National Institute of Health Scholars Program
The 3-year combined Fellowship in Gastroenterology and Hepatology at the University of Maryland and National Institutes of Health (NIH) is designed to provide broad training in both clinical gastroenterology and hepatology and in clinical research. The first year of the fellowship is purely clinical and is centered at the University of Maryland Medical Center and Baltimore VA Medical Center (BVAMC). The second and third years are based at the NIH Clinical Center and are predominantly focused on clinical research. The fellowship leads to board eligibility in Gastroenterology and is designed to prepare fellows for a career in academic clinical investigation and clinical care. Please refer to the UMD Gastroenterology and Hepatology Fellowship Curriculum page for information about the first year of fellowship at UMD. The information below details fellowship training during the 2nd and 3rd years of the UMD-NIH Scholars Program.
The NIH component of the fellowship program is supervised by Stephen Wank, MD, a tenured Senior Clinical Investigator and Chief of the Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, NIH. Nine NIH gastroenterologists, including Dr. Wank, participate in the NIH portion of the program. Find more information at the NIH web site.
- 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 NIH
Routine and daytime emergency GI procedures at assigned hospital
Supervision of residents, students, case presentations at patient management conference outpatient clinic
- Hepatology service (approximately 6 months during fellowship)
Liver consultations at University Hospital or NIH
Inpatient endoscopy on hepatology patients
Attend hepatology clinic
Case presentations, hepatology conference, formal Liver Rounds at NIH, and weekly hepatopathology conference at University Hospital and NIH
- Endoscopy rotation (1 month in first year)
Outpatient endoscopy at University Hospital
Esophageal motility - performance and interpretation
Esophageal 24 hour pH monitoring - setup and interpretation
Wireless capsule endoscopy - setup and interpretation
- Outpatient management
l follow their own patients in the VA clinic and University Clinic. In the second and third years the fellows will follow their own patients in the NIH GI clinic and will periodically see patients in the NIH Hepatology clinic. Direct faculty supervision is available at all sites.
- Clinical research (7 - 8 months in both the second and third years)
Develop research protocol(s), obtain IRB approval(s), and complete research project(s) with faculty mentor(s) at the NIH
Research presentations (GI grand rounds and national meetings)
- Emergency consultations
All fellows share night and weekend call in rotation for emergency consultations and procedures, performed with direct attending supervision.
Year 1- coverage of University Hospital and Baltimore VAMC
Years 2 and 3 - coverage of NIH Clinical Center
GI Consultation Service
At the NIH fellows carry out inpatient consultations in gastroenterology at the NIH Clinical Center, a fully functioning 234 bed research hospital with additional extensive day hospital and outpatient areas. The NIH Clinical Center is the nation's largest hospital devoted to clinical research and has both patient care areas and considerable laboratory space and research support facilities.
At the NIH, hepatology rotations provide a truly unique experience. In addition to providing inpatient consultative services at the Clinical Center, fellows are directly responsible for the care of liver patients admitted for clinical protocols of the Liver Diseases Branch. Most protocols focus around the treatment of viral hepatitis or steatohepatitis and the fellow manages the patients and performs all necessary liver biopsies. Weekly formal liver rounds and liver pathology conferences are held with world-renowned hepatologists and hepatopathologists and provide superior training in hepatology and exposure to the design and implementation of clinical trials.<
GI continuity clinic is held in the NIH Clinical Center. In addition, hepatology clinics are held two times per week; however, fellows attend only when patients they have seen in consultation during inpatient months are seen in follow-up, or if patients involved in protocols in other departments require outpatient liver consultation.
The NIH Clinical Center houses a fully functional endoscopy unit with the capability to perform all standard endoscopic procedures, including wireless capsule endoscopy. ERCP and EUS are not performed at the NIH. During their two years at NIH, fellows return to the Baltimore VAMC or University of Maryland each month for additional endoscopy exposure.
Considerable emphasis is placed on clinical research to prepare trainees for careers in academic medicine and clinical research.
The Digestive Diseases Branch at the National Institutes of Health is uniquely positioned to provide a robust research experience. The facilities of the NIH Clinical Center are second to none and world experts in numerous areas are available for collaboration. Pioneering research takes place every day at the NIH and patients with conditions that most only read about in textbooks become commonplace.
Major areas of current study within gastroenterology and hepatology include familial carcinoid tumors, GI peptides and their receptors, non-invasive methods of performing gastric acid analysis, hepatitis B/C/D, nonalcoholic fatty liver disease, GI manifestations in hyper-IgE syndromes and Behcet's disease, mucosal immunology, and the use of mesenchymal stem cells in Inflammatory Bowel Disease.
At the NIH, fellows provide evening and weekend call for urgent consultations and procedures. Call is taken from home, and weekend rounds are conducted as needed. A faculty attending is also assigned to night call and is always available for consultation. All procedures at night or on weekends are supervised directly by the attending physician.
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.
Applications to this program are handled through the University of Maryland Division of Gastroenterology and Hepatology