 |
Structured Education
|
The structured education program within the curriculum
includes a variety of didactic and other teaching methods.
Intramural conferences are held weekly or biweekly from September
through June.
|
|
|
| Active Participation by Trainees
in Several Structured Education Components |
| Component |
Active
participation |
Frequency during the program |
|
Year 1
|
Years 2, 3
|
| Division Rounds |
Oral presentation |
2/yr.
|
2/yr.
|
| Clinical Correlation
Conference |
Case presentation |
1-3/month
|
1/month
|
| Clinical Journal Club |
Article discussion |
3-4/yr.
|
3-4/yr.
|
| Pathology Conference |
Slide review sessions |
10-12/yr.
|
2-6/yr.
|
| Core Conference/Board
Review |
Topic discussion;
Discussion of Board questions |
2/month
|
2/month
|
| Topics in IBD |
Topic presentation |
1/yr.
|
1-2/yr.
|
| Risk Management |
Self-assessment program
and examination |
1/yr.
|
--
|
| Extramural Postgraduate
Courses |
Course attendance |
1/yr.
|
1-2/yr.
|
Elements of Structured Education
| |
Division Rounds |
| |
| Objectives |
|
Develop the skill of
condensing a clinical topic, critically reviewing and summarizing
relevant literature in a compact 25-minute presentation. Understand
principles of gastroenterology through presentations by faculty, fellows
and visiting professors. |
| |
|
|
| Frequency |
|
Every week except during
the summer and national holidays. |
| |
|
|
| Description |
|
Fellows prepare and present
two topics each year. The fellow chooses the topic with advice from
his or her faculty mentor or the program director. Presentations are
made with slides and include a literature review. Time is allowed
for questions. Fellows receive feedback from members of the faculty
regarding content of presentation, clinical relevance of topic and
skill at delivery. |
| |
|
|
| Evaluation |
|
A feedback letter by
the program director is delivered on a one-to-one basis and is appended
to the fellow’s permanent file.
Formal written evaluation following each rotation. (See form: Fellow
Evaluation by Faculty)
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Clinical Correlation Conference |
| |
| Objectives |
|
Provide an opportunity
for interdepartmental discussions of interesting cases, diagnostic
and therapeutic dilemmas, and rare conditions. Learn to interpret
data regarding a specific aspect of the presented case and summarize
current approach to the diagnostic or therapeutic problem. |
| |
|
|
| Frequency |
|
Once a week except during
summer and national holidays. |
| |
|
|
| Description |
|
Three to four cases are
presented each week. Expert opinion is available from radiologists,
pathologists and surgeons. Fellows are required to keep a list of
appropriate cases available for presentation at this conference. Presentations
are brief and highlight a clinical point or a diagnostic or therapeutic
problem. Fellows are encouraged to review the literature and briefly
discuss a key aspect of the case. (Link to Case of the Week). |
| |
|
|
| Evaluation |
|
Direct one-to-one critique
of presentation style and content, and review of literature.
Formal written evaluation following each rotation. (See form: Fellow
Evaluation by Faculty)
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Clinical Journal Club |
| |
| Objectives |
|
Develop an ability to
critically analyze research work published in leading gastroenterological
journals and determine whether conclusions are reliable. |
| |
|
|
| Frequency |
|
Every two weeks. Each
fellow presents three to four articles during an academic year. |
| |
|
|
| Description |
|
Two articles are presented
and discussed at each session. Fellows select a clinical article from
one of the leading gastroenterology or medical journals with the assistance
of his or her faculty or research mentor. A critical analysis of the
methodology and results is encouraged, followed by the fellow’s
views regarding the topic, the appropriateness of the study and the
conclusions. The topic is opened for discussion and comments by faculty
members and fellows. |
| |
|
|
| Evaluation |
|
Direct feedback from
faculty members at the end of the session.
Formal written evaluation following each rotation. (See form: Fellow
Evaluation by Faculty)
Quarterly feedback sessions with the division chief. |
| |
Pathology Conference |
| |
| Objectives |
|
Familiarize the fellow
with histopathologic appearances of common gastroenterological diseases.
Develop an ability to interpret histopathology in a clinical context,
and to apply this knowledge to the day-to-day management of patients. |
| |
|
|
| Frequency |
|
Every two weeks. |
| |
|
|
| Description |
|
Five to 10 biopsy samples
from procedures performed over the previous two weeks are selected
by the fellow assigned to organize the conference. The patient’s
clinical history is briefly presented by the fellow who performed
the procedure, and the fellows are asked to interpret the biopsy samples
under the supervision of a faculty pathologist specialized in gastroenterologic
biopsy interpretation. |
| |
|
|
| Evaluation |
|
Direct one-on-one feedback
by the faculty pathologist.
Formal written evaluation following each rotation. (See form: Fellow
Evaluation by Faculty)
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Topics in Inflammatory Bowel Disease |
| |
| Objectives |
|
Develop an understanding
of current opinions regarding etiology, pathogenesis and therapy of
IBD. |
| |
|
|
| Frequency |
|
Every four weeks. |
| |
|
|
| Description |
|
Invited speakers from
within and outside the division give lectures on selected topics in
IBD, focusing on pathogenesis, etiology and management, including
newer agents. Fellows are similarly invited to present short topics.
Faculty members interested in IBD discuss their research. Difficult
management problems are presented to get an opinion from other specialists. |
| |
|
|
| Evaluation |
|
Direct one-on-one feedback
after topic presentation.
Faculty critique of presentations.
