Gastroenterology (GI) Elective

The gastroenterology (GI) elective is structured to expose the internal medicine resident to a large number of patients with gastrointestinal diseases. The core of the elective is a busy inpatient gastroenterology service that includes patients requiring GI consults as well as patients with primary gastrointestinal disorders.

The resident is part of a team formed by attending physicians, gastroenterology fellows, medicine resident(s) and medical students on elective. This team functions together to provide the gastroenterology services in both the north and south campuses of Barnes-Jewish Hospital.

During the rotation, the resident also participates in the outpatient activities and the structured educational program of the division.

Objectives

  • Expose the resident to a broad spectrum of GI diseases seen in the inpatient and outpatient settings.
  • Show the resident how a subspecialist in gastroenterology approaches patients from a diagnostic and therapeutic standpoint.
  • Teach the resident the pathophysiologic basis of GI diseases and provide mechanistic explanations for treatment interventions.
  • Develop an interest on the part of the resident in gastroenterology as a sub-specialty field.
  • For the interested resident, provide exposure to scholarly investigation.

Teaching methodology

The principal teaching mechanism will be daily participation in team activities, and teaching will come from both fellows and attending physicians.

The resident will be assigned one to two consultations daily. He or she will take the initial history, perform the physical examination and develop a tentative assessment and management plan. The information and tentative approach is presented to the team, and, under the direction of the attending physicians, is critiqued and modified.

The resident learns appropriate diagnosis and management of common and uncommon disorders, and mechanistic information is relayed during teaching rounds. The resident attends at least one half-day clinic per week and is directly responsible for the initial evaluation of at least three patients per session.

Didactic conferences further teach appropriate diagnosis and management algorithms. Division rounds provide pathophysiology background and mechanistic explanations.

Resident responsibilities

The resident participates in all team activities, assigned outpatient clinics and conferences during a five-day work week. The resident may be asked to participate on weekends at the discretion of the attending physicians – this will typically be limited to one weekend day each week or less, shared with other residents rotating through GI.

The resident may be asked to present cases at the Wednesday evening Clinical Case Correlation Conference, but the resident will not be asked to prepare other formal conference presentations, e.g. for division rounds.

The typical workday begins between 7 and 8 a.m. depending on the degree of team responsibilities. The resident will remain with the team until daily activities are completed.

The resident also will be expected to participate fully in the division’s five weekly conferences. The weekly conferences are:

  1. Gastroenterology Division Rounds (Wednesdays, 7:30 a.m., Clouse Conference Room, fourth floor Wohl Building)
  2. Clinical Case Correlation Conference (Wednesdays, 5 p.m., Clouse Conference Room, fourth floor Wohl Building)
  3. GI Research Conference (Friday, noon, CSRB Conference Room)
  4. GI Journal Club/Core Conference/Board Review (Thursday, 7:30 a.m., Clouse conference room, fourth floor Wohl Building; conferences alternate)
  5. GI Professors’ Rounds (Fridays 7:30 a.m., Clouse Conference room, fourth floor Wohl Building)

Journal Club

Articles of recent interest on important or controversial topics concerning diagnosis and therapy are discussed at the GI Journal Club. A list of articles discussed at Journal Club over the past one to two years is provided to inform the resident of publications that fit this description.

Core GI topics are discussed at the Core Conference/Board Review, with question and answer sessions discussing GI Board questions. A pathophysiology overview and a lecture series concerning the gastrointestinal procedures are offered in the early months of each academic year.

The resident selecting the gastroenterology elective in July and August is welcome to participate in these conferences.

Evaluation

The resident will be evaluated by the attending physicians and fellows. The resident is expected to actively participate in all components of the elective so that the teaching objectives can be achieved. There is no formal exam.

At the end of the rotation, an opportunity will be offered for the resident to evaluate the elective either by discussing aspects of the elective directly with the attending physicians involved or by arranging a private meeting with the elective coursemasters (Dr. Avegail Flores).