UMD MMC Clinician Scholar Program - Gastroenterology and Hepatology Fellowship
The three-year combined Fellowship in Gastroenterology and Hepatology at the University of Maryland and Mercy Medical Center is designed to provide broad training in clinical gastroenterology and hepatology and in clinical research.
The first year of the fellowship centered at the University of Maryland Medical Center and Baltimore VA Medical Center (BVAMC). The second and third years are based at Mercy Medical Center, a community teaching hospital affiliated with University of Maryland School of Medicine. The fellowship leads to board-eligibility in Gastroenterology and is designed to develop fellows into exceptional clinical practice, academic clinical investigator or academic clinician-educators.
The Mercy Medical Center component of the fellowship program is supervised by Paul J. Thuluvath, MD, director for the Institute of Digestive Health and Liver Diseases (IDHLD) at the Mercy Medical Center. The IDHLD has many nationally and internationally recognized clinicians and researchers with many years of academic experience of training gifted GI fellows. Mercy Medical Center also has a long-established tradition of co-training residents in conjunction with University of Maryland Medical Center. Find out more information about the IDHLD.
Outline of Training ProgramToggle accordion item
GI Consultation Service
(approximately 9 months over the first year and three months during each of the second and third years)
- Year 1 - consultations at University Hospital and Baltimore VAMC
- Years 2 and 3 - consultations at MMC
- Routine and daytime emergency GI procedures at assigned hospital
- Supervision of residents, students, case presentations at patient management conference
- Outpatient clinic
(approximately 6 months during fellowship)
- Liver consultations at University Hospital and MMC
- Liver biopsies
- Inpatient endoscopy on hepatology patients
- Attend hepatology clinic
(1 month in first year, 4-6 months in years 2-3)
- Outpatient endoscopy at University Hospital and MMC
- Esophageal motility - performance and interpretation
- Esophageal 24 hour pH monitoring - setup and interpretation
- Wireless capsule endoscopy - setup and interpretation
Inflammatory Bowel Disease Consultation service
- Inpatient consultations in inflammatory bowel disease at University Hospital or MMC
- Attend IBD clinic
(approximately 2 - 6 months, in years 2-3)
- ERCP (both diagnostic and therapeutic) at MMC
Throughout the first year all fellows will follow their own patients in the VA clinic and University Clinic. In the second and third years the fellows will follow patients in the MMC IDHLD. Direct faculty supervision is available at all sites.
(4-6 months in years 2-3)
- Develop research protocol(s), obtain IRB approval(s), and complete research project(s) with faculty mentor(s) at the MMC and UMD
- Research presentations (GI grand rounds and national meetings)
- Publish findings
GI Consultation ServiceToggle accordion item
In the first year fellows carry out inpatient consultations in gastroenterology at the University of Maryland Medical Center, Baltimore VAMC, and Shock Trauma Hospital on a daily basis, under the close supervision of a full-time faculty member. Fellows usually will supervise medical residents and/or students doing a GI subspecialty rotation. The consultation service includes didactic teaching and bedside evaluation of patients on work rounds. Fellows participate in any GI procedures required for the patient's evaluation.
At MMC, fellows will carry out inpatient consultations in gastroenterology at the Medical Center Campus under supervision of MMC faculty. MMC was recognized as the #2 hospital in the State of Maryland for 2014-15 by U.S. News & World Report.
Hepatology/Liver TransplantationToggle accordion item
The hepatology rotations at the University of Maryland provide a comprehensive experience in outpatient and inpatient consultation in liver diseases, management of patients with acute and chronic liver diseases, evaluation of patients for liver transplantation, and consultative services for patients pre and post liver transplantation. Instruction is provided in techniques of liver biopsy, interpretation of liver biopsies, and participation in hepatology/transplantation rounds and conferences.
At MMC, hepatology rotations provide a truly unique experience. In addition to providing inpatient consultative services at MMC, fellows will have exposure to the breadth of community as well as referral-level hepatic disorders, including patients with end-stage liver disease in the pre-transplant as well as post-transplant outpatient setting. Exposure to the design and implementation of clinical trials in liver disease is also available.
GI ClinicsToggle accordion item
Year 1: Two outpatient continuity clinics are held for fellows, one at University Hospital and one at the Baltimore VAMC, with a total of approximately 4,650 patient visits (3,500 VA, 1,150 UMMS). This provides fellows with extensive experience in outpatient management of common gastrointestinal problems.
Years 2 and 3: GI continuity clinic is held in the MMC IDHLD. In addition to general gastroenterology clinics, outpatient continuity clinic experiences at The Center for Inflammatory Bowel and Colorectal Diseases, The Center for Heartburn and Reflux Disease, The Center for Liver and Hepatobiliary Disease and The Center for Pancreatic Care are available.
GI ProceduresToggle accordion item
Approximately 11,000 procedures are performed annually in the Division of Gastroenterology at the University of Maryland and Baltimore VAMC. There are three combined inpatient/outpatient endoscopy facilities, two in the University Hospital and one at the Baltimore VAMC. Fellows are closely supervised and are trained progressively in upper endoscopy, flexible sigmoidoscopy, colonoscopy and polypectomy, percutaneous endoscopic gastrostomy placement, treatment of GI bleeding, endoscopic band ligation of esophageal varices, foreign body retrieval, and dilation of esophageal strictures. Training is also provided in performance and interpretation of esophageal motility studies, 24 hour pH monitoring, wireless capsule endoscopy, balloon enteroscopy, and percutaneous liver biopsy. Procedural training meets all board eligibility requirements and is designed to prepare fellows for clinical practice. Computerized endoscopy reporting systems are used at each hospital.
The MMC houses a fully functional endoscopy unit with the capability to perform all standard endoscopic procedures, as well as wireless capsule endoscopy, balloon enteroscopy, ERCP and EUS. During their two years at MMC, fellows will have the opportunity for significant exposure to advanced endoscopy procedures and endoscopic techniques, including EMR (endoscopic mucosal resection) and ESD (endoscopic submucosal dissection).
EvaluationsToggle accordion item
Emphasis is placed on day-to-day feedback to fellows on individual cases and procedures. In addition, attendings provide formal written and informal feedback at the end of the rotation for each fellow. Written evaluations are available for review by the fellow and are discussed with the program director at least every six months. Likewise, fellows provide written confidential evaluations of each faculty member and of the training program. The fellow has ample opportunity for discussion with the program director throughout the training period.
In addition to the minimal requirements above, emphasis is placed on mentoring trainees by individual faculty members regarding research projects, didactic presentations, and long-range career goals.