Gastroenterology Fellowship Program
About the Gastroenterology Fellowship Program
The Gastroenterology Fellowship Program at Lankenau Medical Center is a three-year program that provides comprehensive clinical training in gastroenterology (GI) and hepatology. The fellowship requires 18 months of inpatient consultations. An additional 18 months of training focuses on subspecialty electives including inflammatory bowel disease (IBD), hepatology, GI motility, advanced interventional endoscopy, GI oncology and functional bowel disease. Emphasis is placed not only on clinical care in the acute care setting, but also in the ambulatory setting. Fellows are exposed to a very wide range of patient demographics and disease processes in both the community hospital and urban, tertiary care center setting.
Clinical training is primarily based at Lankenau Medical Center, but includes rotations at Jefferson University Hospital, a major orthotopic liver transplant center. Extensive endoscopic training is provided throughout all three years and includes training in advanced procedures such as ERCP. Weekly fellows’ conferences and multi-disciplinary conferences provide forums for didactics and review of the most up to date information and society practice guidelines on all areas within GI and hepatology.
Research is not the main focus of our program, but understanding and critically reviewing the literature and participating in at least one clinical or basic science research project during fellowship is required. Teaching opportunities are abundant at fellows’ didactic conferences, internal medicine resident conferences and hands-on training of students rotating from medical and physician assistant schools.
Upon completion of our fellowship program, all fellows are expected to:
- Understand the pathophysiology and natural history of GI and liver diseases
- Manage basic and complex GI and liver diseases in the acute care setting
- Manage basic and complex GI and liver diseases in the ambulatory setting
- Evaluate pre and post-liver transplantation patients
- Know up-to-date society guidelines in the management of GI and liver diseases
- Read and interpret motility studies of the upper and lower GI tracts
- Read and interpret wireless capsule endoscopy studies
- Read and interpret GI radiographic studies including CT scans and bleeding scans
- Perform the following endoscopic procedures:
- Esophagogastroduodenoscopy (EGD)
- Esophageal dilatation
- EGD with pH probe placement
- EGD with botox injection
- EGD with foreign body extraction
- Percutaneous endoscopic gastrostomy (PEG)
- Colonoscopy with polypectomy
- Non-variceal hemostasis including epinephrine injection, clips, thermal therapy, hemospray
- Variceal hemostasis
- ERCP, sphincterotomy and biliary stent placement
- Write a research IRB proposal and conduct an original research study from start to finish
- Critically review literature and understand basic statistics and epidemiology
- Read and interpret representative histologic slides of various GI and liver pathology
Application information
All applications must be submitted through Electronic Residency Application Service (ERAS).
The following documents are required:
- Official medical school transcript
- ERAS application
- Personal statement
- Two letters of recommendation
- USMLE or COMLEX scores
Interview invitations will be sent out by August 23, 2024. Interviews are currently expected to be conducted virtually. We will notify applicants if there are any changes to a live format.
If you have any further questions about the fellowship application, please contact our fellowship coordinator, Kathryn Lattanzio at [email protected] or 484.476.3305.
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Curriculum
Learn more about the Gastroenterology Fellowship curriculum.
Goals and objectives
The Gastroenterology Fellowship Program at Lankenau Medical Center provides fellows with extensive clinical experience and interactive patient contact. When the fellow is on the clinical service, the fellow will serve as the team leader, coordinating, directing and instructing students and residents on the service. The fellow is responsible for distributing, reviewing and evaluating all clinical work on the service. The fellow is also responsible for teaching and directing all students and residents on the service. The clinical fellow will in turn report directly to the attending physician on service reviewing each patient including pertinent clinical data with the attending physician. The fellow is also responsible for directing and coordinating work and teaching rounds with the attending physician.
Fellows have intense endoscopic training throughout all 3 years of their fellowship training. All endoscopic procedures are performed under the direct supervision of an attending physician. The attending physician must be present during every endoscopic procedure in its entirety.
