Clinical training

Although clinical assignments are flexible, the Esophageal Diseases Fellowship is designed as follows:

Esophageal Clinic

During our one-year program, you spend mornings in the Esophageal Clinic seeing patients under the direct supervision of the consulting staff member. Your Esophageal Clinic rotation is mentored by senior esophageal specialists.

Motility testing

For four weeks, you spend mornings in the Esophageal Motility Laboratory in the Gonda Building instructed by the lead motility gastroenterology assistant, learning the techniques of high resolution esophageal manometry and pH testing and impedance studies. You interpret all 24-hour pH and esophageal motility studies done that day, and then present your interpretation to the staff consultant reading tracings. Experience in performing and interpreting EndoFlip studies will also be available.

Esophageal Motility Interpretation Session

You also actively participate in the Interactive Esophageal Motility Interpretation Session, which meets once a month, to review challenging motility, 24-hour pH and impedance studies. While in the Esophageal Clinic, you are encouraged to read all motility and 24-hour pH tracings that day and review them with the staff to gain one-on-one experience with interpretation over the entire year.

Endoscopic training

The Barrett’s Esophagus Unit located at Mayo Clinic Hospital, Saint Marys Campus is a renowned quaternary referral center, staffed by two experienced endoscopists, equipped with advanced imaging technology and performing all aspects of esophageal endotherapy including EMR and ablation (RFA, Cryotherapy, Hybrid APC). Exposure to and training in these techniques will be provided as per interest and career objectives. Exposure to ESD and POEM can also be provided. Experience in performing and interpreting EndoFlip studies will also be available.

Gastrointestinal pathology/esophageal radiology/thoracic surgery elective

For two to four weeks, you will have the opportunity to:

1. Spend mornings reviewing gastrointestinal pathology slides from the esophagus and discussing their interpretation with gastrointestinal pathology staff.
2. Spend mornings reviewing esophageal radiology studies and their interpretation with expert GI Radiologists.
3. Spend time with Thoracic Surgery consultants in clinic and OR to gain exposure to surgical management of esophageal diseases.

Didactic training

As an advanced esophagus fellow, you help coordinate and attend the monthly Esophageal Interest Group meeting. You assist in teaching clinical fellows assigned to the esophageal rotation.

You are also expected to actively participate in the Esophageal Motility Interpretation Session and the Gastrointestinal Fellows Journal Club.

Research training

Several members of the Esophageal Interest Group are actively involved in esophageal research. These programs are quite vibrant and span the spectrum of esophageal disease. Interest group members are investigating the pathophysiology of cervical dysphagia, the epidemiology and pathophysiology of gastroesophageal reflux disease, and esophageal function.

The research program in Barrett's esophagus is especially strong and addresses early detection, epidemiology, and advanced diagnostic and therapeutic techniques.

During the first month of training, you meet with each member of the Esophageal Interest Group involved in research and who has been approved for mentorship privileges by the Division of Gastroenterology and Hepatology. You are also encouraged to contact those individuals before starting the fellowship.

You have 50% time over the course of the year (47 weeks) to participate in research. You are expected to complete at least one major research project. Participation in several smaller projects is also encouraged. You must demonstrate skills in the design, conduct, analysis, and reporting of results of a research study.

Courses in these topics are offered through Mayo Clinic Graduate School of Biomedical Sciences and the Department of Health Sciences Research at no cost throughout the year. Find out more about clinical and translational research training at Mayo Clinic.

Teaching opportunities

Opportunities are available for teaching rotating residents and medical students.

Conference attendance

The Division and Mayo Clinic School of Graduate Medical Education provide generous stipends and dedicated research travel time for the presentation of scholarly work at premier societal conferences, enabling networking opportunities, and allowing fellows to gain exposure to national and international experts in the world of esophagology.

Moonlighting

One year is spent on focused training and research, so moonlighting is generally not allowed.

Evaluation

To ensure that you acquire adequate knowledge and develop your technical skills, your performance is monitored carefully during the course of the Esophageal Diseases Fellowship.

You are evaluated formally by your supervising faculty member after each clinical rotation, and you meet with the program director to review these evaluations. In addition, you regularly evaluate the faculty to ensure that your educational needs are being met.