The curriculum for the Gastroenterology Fellowship varies depending upon whether you choose the Clinical Scholar Track or the National Institutes of Health (NIH)-Sponsored Track. All clinical training includes patient care, procedures, elective rotations, didactic training, and teaching opportunities.

Patient care

Every ambulatory and inpatient rotation has been uniquely crafted to maximize learning and skills development. The hospital experience ranges from primary gastroenterology services to luminal, hepatobiliary, and procedural consults, as well as multidisciplinary nutrition and liver transplant rotations.

The primary gastroenterology services are run by internal medicine residents who are responsible for most direct patient care. As a fellow, you will serve in a junior faculty-type role, directly supervising and guiding medical residents and students on the team, together with the staff physician. In this rotation, you learn how to lead a large medical team and to balance patient care with supervision and teaching.

In contrast, on consultative inpatient rotations, you assume the primary role of expert specialists providing guidance and support to patients with gastrointestinal illnesses admitted to other medical or surgical services. These experiences help you learn pragmatic and scholarly approaches to a wide array of simple and complex inpatient gastrointestinal problems while working 1:1 with expert faculty. A separate dedicated inpatient emergency endoscopy rotation will allow you to maximize your learning and practice diagnostic and therapeutic procedures with minimal disruption in the hospital.

The inpatient rotations alternate every two weeks with outpatient clinics or procedures. You will rotate through all subspecialty clinics (pancreas, motility, hepatobiliary, esophagus, celiac, neoplasia, and inflammatory bowel disease) during your first year to build a solid foundation across all areas of GIH. In the outpatient clinics, you work directly with expert leaders and start building your own diverse panel of longitudinal patients, whom you will follow for the duration of your training.

Procedures

All procedures are performed under the direct supervision of Mayo Clinic staff gastroenterologists. Procedural training (both inpatient or outpatient) includes upper endoscopy, esophageal dilation, esophageal and anorectal manometry, esophageal pH readings, small bowel enteroscopy (including capsule enteroscopy), paracentesis, percutaneous endoscopic gastrostomy placement, colonoscopy, endoscopic retrograde cholangiopancreatography, as well as a wide range of therapeutic endoscopic procedures, which includes electrocoagulation, hemoclip application, variceal banding, and various stenting procedures. You also have opportunities to learn about gastrointestinal motility studies and the dynamic assessment of pancreatic, hepatobiliary, and gastrointestinal function, among others.

The procedural rotations are built stepwise so that technical skills are learned in a complementary fashion from routine to highly complex. In addition, you will have dedicated procedure rooms where you will work 1:1 with select faculty, chosen by the fellows based on their teaching skills. Our team has also built an automated electronic tool for individual tracking of technical and cognitive competencies, which are used to tailor endoscopy training. This tool has been externally validated and adopted by other academic institutions with the support of ASGE.