FIRST YEAR FELLOWS
Fellowship rotations are designed to provide a variety of clinical experiences. The first year or fellowship is focused on laying the foundation of GI consultative care, with the addition of rotations in endoscopy, hepatology and liver transplant,
inflammatory bowel disease, and other sub-specialty clinics, as well as dedicated research time.
SECOND AND THIRD YEAR FELLOWS
As fellows advance in their training, rotation blocks shift to increasing focus on advanced endoscopy exposure as well as increased time for academic pursuits. Senior fellows continue to work with faculty on rotations in IBD, transplant hepatology,
endoscopy, as well as sub-specialty clinic/motility.
CORE FELLOWSHIP ROTATIONS
- Galveston Consult Service
Traditional consult experience at a large tertiary care academic medical center. Two fellows serve as team leaders - mentoring and teaching other trainees including residents, interns, and medical students. This rotation is located on a single
inter-connected medical campus - with fellows providing consultative care at Jennie Sealy Hospital, a new 310-bed hospital, as well as the Texas Department of Criminal Justice Hospital, a 110-bed correctional care facility. This experience provides
exposure to an unparalleled variety of disease processes and pathology.
- Victory Lakes/Clear Lake Consult Service
Senior fellows provide consultation and perform endoscopy in an academic affiliated community based setting.
- Transplant Hepatology
Fellows work closely with our transplant hepatology team to provide pre- and post- transplant medical care for patients with advanced liver disease in both an inpatient and ambulatory setting. Fellows will accumulate significant experience with
the common and unusual hepatobiliary diagnoses, the complications of acute and chronic liver disease, the role of liver biopsy and radiographic investigations (including invasive radiology, i.e. transjugular intrahepatic portosystemic shunt (TIPS),
portal venography, arteriography, and wedged hepatic vein pressure measurements), and the technique of liver biopsy. There is ample opportunity on the hepatology rotation to interact in a meaningful way with physicians from a variety of disciplines
and manage complex, multifaceted disease processes in a coordinated way. Fellows will learn the natural history of liver disorders and risk of procedures (including surgical procedures, i.e. cholecystectomy in a cirrhotic patient) in the management
of patients with liver disease. Fellows participate in transplant committee selection meetings. This rotation also includes endoscopy time with our transplant hepatologists focusing on pathology related to portal hypertension, including
APC management of GAVE and variceal band ligation.
- Inflammatory Bowel Disease
UTMB Gastroenterology serves as a regional referral center, providing care for a large population of patients with inflammatory bowel disease. Fellows rotate in sub-specialty IBD clinics designed to provide longitudinal comprehensive care to patients
with both Crohn's disease and ulcerative colitis. Additionally, this rotation includes multiple ambulatory endoscopy days each week with an inflammatory bowel disease specialist. Fellows on this rotation help organize and moderate a disciplinary
IBD conference to discuss complex patients in conjunction with colorectal surgery.
- Advanced Therapeutic Endoscopy
On the advanced endoscopy rotation, which fellows begin during their second year of fellowship, fellows work closely with advanced endoscopy faculty performing complex procedures. This rotation provides a wide range of exposure to interventional
endoscopy techniques including ERCP, EUS, and endoluminal stenting. The curriculum includes both technical and cognitive training for management of advanced hepatobiliary esophageal pathology, and complex polypectomy and lays the foundation
for fellows interested in careers as advanced endoscopists.
- Ambulatory Consultation Rotation
This rotation provides clinical experience within sub-specialty focused clinics. Faculty clinics include general hepatology, IBD, complex functional GI and motility disorders, pelvic floor disorders, and pancreaticobiliary care.
- Ambulatory and Inpatient Endoscopy
Endoscopy rotations include dedicated ambulatory endoscopy time, which takes place in the Galveston and Victory Lakes endoscopy units. Starting in the first year, fellows work one-on-one with faculty performing EGDs, colonoscopies, and sigmoidoscopies
with associated interventions - such as polypectomy and dilations.
In addition to ambulatory endoscopy time, second and third year fellows work in conjunction with the Galveston consult service to learn endoscopy in the inpatient setting. This is designed to provide a focused learning opportunity to treat high
acuity patients, including GI bleeding, foreign body removal, and other endoscopic emergencies.
- Research and Elective Time
The pursuit of academic endeavors beyond direct patient care is a core tenet of the UTMB Gastroenterology Fellowship Program. As fellows advance through the program, additional dedicated research time is built into the curriculum. Additionally,
interested fellows have the opportunity to pursue internal elective rotations outside of the GI division, as well as any external rotations.