Curriculum

The Gastroenterology and Hepatology Fellowship at Dell Medical School accepts two fellows every year. Over a three-year period, fellows receive comprehensive training in endoluminal, pancreatic and hepatobiliary diseases and endoscopy. The Division of Gastroenterology and Hepatology includes faculty with subspecialization in inflammatory bowel disease, hepatology, motility and advanced endoscopy. 

The first year is devoted to reaching competence in general gastroenterology and endoscopy. Years two and three include elective and research time for fellows to take advantage of the diverse clinical offerings and research opportunities available at Dell Medical School.

Guiding Principles

The changing health care landscape requires a renewed focus on high-value care and health care equity. This focus is foundational to Dell Med and it permeates to the department and division level. The training in this fellowship emphasizes improving outcomes while decreasing costs of care; it also promotes learning in a diverse and inclusive environment. These skills combined with clinical training will prepare fellows to practice in any setting and lead the field of gastroenterology.

Rotations

Inpatient Consultation Service

The inpatient consult service at Dell Seton Medical Center rigorously trains fellows in performing consultations for a wide range of gastroenterology and hepatology problems. Dell Seton is the only adult level 1 trauma center in Central Texas and in the Austin metropolitan area. 

The consult service is comprised of the attending gastroenterologist, gastroenterology fellow, internal medicine resident and medical students. Some months may have one senior fellow and one junior fellow. First-year fellows are primarily responsible for conducting and supervising consultations as well as performing inpatient endoscopy. Senior fellows are primarily responsible for leading and coordinating all aspects of the consult service, teaching residents and performing outpatient endoscopy. The program believes this training simulates real-world GI practice and the fellows will feel comfortable and ready to practice in academic or private settings.

Senior fellows will also rotate on the consult service at Ascension Seton Medical Center Austin, a 400-bed tertiary referral hospital in central Austin with a patient population that compliments those at Dell Seton Medical Center.

Endoscopy Rotation

The endoscopy rotation will predominantly focus on outpatient endoscopic procedures along with pre- and post-procedural care. In addition to this rotation, fellows also perform endoscopic procedures on the inpatient consult service. Gastroenterology faculty perform more than 3,500 endoscopic procedures per year at Dell Seton. Fellows will conduct outpatient endoscopic procedures at Dell Seton and other facilities.

Ambulatory Rotation

Fellows will rotate on faculty clinics including general gastroenterology, hepatology and inflammatory bowel disease. Fellows will also be trained in the interpretation of esophageal manometry, pH monitoring and video capsule studies.

Hepatology Service

Fellows will perform inpatient and outpatient hepatology consults. Senior fellows will have the option of conducting this rotation at a liver transplant center.

Research Rotation

Fellows will have one month of research in their first year, one month in the second year and two months in the third year. First-year fellows will identify a research question and then mentor, assess feasibility, plan a project and start Institutional Review Board review (as needed). Second-year fellows will conduct a study, analyze results and prepare an abstract for submission to a national-level gastroenterology conference. Third-year fellows will complete their study, prepare the manuscript and submit to a peer-reviewed journal with the goal of publication. View recent publications by core gastroenterology faculty »

Elective Rotation

Fellows may pursue open-ended rotations focused on individual clinical, endoscopic or research interests. Examples include gastrointestinal pathology, radiology, pancreaticobiliary, motility, social medicine, inflammatory bowel disease or liver transplant.

Continuity Clinic

Each fellow will have one half day of continuity clinic per week.

Call Responsibility

Fellows will cover calls at Dell Seton Medical Center with the following responsibilities:

• Two weeks of overnight weeknight calls per month required while on the consult rotation.
• Weekend call is shared by fellows on consult, hepatology, ambulatory, and endoscopy rotations (one weekend per month per fellow).
• Fellows on ambulatory, elective and research rotations do not have call responsibilities.
• All calls are from home; none are overnight in hospital.

Conferences

Gastroenterology Grand Rounds

Grand rounds include two sessions per month. In each session, one fellow presents patient cases followed by a literature review. Each fellow presents at least three sessions per year. Faculty or guest faculty will also present research and clinical topics.

Reading Conference

This conference includes two sessions per month. In faculty-led sessions, pre-assigned fellow readings are reviewed with a focus on high-yield teaching. Topics chosen for these sessions fall under two categories. The first is comprised of broad symptom-based topics designed to understand the approach to common GI symptoms such as dysphagia, diarrhea, nausea, etc. The second category is comprised of more detailed topics that are covered on board exams but not commonly or frequently seen in day-to-day practice.

Pathology Conference

This conference includes one session every other month. Fellows learn from a pathology curriculum and are led by pathology faculty.

Gastroenterology Morbidity and Mortality Conference

Approximately every other month, this fellow-led conference discusses a patient seen by our division with a focus on reviewing evidence on how to deliver improved care.

Journal Club

This club includes one session per month. Two fellows present per session, with each presenting a recent study with analysis. Each fellow will have a faculty mentor.

Inflammatory Bowel Disease Conference

This conference includes one session every month. Fellows attend both a local city-wide IBD conference as well as a national Veterans Administration IBD conference in an alternating fashion.

Livestrong Cancer Institutes Multidisciplinary Conferences (Tumor Board)

The gastroenterology tumor board is conducted every week and the hepatobiliary tumor board is conducted every other week at noon. Fellows are expected to attend both of these conferences.