Gastroenterology Fellowship

First-year fellows spend the majority of their time acquiring cognitive skills; learning how to apply them effectively in answering consults and beginning to learn diagnostic and therapeutic endoscopy. They are taught fundamentals of consultation in gastroenterology and hepatology and serve as the primary contact on the inpatient services, while also starting to learn ambulatory care. They are taught all basic endoscopy procedures including colonoscopy; esophageal dilation; gastrostomy; mucosal biopsies; sigmoidoscopy and upper endoscopy.

Fellows rotate through all three participating hospitals (Jackson Memorial Hospital, UHealth Tower and VA Medical Center) and, in addition, have a half-day continuity gastrointestinal clinic weekly at one of the above locations. During the first year, fellows have at least one month of blocked research time and attend three hours of conference per week, where they are responsible for presenting at conferences including journal club, morbidity and mortality and multidisciplinary conferences, like surgery, in addition to presenting their scholarly work at a research conference.

As the primary inpatient consultation fellows, the first years play a critical role in teaching the residents and students rotating on our services. All six of the core ACGME competencies are taught and evaluated, with the expectation of reaching specialty-accepted milestones before proceeding to the next level of training.

Second-year fellows expand on the aforementioned skills learned in their first year by assisting first-year fellows in all aspects of their experience. They are responsible for helping in the education of the first-year fellows, as well as providing further higher-level education to the rotating students and residents. Second-year fellows further refine the endoscopic skills obtained in their first year and also learn advanced endoscopic procedures, including capsule and deep enteroscopy; colonoscopy with polypectomy; endoscopic control of bleeding (variceal and non-variceal); endoscopic ultrasound; endoscopic retrograde cholangiopancreatography; enteral stenting; esophageal motility and pH studies and percutaneous and laparoscopic liver biopsy. They rotate through all four participating hospitals and in addition, have a half-day continuity GI clinic weekly at either Jackson Memorial Hospital, UHealth Tower or the VA Medical Center. They also continue to refine their knowledge in inpatient and outpatient consultative gastroenterology and hepatology and rotate on the subspecialty services. Fellows can also do electives in multidisciplinary areas both within and outside of internal medicine, such as genetics, oncology, pathology, radiology and surgery.

Second-year fellows start to acknowledge and appreciate the subtle differences in care provided at government, public and university institutions including access to care, cultural differences and different electronic health record systems. They continue to participate in the scholarly work that had been initiated during their first year, both longitudinally and in at least one month of blocked research time. These middle-level fellows attend three hours of conference per week and present at the journal review and inflammatory bowel disease conferences, as well as presenting their scholarly work at research conferences. All six of the core ACGME competencies are taught and evaluated, with the expectation of reaching specialty-accepted milestones before proceeding to the next level of training.

Third-year fellows further expand on their cognitive and procedural base by supervising first- and second-year fellows and learning the subtleties of advanced and therapeutic endoscopic procedures, while fine-tuning their skills in basic endoscopy and becoming ready to perform procedures independently. They also serve in the role of team leader on the consultative and primary inpatient services in gastroenterology and hepatology at all sites, being allowed progressively more independent decision making, while still having faculty oversight at all times. It is also in this capacity that they are being readied for independent practice.

Fellows rotate through all four participating hospitals and in addition, have a half-day continuity GI clinic weekly at Jackson Memorial Hospital, UHealth Tower or the VA Medical Center. Third-year fellows rotate through more of the subspecialty and elective services and gain a further appreciation for the practice of our specialty in various settings. They conclude their scholarly work, both longitudinally and in at least one month of blocked research time, with most fellows producing presentations at national meetings and/or manuscripts in peer-reviewed journals. For some fellows, this research serves as a springboard for continued research productivity in their careers. The fellows at this level of training can spend a greater block of time focusing on an area of subspecialty (either clinically or in research) or continue mastering general gastroenterology and hepatology. In their role as senior fellows, their teaching skills are further refined, providing education to more junior fellows, residents, students and other healthcare professionals. They attend three hours of conference per week and present at endoscopy, inflammatory bowel disease and motility conferences, as well as presenting their scholarly work at research conferences. All six of the core ACGME competencies are taught and evaluated, with the expectation of reaching specialty-accepted milestones before graduating. The full three years of training provide fellows all of the tools to be successful in academic or community-based settings, either in general or niche-specific practices, with the ability to serve effectively as clinicians, educators and/or researchers.

An additional pathway, known as the T32 Research Track, provides applicants with systematic, multidisciplinary postdoctoral research training in translational gastroenterology and hepatology. Opportunities for graduate degrees are available through this pathway. The program will provide training in three thematic areas including: healthcare disparities, inflammation and regeneration. Core faculty from across the University of Miami campus provide mentorship for this unique opportunity. Fellows selected in this pathway can participate in either a basic/translational science research track or health disparities/clinical outcomes track in a theme chosen by the fellow and selected mentor. Upon matriculation, trainees will complete the full clinical curriculum along with a two-year research requirement as stipulated by the T32 criteria. This track is designed for those interested in the pursuit of an academic career as a physician-scientist.