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PROGRAM DESIGN 

Our training program provides a 12 months curriculum based on supervised clinical work with increasing (progressive) responsibility for patient care in the outpatient and inpatient settings. There is also synchronized instruction in basic and clinical Gastroenterology.

Fellows are required to obtain competency in the following seven (7) core areas:

  1. Patient Care: compassionate and effective for the treatment of disease and promotion of health. 
  2. Medical Knowledge about evolving biomedical, clinical, epidemiologic, and social and behavioral sciences and the application of this knowledge to patient care. 
  3. Practiced Based Learning & Improvement involving investigation and assessment of patient care; appraisal and assimilation of scientific evidence for improvements in patient care. 
  4. Interpersonal and Communication Skills resulting in effective information exchange and teaming with patients, families, and other health professionals. 
  5. Professionalism manifested as a commitment to carrying out professional responsibilities, adhering to ethical principles, and sensitivity to a diverse patient population. 
  6. System Based Practice demonstrated by actions that show awareness and responsiveness to the larger context and system of health care and the ability to effectively call upon system resources to provide cost-effective care of optimal value without compromising the quality of care. 
  7. Osteopathic Manipulative Treatment integrated to all educational experiences as appropriate. 

Clinical Requirements:

  1. Integration of osteopathic principles and practice appropriate to Gastroenterology. 
  2. 36 months of training will be devoted to clinical gastroenterology with major emphasis on acquiring the required technical and clinical skills.
  3. Up to 3 months of the 36 months will be spent in full time gastroenterology research.

The research will be related to gastroenterology associated topics and the mentor will be a gastroenterologist. There will be evidence that the research will contribute to the educational experience of the fellow.

  1. Twelve (12) months will be spent in GI electives such as inflammatory bowel disease, motility, nutrition, hepatology, oncology, biliary tract disease, pediatric gastroenterology, ERCP, endoscopic ultrasound, or transplant medicine and other electives as approved by the program director.
  2. One month of training in gastrointestinal motility disorders. This requirement could be met at the outside clinic.

The program will provide training in the skills required to be the director of an endoscopy center, to include training in the regulations (i.e. OSHA) regarding the protection of health care workers, universal precautions, and other regulatory requirements pertinent to the operation of an endoscopy lab. The training will include the processes involved in the use and maintenance of equipment, handling of contaminated and hazardous materials, and sharing of information (HIPAA). There will also be training in the business practice of gastroenterology, and accreditation processes.  

