinical nutrition and gastrointestinal oncology. The fellowship requires a minimum of 18 months of clinical experience in general gastroenterology and hepatology. The additional 18 months of training are available for electives, including hepatology, gastrointestinal motility, interventional endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Additional electives outside Lankenau Medical Center are encouraged. In addition, electives in clinical and basic science research are also encouraged.

As a result of the clinical fellowship training in gastroenterology, the fellows should be able to:

  • Understand and describe details of gastrointestinal and hepatic anatomy and physiology.
  • Describe the physiology basis for gastrointestinal hepatic function testing.
  • Possess knowledge base regarding pathophysiology, natural history and treatment of patients with gastrointestinal/liver disease.
  • Integrate knowledge with clinical evaluation skills including history, physical examination, laboratory, and radiographs to develop treatment plans including identification of important psychosocial aspects of disease.
  • Describe with sensitivity and specificity indications, contraindications, risks, cost, and benefits associated with the following procedures in this specialty:
    • Esophagogastroduodenoscopy
    • Esophageal dilatation
    • Proctoscopy and flexible sigmoidoscopy
    • Colonoscopy and polypectomy
    • Percutaneous liver biopsy
    • Percutaneous endoscopic gastrostomy
    • Biopsy of mucosa of the esophagus, stomach, small bowel and colon
    • Gastrointestinal motility studies
    • Non variceal hemostasis
    • Variceal hemostasis
    • Enteral and parenteral alimentation
    • Liver biopsy
    • Endoscopic retrograde cholangiopancreatography, sphincterotomy, and biliary stent placement
    • Endoscopic ultrasonography
    • Laser therapy

The First Year Fellow

  • Spends the majority of his or her time on clinical services.
  • The fellow will be introduced to various endoscopic procedures including flexible sigmoidoscopy, upper endoscopy, colonoscopy and liver biopsy, paracentesis.
  • He or she dedicates their time to developing consultative skills, developing clinical judgment as it pertains to gastrointestinal disorders.
  • Communicates with other attendings, residents and students.
  • Will be introduced to clinical and/or basic science research.
  • Will lecture to students, residents and attending staff on various GI topics.
  • Clinic Responsibilities:
    • Include one afternoon a week during which time each fellow will see patients in the Gastroenterology Clinic under the supervision of an attending physician.
    • Three months of the first year will include protected research time which can be clinical or bench research at the discretion of the fellow.
    • Each fellow will have teaching responsibilities both on the floor and in the form of scheduled conferences to the residents, fellows and attending physicians.

The Second Year Fellow

  • Majority of time remains on clinical services.
  • Additional focus on endoscopic skills which will emphasize colonoscopy and therapeutic endoscopy including polypectomy, treatment of variceal bleeding, bleeding ulcers and introduction to ERCP.
  • The fellow in the second year will refine their consultative skills.
  • Three months of protected research time will again be available this year in either clinical or bench research.
  • One month of liver transplant service will be required during this year. This will be completed at Jefferson University Hospital or Albert Einstein Medical Center.
  • Will present lectures and clinical cases as scheduled to students, residents and attending staff.

The Third Year Fellow

  • This year stresses the balance between research and clinical work. Six months will be spent on the clinical services, which will include the general Gastroenterology Service but may also include elective time outside of Lankenau Medical Center. The six months will be either bench or clinical research.
  • Endoscopic skills will be refined, especially therapeutic endoscopy and specifically concentrating on ERCP and introduction to endoscopic ultrasound.
  • The third year fellow will spend a considerable amount of time giving conferences to residents fellows, and attending staff.
  • During six months of research, one month will be dedicated to the Liver Transplant Service at Jefferson Hospital and another month of clinical time will be spent at Graduate Hospital concentrating on esophageal motility, interpretation and evaluation of esophageal manometry and 24-hour PH studies.
  • Will present lectures and clinical cases as scheduled to students, residents and attending staff.

Clinical Skills

Fellows will also be able to interpret histologic specimens in consultation with pathologists, learn the rationale behind an approach to preoperative risk assessment in gastrointestinal/liver patients undergoing a surgery and other procedures, become skilled at critically reviewing the literature in gastrointestinal/liver disease, and to use evidence based medicine to support clinical decisions in the care of patients.

Additional clinical expectations:

  • To demonstrate an investigatory analytical thinking approach to clinical situations, to know and apply the basic and clinical supportive sciences which are appropriate to the discipline of gastroenterology.
  • To analyze practice experience and perform practice-based improvement activities using a systemic methodology.
  • To apply knowledge of study design and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
  • To use information technology to manage information, access on-line medical information and support their own education.
  • To facilitate the learning of students and other health care professionals in the field of gastroenterology.
  • To display a humanistic approach to patient care including the understanding of ethical principles involved in end-of-life decisions which include withholding and withdrawing life support as well as standards for advanced directives and do-not-resuscitate orders.
  • To communicate effectively and demonstrate caring and respectful behavior when interacting with patients and their families, gather essential and accurate information about their patients and make informed decisions about diagnostic and therapeutic interventions based on patients information and preferences, and up-to-date scientific evidence in clinical judgment.
  • To work with health care professionals including those of other disciplines to provide patient focus care.
  • To create and sustain a therapeutic ethically sound relationship with patients, use effective listening skills and elicit and provide information using effective non-verbal explanatory and questioning and writing skills.
  • To work effectively with others as a member or leader of health care teams or other professional groups.
  • To demonstrate respect, compassion and integrity; a responsiveness to the needs of patients and society that supersedes self-interest.
  • To display accountability to patients, society and the profession and a commitment to excellence and ongoing professional development.
  • To develop and practice teaching skills as it relates to students and residents.
  • To understand how their patient care and other professional practice effects other health care professionals, the health care organization and the larger society and how these elements of the system affect their own practice.
  • To practice cost effective health care and resource allocation that does not compromise quality of care.
  • To provide quality patient care and assist patients in dealing with system complexity and they are to know how to partner with health care managers and health care providers to assess, coordinate and improve health care and know how these activities can affect system performance.


Teaching is an integral part of the fellowship program. Each fellow is expected to teach medical residents and students on rounds and be available to provide consultation and information to all residents involved in the care of mutual patients. In addition, the fellows are assigned specific lectures given to medical residents and students during the course of the year. They are also expected to be involved in the medical residents' teaching rounds in order to provide insight for gastrointestinal patients on their service.