Goals and objectives are as follows:
Patient care
- Fellows must be able to provide care to gastroenterology patients in the hospital that is effective, appropriate and compassionate
- Demonstrate competency in gathering essential and accurate gastrointestinal history from patients, formulating a course of action and conveying the information in a succinct manner to the attending
- Evaluate patients and initiate appropriate management in a timely fashion
- Be available to the patient, staff and attending physicians to address ongoing changes in patient status
- Communicate effectively with patients, attendings, co-fellows and all providers involved with a patient’s care
Medical knowledge
- Fellows must demonstrate knowledge of established and evolving practice guidelines and apply their knowledge to patient care
- Demonstrate competency in recognizing and managing common and complex GI disorders, including anemia, peptic ulcer disease, complicated pancreatitis, inflammatory bowel disease, motility disorders, malnutrition
- Demonstrate competency in recognizing and managing common and complex liver disorders, including pre and post liver transplant evaluations, decompensated cirrhosis, acute liver failure
- Understand the pathophysiology of gastrointestinal and liver disorders
- Understand appropriate indications for endoscopic procedures as well as other diagnostic studies
- Review appropriate radiographic studies and laboratory data
- Demonstrate knowledge of pharmacologic drugs used to manage GI and liver disease
Technical skills
- Fellows must demonstrate proficiency in performing various endoscopic procedures including colonoscopy, upper endoscopy, push enteroscopy
- Treatment of bleeding varices and non-variceal bleeds
- Exposure to ERCP and sphincterotomies, stone extractions, placement of biliary stents. If a fellow completes the elective 3 months of extra ERCP training, he/she may be signed off as being proficient in ERCPs at the end of fellowship
- Removal of foreign bodies and food impactions
- Dilation of esophageal strictures and rings
- Ablation of vascular lesions with argon plasma coagulation
- Placement of PEG tubes
- Submucosal injections using botox, tattoo ink, saline lifts for removal of large polyps
Practice-based learning and improvement
- Fellows must be able to investigate and evaluate their patient care practice
- Appraise and assimilate scientific evidence to improve patient care
- Facilitate learning of other health professionals
- Demonstrate positive utilization of feedback provided during bi-annual formal feedback sessions with fellowship leadership
Interpersonal and communication skills
- Fellows must demonstrate interpersonal communication skills that result in effective information exchange in teaming with patients, patient’s families and all providers involved in patient care
- Demonstrate an effective relationship with other health care professionals
- Use effective listening skills and demonstrate effective non-verbal explanatory and questioning writing skills
Professionalism
- Fellows must demonstrate a commitment to carrying out professional responsibilities
- Adhere to professional ethical standards
- Maintain confidentiality of patient information
- Demonstrate sensitivity towards a diversity of cultures, ages, genders and disabilities
System-based practice
- Fellows must demonstrate awareness of and responsiveness to the larger context and system of healthcare
- Demonstrate effective utilization of resources
- Advocate for the patient within complex healthcare systems
Faculty, fellows and alumni
Learn more about the Gastroenterology Fellowship Program's faculty, fellows and alumni.
Research
Research is an integral part of our three-year Gastroenterology Fellowship Program at Lankenau Medical Center. Each fellow will have participated in one year of clinical or bench research. Each fellow is expected to publish at least one article in a peer-reviewed journal during his/her fellowship. Additional publications are also encouraged. There is a monthly research conference during which research projects are discussed.
- Basic science and clinical research is encouraged.
- The fellows are exposed to basic science research at the Lankenau Institute for Medical Research. Basic science lectures are given by onsite instructors as well as guest speakers.
- Joint research projects are arranged with other departments at Lankenau Medical Center which have active research programs and fellowship programs.
- At least one clinical/basic science research paper is expected from each fellow during their fellowship program. Fellows are given ample dedicated research time in order to procure such a paper. The fellows review their research project on an informal basis monthly with the attending physician they are doing the research paper with and at least twice a year with the program director.
Visiting rotations
Residents and students from Lankenau Medical Center as well as external residency programs, medical schools, osteopathic schools and physician assistant schools are all welcome to rotate on the GI inpatient service. Rotations are typically 2- 4 weeks long. Students are expected to follow 2-3 inpatients, depending on the level of clinical experience and the complexity of each patient. Responsibilities include obtaining history and physicals, rounding daily on patients they are following, writing daily progress notes and providing updates to the GI fellows and attending physician on service on rounds. Visitors may watch endoscopic procedures but may not perform them.
Residents and students are expected to attend GI conferences while on the inpatient service and to also give one informal talk on a GI topic of their choice. They may be excused for mandatory medical school events and to attend internal residency noon conference.
Interested students should contact Kathryn Lattanzio to schedule a rotation at [email protected] or 484.476.2169. Availability depends on the number of other residents and students on the rotation at the time of interest.
Conferences
Residents and students from Lankenau Medical Center as well as external residency programs, medical schools, osteopathic schools and physician assistant schools are all welcome to rotate on the GI inpatient service. Rotations are typically two to four weeks long. Students are expected to follow two to three inpatients, depending on the level of clinical experience and the complexity of each patient. Responsibilities include obtaining history and physicals, rounding daily on patients they are following, writing daily progress notes and providing updates to the GI fellows and attending physician on service on rounds. Visitors may watch endoscopic procedures but may not perform them.
Residents and students are expected to attend GI conferences while on the inpatient service and to also give one informal talk on a GI topic of their choice. They may be excused for mandatory medical school events and to attend internal residency noon conference.
Interested students should contact Kathryn Lattanzio to schedule a rotation at [email protected] or 484.476.2169. Availability depends on the number of other residents and students on the rotation at the time of interest.