Allowing the trainee to develop leadership skills is an important goal of the program.
The core curriculum is highly supervised by faculty, yet the establishment of independent thinking on the part of the trainee is encouraged. For example, trainees develop their own assessments and management plans in the outpatient offices before engaging in formal discussion with the attending physician. The trainee is expected to compose completed endoscopy reports before critical review by the attending physician.
The degree of independence in clinical, research and teaching responsibilities increases throughout the curriculum. Nevertheless, in the Washington University program, no procedures are performed without a faculty member in attendance, the trainee is fully aware of the published backup schedules for all services, and every patient is managed, at a minimum, within HCFA guidelines from the standpoint of supervision. Past trainees have found the program’s graduated approach to developing independent thinking extremely effective.
Trainees are also encouraged to accrue skills as educators while completing the curriculum. Several components of structured education provide an opportunity for lecturing and formal case presentation. Critiques of trainee speakers at division rounds are specifically intended to hone the presenter’s skills. Trainees are also encouraged to observe the educational methods of faculty members at small group sessions during second-year medical student pathophysiology instruction. Opportunities also arise to teach allied health professionals. Although optional for the trainee, these teaching opportunities can be particularly advantageous for trainees planning academic careers.
The program also fosters development of administrative talent. The senior fellow on the gastroenterology inpatient/outpatient rotation organizes one structured conference (Professors’ Rounds). A trainee from each PGY group will be selected annually as a representative to appropriate division and University committees and participate in selected faculty meetings for purposes of shaping the mission and monitoring the quality of the fellowship program. Additionally, all fellows are expected to review and evaluate faculty teaching skills and their training experience on a quarterly basis using written evaluation forms.