 |
Meeting Gastroenterology Core Curriculum recommendations/ACGME requirements The division philosophy conforms to the recommendations outlined in the Gastroenterology Core Curriculum* as follows: Fellowship Introduction The program stresses the role of the gastroenterologist as a consultant who interacts with the referring physician. The program leadership, supporting staff, faculty and administration are fully committed to the educational program. The program is oriented toward cultivating an attitude of skepticism and inquiry and a dedication to continuing education that will remain with the trainee after matriculation. Two career track options The program design conforms to the recommendations outlined in the Gastroenterology Core Curriculum* and requirements of the ACGME in that: A minimum of three years of training is required. At least two trainees are enrolled in the program at all times to allow for peer interactions. The core curriculum exceeds the minimum of 18 months and consists of traditional inpatient and outpatient consultation experience as well as other educational activities. Longitudinal outpatient experience continues throughout the three years of training with at least one half-day per week in the ambulatory care clinics. Approximately 30 percent of the core curriculum consists of clinical training in hepatobiliary disease (at Washington University, >30 percent in the clinical track and >25 percent in the investigator track considering inpatient rotations, outpatient clinics and liver disease encountered on GI, VA and endoscopy services). Minimum threshold levels of basic endoscopic procedures are met. A substantial research experience of at least six months is included in the curriculum. Structured education The structured education aspect of the program conforms to the recommendations outlined in the Gastroenterology Core Curriculum* in that: Trainees develop a scholarly approach to education by independent study through textbook reading, literature reviews and attendance at society meetings, seminars and postgraduate courses. (Relevant conferences include: Journal Club, Core Conference and Board Review; attendance at a major annual meeting is required annually; postgraduate courses are encouraged and allowed annually; trainees are sent to educational seminars as funding and scheduling permit.) A weekly clinical conference is held. (Division rounds are held weekly.) Basic science, journal club and research conferences are held at least monthly. (Journal Club for basic and clinical article review is held biweekly; Research Conference is held weekly.) Interdisciplinary conferences with radiology, pathology and surgical services are held at least monthly. (Clinical Correlation Conference is held weekly.) A series of lectures covering physiology/pathophysiology/pharmacology is offered during the curriculum. (Core Physiology is offered every three years; Pathophysiology lecture series and monograph as used for the second-year medical students is provided yearly and includes gut pharmacology.) Visiting professor and scholars are included in the curriculum. (At least four visiting professors are included in Division Rounds annually; visiting scholars present at Research Conference.)
The Clinical Curriculum Faculty supervision of patient care by trainees is provided in both inpatient and outpatient settings. The trainees have the clinical experience and opportunity to acquire expertise in the evaluation and management of patients with the wide variety of presenting complaints and diagnoses encountered in the field of gastroenterology. Trainees in the ambulatory care setting should be reponsible, on the average, for between one and three new patients and between three and six follow-up patients during a typical half-day clinic session.
Procedural Training At completion of training, the trainee should be able to: Recommend endoscopic procedures based on findings of a personal consultation and in consideration of specific indications, contraindications and diagnostic/therapeutic alternatives. Perform a specific procedure safely, completely and expeditiously. Interpret most endoscopic findings correctly. Integrate endoscopic findings or therapy into the patient management plan. Understand the risk factors attendant to endoscopic procedures and recognize and manage complications. Recognize personal and procedural limits and know when to request help. Meeting Gastroenterology Core Curriculum recommendations/ACGME requirements: Procedural training within the program conforms to the recommendations outlined in the Gastroenterology Core Curriculum* in that: Minimum threshold levels of basic endoscopic procedures are met. Competence of training in basic endoscopic procedures is not based solely on meeting minimum threshold requirements. Participation in quality assurance programs is required. (Quality Assurance Review occurs quarterly as a formal intramural conference.) Research Experience The appropriate facilities and faculty to provide training and support in gastrointestinal research are available. A substantial research experience of at least six months is included in the curriculum. Scholarly attitude is enhanced by active participation in one or more research projects, followed by presentation at national meetings and publication in peer-reviewed journals. Opportunity to study formally the elements of study design, decision analysis, other statistical methods, and skills required for clinical investigation is available. The Environment The working environment conforms to the recommendations outlined in the Gastroenterology Core Curriculum and requirements of the ACGME in that: The program resides within a medical institution that is accredited for internal medicine and gastroenterology by the ACGME and is affiliated with an established medical school. Evidence of insitutional commitment to education includes adequate financial resources to support faculty and trainees; adequate and modern facilities, space and equipment to accomplish the overall educational program; adequate clinical support services available on a 24-hour basis; peer interaction among specialty and subspecialty trainees; and sponsorship of meaningful biomedical research by the primary teaching site. An intellectual environment is provided for acquiring the knowledge, skills, clinical judgment, attitudes and values of professionalism that are essential to the practice of gastroenterology. The trainees interact fully with the internal medicine program. Trainees work closely and effectively with members of other specialties and subspecialties, including critical care medicine, oncology, surgery, pathology and radiology. A sufficient number of patients of wide demographic diversity is available to ensure adequate inpatient and outpatient experience. Contemporary inpatient and outpatient facilities are utilized. The procedure laboratories are fully equipped with state-of-the-art endoscopy and motility equipment and are capable of specialized diagnostic studies, computerized report generation, and basic gastrointestinal function tests. Facilities for parasitology testing are provided. Support services are available and include: modern intensive care units, full-service emergency room, diagnostic and interventional radiology unit, pathology laboratory, nuclear medicine facility, general and hepatobiliary surgery facilities, and oncology facilities. A comprehensive medical library with online capabilities for literature search and review is available to the trainees. The appropriate facilities and faculty to provide training and support in gastrointestinal research are available. Leadership These aspects of the training program conform to the recommendations outlined in the Gastroenterology Core Curriculum* in that: The program promotes gradual reduction in the level and degree of supervision, making the trainee confident in his or her own abilities to independently manage complicated cases. Trainees participate actively in the teaching of medical students and medical residents. Faculty The faculty composition conforms to the recommendations outlined in the Gastroenterology Core Curriculum* or required by the ACGME in that: The training director is appropriately qualified, committed full-time to the training program, and based at the primary training site. The ratio of faculty to trainees exceeds 1:1.5 (1:0.65 in 1998). The faculty includes a full-time hepatologist. The faculty is sufficiently large to ensure adequate supervision of trainees and coverage of programmatic components (a recommendation satisfied exclusively by full-time faculty at Washington University). At least three full-time faculty members are present who devote 20 hours per week or more to various aspects of training nine in 1998). Faculty are qualified to serve as role models in their clinical practices and academic performance. * The Gastroenterology Leadership Council (AASLD, ACG, AGA, ASGE). Training the gastroenterologist of the future: the gastroenterology core curriculum. Gastroenterology 1996;110:1266-1300. Back to top | Back to Fellowships | Application
Division of Gastroenterology
|