Formal written evaluation following each rotation. (See form: Fellow
Evaluation by Faculty)
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Extramural Conferences |
| |
| Objectives |
|
Develop an understanding
of surgical issues in gastroenterology and medical problems seen in
conjunction with gastroenterological problems. Continue training the
gastroenterology fellow as an internist who can deal with investigation
and management of common medical problems. |
| |
|
|
| Description |
|
Fellows are encouraged
to attend the following conferences:
Colorectal surgery conference: held weekly in a case-presentation
format, after which the cases are opened for discussion by other faculty
members.
Medicine grand rounds: held weekly in a lecture format. Presenters
are either faculty members from internal medicine, medicine residents
and chief residents, or invited speakers from other departments or
other institutions. Question-answer sessions follow each presentation.
Medicine clinico-pathologic conference: held weekly in a case
discussion format. A distinguished clinician is presented a difficult
or rare case and is asked to analyze the problem and his approach
to further investigation and diagnosis. The clinician delivers a short
didactic session on the best investigation of the presenting symptom. |
| |
|
|
| Evaluation |
|
Evaluation is based on
appropriate gain in knowledge toward fulfillment of the integrated
objectives. The participation of the fellow in these conferences is
not directly evaluated. |
| |
Medical Ethics |
| |
| Objectives |
|
Develop an understanding
of the composite issues in medical ethics. Encourage ethical conduct
in the fellow’s approach to clinical medicine. |
| |
|
|
| Description |
|
Direct one-on-one discussions
occur when situations are encountered in which ethics play a role
in the consult service’s recommendations. Fellows are encouraged
to attend formal ethics conferences held twice a month by the Department
of Internal Medicine. These sessions consist of discussions of situations
in which ethics play an integral part in patient care, with didactic
lectures on ethics. |
| |
|
|
| Evaluation |
|
Direct observation of
the trainee’s skills and knowledge of ethical conduct during
clinical rotations.
Comment on professional conduct on the quarterly faculty evaluations
and during semiannual feedback sessions with the division chief. |
| |
Risk Management |
| |
| Objectives |
|
Encourage practice of
safe and appropriate medical care and good documentation in patient
charts. Develop ability to identify situations where the assistance
of risk management may be required. |
| |
|
|
| Description |
|
Fellows are required
to complete a risk management self education tool involving multiple
choice questions, descriptions of clinical situations, and issues
involved in documentation and interpretation of medical records. The
Department of Risk Management is available by phone 24 hours a day
for discussion of patient-related issues. |
| |
|
|
| Evaluation |
|
Scoring of multiple choice
questions in the self-education tool and feedback of deficiencies.
Continued re-education until satisfactory scores achieved.
Deficiencies are discussed at faculty meetings.
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Summer Start-Up Lecture Series |
| |
| Objectives |
|
To introduce the new
first-year fellow to the basic workings of procedural aspects of gastroenterology
and hepatology. Understand the basic indications, complications, logistics
and techniques of commonly performed procedures in gastroenterology.
Learn an approach to the management of common situations encountered
in the consult service. Understand basic principles of being a consultant. |
| |
|
|
| Frequency |
|
One-hour didactic sessions
every weekday during the month of July. |
| |
|
|
| Description |
|
The new fellow is introduced
to procedural logistics and other basic clinical aspects of the gastroenterology
division. Scheduling of procedures, indications for urgent procedures,
conscious sedation issues, working as a consultant, and indications
for specialized procedures are discussed. Approaches to common problems
encountered on the consult service are dealt with in a lecture format,
with question-answer sessions at the end of each lecture. Introductory
techniques for the procedures performed by the first-year fellow are
explained. |
| |
|
|
| Evaluation |
|
Limited evaluation for
this part of the structured education curriculum.
Comprehension and appropriate progress is subsequently evaluated during
the clinical rotations. |
| |
Core Conference and Board Review |
| |
| Objectives |
|
Develop a more detailed
understanding of GI and liver diseases. Review topics that may not
be covered otherwise during the curriculum in clinical rotations and
conference settings. Develop comprehensive knowledge base to better
prepare the trainee for the GI Boards and for a consultative career. |
| |
|
|
| Frequency |
|
Two one-hour sessions
every month, excepting the summer months and national holidays. |
| |
|
|
| Description |
|
This conference begins
in the fall and cycles for two years. Core GI topics are discussed
under the supervision of a faculty attending. Core topics essential
for GI boards are of particular focus. |
| |
|
|
| Evaluation |
|
Oral quizzing of the
fellow during the review sessions.
Faculty review of basic knowledge base during quarterly evaluations.
Semiannual summary of knowledge base during feedback sessions with
the division chief. |
| |
Extramural Postgraduate Courses |
| |
| Objectives |
|
Develop an understanding
of GI diseases. Augment knowledge of core topics in preparation for
board examination. Learn about newer techniques and approaches by
experts in the field. |
| |
|
|
| Description |
|
Fellows are encouraged
to attend postgraduate courses hosted by the gastroenterologic associations
in conjunction with national and international meetings. Travel and
registration costs are covered by the division for one course during
each year of fellowship. Fellows are also encouraged to attend board
review courses in preparation for board examinations. |
| |
|
|
| Evaluation |
|
Quarterly feedback sessions
with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
| |
Professor's Rounds |
| |
| Objectives |
|
Understand the approach
to management of complicated GI problems. |
| |
|
|
| Description |
|
Fellows are encouraged
to present complicated cases with difficult diagnostic or management
issues. Patients are presented and discussed in a group discussion
format with ample question and answer opportunities. |
| |
|
|
| Evaluation |
|
Direct one-on-one critique
after presentation.
Quarterly feedback sessions with the division chief.
Fellow evaluation form. (See form: Fellow Evaluation by Faculty) |
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| Back to Fellowships
| Application
Division of Gastroenterology
Department of Medicine
Washington University School of Medicine
|