Specific Program Content for Knowledge Areas

Diagnosis and treatment of the following conditions:
  1. Disorders of the esophagus including cancer, gastro-esophageal reflux and strictures.  
  2. Non-cardiac chest pain.  
  3. Gastrointestinal bleeding including upper, lower, and anorectal bleeding.  
  4. Disorders of the stomach including peptic ulcer disease, cancer and gastroparesis. 
  5. Severe malabsorption. 
  6. Disorders of the pancreas including acute and chronic pancreatitis and cancer.  
  7. Complications of endoscopic procedures.  
  8. Disorders of the hepato-biliary system including cancer, biliary obstruction, hepatitis and cirrhosis. 
  9. Infectious diseases of the gastrointestinal system.  
  10. Irritable bowel syndrome.  
  11. Disorders of the small intestine including obstruction and cancer. 
  12. Inflammatory bowel disease. 
  13. Disorders of the colon including cancer.  
  14. Intra-abdominal abscesses.  
  15. Disorders of nutrient assimilation, Acute and chronic malnutrition.  
  16. Vascular disorders of the gastrointestinal tract. 
  17. Mesenteric insufficiency and its complications. 
  18. Gastrointestinal disorders in relation to systemic diseases.  
  19. Gastrointestinal infections including viral, bacterial, mycotic and parasitic diseases.
The fellows will receive formal instruction, clinical experience, and opportunities to acquire expertise in the evaluation and management of the following disorders:
  1. Gastrointestinal pancreatic neoplasms 
  2. Gastrointestinal diseases with an immune basis 
  3. Pancreatitis 
  4. Gallstones and cholecystitis 
  5. Alcoholic liver diseases 
  6. Viral and immune hepatitis 
  7. Cholestatic syndromes 
  8. Drug-induced liver injury 
  9. Hepatobiliary neoplasms 
  10. Chronic liver disease 
  11. Gastrointestinal manifestations of HIV infections 
  12. Gastrointestinal neoplastic disease 
  13. Acute and chronic hepatitis 
  14. Biliary and pancreatic diseases 
  15. Women’s health issues in digestive diseases 
  16. Geriatric gastroenterology, Gastrointestinal bleeding 
  17. Cirrhosis and portal hypertension 
  18. Genetic/inherited disorders 
  19. Medical management of patients under surgical care for gastrointestinal disorders.
Expertise in the following knowledge areas:
  1. Normal gastrointestinal physiology. 
  2. Gastrointestinal pharmacology.  
  3. Enteral and parenteral alimentation. 
  4. Ethics and public policy in relation to gastrointestinal disorders. 
At the completion of this training, the fellows should have mastered specific objectives as they concern to each of the specific goals of our curriculum, and they will demonstrate Clinical Competence in a variety of clinical settings:
  1. All fellows should be competent in the specific clinical objectives for the majority of diseases seen in the practice of Gastroenterology. 
  2. Understand current diagnostic approaches in the fields of gastroenterology, hepatology and pancreaticobiliary diseases.  
  3. Understand current therapeutic approaches in the fields of gastroenterology, hepatology, and pancreaticobiliary diseases.  
  4. Understand the physiology, pathophysiology, and pathobiology of diseases relevant to gastroenterology, hepatology, and pancreaticobiliary diseases.  
  5. Understand the importance of a multidisciplinary approach through integration of surgery, radiology, pathology, and nutrition into management of patients with gastrointestinal, pancreaticobiliary, and hepatic diseases.  
  6. Demonstrate proficiency as a member, consultant and/or leader of a multidisciplinary health care team, and possess the proper communication skills. 
  7. Accomplish clinical proficiency at a level where the trainee may be able to exhibit good teaching and administrative skills. 
  8. Demonstrate qualities of professionalism and humanistic skills at a high level which the fellows may serve as role models for trainees at junior levels. 
  9. Accomplish a research work and submit it for peer reviewed presentation, scientific meetings, manuscript submissions, or grant applications for research funding. 
  10. Maintain their skills in internal medicine and develop lines of communication with medicine residents and faculty. Fellows will be expected to coordinate care with appropriate internal medicine personnel and to participate in educating medicine interns and residents.

Rotations By Year

PGY – 1
5 months of Gastroenterology Consult Service
3 months of General Endoscopy
2 months of Hepatology
1 month of Gastrohealth
1 month of Outpatient Endoscopy
PGY – 2
4 months of Gastroenterology Consult Service
3 months of Outpatient Endoscopy
2 months of Hepatology
1 month of General Endoscopy
1 month of Ambulatory Gastroenterology
1 month of Gastrohealth
PGY – 3
5 months of Outpatient Endoscopy
2 months of Hepatology
1 month of Gastroenterology Consult Service
1 month of Ambulatory Gastroenterology
1 month of Endoscopy Ultrasound
1 month of General Endoscopy
1 month of Gastrohealth

Affiliated Sites

Larkin Community Hospital
Palmetto General Hospital – Gastroenterology Consults
Center for Digestive Medicine – Hepatology Outpatient
Cleveland Clinic Florida – Hepatology
Advanced Gastroenterology of South Florida – Ambulatory Gastroenterology/Endoscopy Ultrasound 
Palmetto Lakes Surgical Center – Outpatient Endoscopy
Gastro Health – GI Motility/Capsule/ IBD/ Colorectal Surgery/ Advance Endoscopy/ Hepatology/ Pediatric GI & Nutrition 
Hialeah Hospital – General Endoscopy
West Palm Beach VA – Outpatient Endoscopy
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