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Curriculum

The Gastroenterology and Hepatology fellowship 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 Med.

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

Block Rotation Schedule

  • 6 months: Consult
  • 1 month: Endoscopy
  • 2 months: Ambulatory
  • 2 months: Hepatology
  • 1 month: Research
  • 4 months: Consult
  • 2 months: Endoscopy
  • 3 months: Ambulatory
  • 1 month: Hepatology
  • 2 months: Research
  • 2 months: Consult
  • 3 months: Endoscopy
  • 1 month: Ambulatory
  • 2 months: Hepatology
  • 2 months: Research
  • 2 months: Elective

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 one trauma center in central Texas and 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.

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 greater than 3500 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 away 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 project and start IRB review (as needed). Second-year fellows will conduct the study, analyze results and prepare an abstract for submission to a national-level gastroenterology conference. Third-year fellows will complete the study, prepare the manuscript and submit to a peer reviewed journal with the goal of publication. Recent publications by core gastroenterology faculty may be found here.

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.
  • Two weeks of weeknight overnight call per month are required while on the consult rotation.
  • Weekend call is shared by fellows on consult, hepatology 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 case followed by literature review. Each fellow presents at least three sessions per year. Faculty or guest faculty will also present research or clinical topics.

Reading Conference

This conference includes two sessions per month. Faculty-led sessions review pre-assigned fellow readings with a focus on high yield teaching. Topics chosen for these sessions fall under two categories. The first category is comprised of broad symptom-based topics designed to understand 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 session every other month (alternates with Radiology Conference). Fellows learn from pathology curriculum led by pathology faculty.

Radiology Conference

This conference includes one session every other month (alternates with Pathology Conference). Fellows learn from radiology curriculum led by radiology faculty.

Fellow Research Conference

This conference includes one session for every fellow every year during the month that the fellow is on research rotation. Fellows present the following components of their research project: core hypothesis and study design in the first year, progress update in the second year and results in the third year.

Journal Club

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

Livestrong Cancer Institutes Multidisciplinary Conferences (Tumor Board)

Gastroenterology tumor board is conducted every week and hepatobiliary tumor board is conducted every other week at noon. Fellows are expected to attend these conferences.

Clinical Practice Conference

This conference includes one session every other month (alternates with Human Flourishing). Faculty or guest faculty leads an open discussion on wide range of clinical practice topics. Examples include new techniques or devices, career and job discussions, legal topics, artificial intelligence and biostatistics.

Human Flourishing Sessions

These sessions include one session every other month (alternates with Clinical Practice Conference). Human Flourishing curriculum is developed in partnership with Kern National Network to harbor caring, character and human flourishing. This is a unique aspect of the program designed to harbor personal and professional fulfillment.