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Fellowship

Educational Curriculum

There are five major rotations in the fellowship program:  inpatient and consult service at Robert Wood Johnson University Hospital (RWJUH); the core clinical teaching site of Rutgers Robert Wood Johnson Medical School (RWJMS); consult service at the VA New Jersey Health Care System at Lyons (VANJHCS); IBD rotation at the Crohn’s and Colitis Center of New Jersey; interventional endoscopy at RWJMS; and research.  In addition, there is a one-month rotation at the liver transplant service at Rutgers New Jersey Medical School, where the fellows will have direct, hands-on experience in the management of patients in the pre- and post-liver transplant periods.

The inpatient/consult service rotation exposes the fellow to a wide range of GI pathology in the acute inpatient setting, including GI emergencies.  The fellow will learn how to perform the various endoscopic procedures and about the various aspects of GI oncology and GI manifestations of various oncologic diseases and management.  This rotation will include managing different aspects of patient care from arranging various diagnostic/therapeutic procedures to discharge planning.  The mix of diseases include, but are not limited to, abdominal pain, GI bleeding, IBD, GI oncology, liver diseases, biliary and pancreatic diseases.

The VANJHCS rotation exposes the fellows to a patient population that may have different disease entities or disease manifestations.  In the VA system, patients have high incidence of chronic liver diseases related to gastrointestinal and liver problems.  The mix of diseases include, but are not limited to, GERD, peptic ulcer disease, including H. pylori, upper and lower GI bleeding, chronic liver disease, pancreatitis, benign and malignant colorectal neoplasm and biliary tract diseases.

During the IBD rotation, the fellow gains experience and expertise in the diagnosis and management of ulcerative colitis and Crohn’s disease and various complications related to IBD. They will learn various pharmacological and nonpharmacologic treatments to induce remission and prevention of relapse.  The fellow will also interact with two colorectal surgeons who are involved in the multidisciplinary Crohn's and Colitis Center of New Jersey. Currently, we have been following approximately 1,500 patients with IBD. The fellow is given the opportunity to participate in the various research (clinical or basic) studies conducted at the Crohn’s and Colitis Center of New Jersey.

The interventional endoscopy rotation will take place during the second or third year of fellowship, when the fellow will be able to perform (depending on the level of endoscopic skill) ERCP diagnostic and/or therapeutics. During this rotation, the fellow will also be exposed to endoscopic ultrasonography. GI training (e.g., continuity clinic) for the ambulatory patients includes taking care of patients with chronic GI illnesses, especially IBD, liver diseases, GERD and IBS, and to recognize urgent situations and how to arrange for the appropriate treatment and how to expedite the workup.  In addition, this rotation gives the fellow the opportunity to see the patient for the follow-up visit and, therefore, the fellow can be educated about the results of the diagnostic workup and the efficacy of the treatment.  The fellow learns how to communicate with the referring physicians regarding their patient care and how to delegate clinical responsibility.  It exposes the fellow to telephone medicine and how to manage patients’ requests and complaints over the phone and to triage who needs to be seen by a physician, especially when and where.  The mix of diseases include, but are not limited to, abdominal pain, GERD, constipation, functional GI disorders, women’s health, nausea and vomiting, weight loss, anemia, GI bleeding, IBD, GI oncology, chronic liver diseases, biliary and pancreatic diseases.

Research is required of all trainees.  The departmental minimal research requirements for graduation are a submission of a paper to a peer-reviewed journal as first author; or presentation and publication of an abstract as first author; or submission of a grant or a preparation and submission of an IRB protocol (the faculty mentor will serve as PI).  Basic science:  This division has well-equipped, active labs with funding from various sources, including the Rutgers Cancer Institute of New Jersey (CINJ).  In addition, there is one PhD, one MD faculty member/research teaching specialist and two technicians in the division exclusively involved in basic and molecular research. During their research rotation, the fellows have the opportunity to learn a fair amount of basic science-related information by interacting with their respective preceptor, the research staff and a number of scientists from basic science departments and the CINJ faculty and research staff. The fellows can also be involved in a clinical research project and ongoing multicenter clinical trials and other investigator-initiated clinical research   In addition, they can take an active role in various clinical studies conducted by the fulltime GI faculty members.

During the liver transplant rotation at Rutgers New Jersey Medical School, the fellow gains exposure to and experience in the management of patients with chronic liver diseases in the pre-transplant, transplant and post-transplant periods. The fellow will evaluate the patients under the direct supervision of the transplant hepatologist and will work closely with the transplant surgeons.  There is a broad range of specialty and subspecialty services at this location, access to extensive radiology and pathology services and a close working relationship with the transplant surgeon.