Educational/Clinical Experience - Gastroenterology Fellowship Program

The training program offers intensive clinical experience in gastroenterology, both in the inpatient environment of the Ochsner Foundation Hospital and in the outpatient setting of the Ochsner Clinic. Fellows have the major responsibility for the gastroenterology consult service and supervise the training of students and internal medicine house officers rotating on the GI consult service. Fellows hold Continuity Care clinics under the supervision of a senior staff member with the intent of developing a population of patients for whom they will serve as a primary provider of gastroenterology services. Considerable experience is gained through the consultation service, which provides expertise in gastroenterology to other medical and surgical services, and through rotations on the liver transplant and pancreaticobiliary services of the Ochsner Foundation Hospital. The clinical material is varied and interesting. The performance of upper gastrointestinal endoscopy, endoscopic retrograde pancreatography and cholangiography, colonoscopy with polypectomy, bougienage, esophageal manometry, and percutaneous liver biopsy and the diverse technologies involved in endoscopic hemostasis for upper gastrointestinal bleeding provide excellent practical experience for the fellows in training. The review of gross and microscopic specimens with senior staff members of both the Departments of Gastroenterology and Pathology results in correlation between endoscopic, surgical, and postmortem findings. Gastroenterology fellows are also exposed to clinical research opportunities in conjunction with a senior staff member, and all fellows are expected to plan, execute, and complete an original clinical research effort during their 3-year fellowship and to submit a report of their results for publication. Clinical research projects in the following areas are particularly well suited to the strengths within the section: antiviral therapy of chronic viral hepatitis, pancreaticobiliary disorders, hemostasis of bleeding upper gastrointestinal lesions, esophageal motor disorders, inflammatory bowel disease, and liver transplantation.

The time spent on liver service constitutes approximately one-third of the 18-month clinical curriculum. During this time, the GI fellow has extensive exposure to ambulatory as well as hospital-based liver disease. The outpatient liver clinics expose the fellow to a broad array of liver disorders and clinical research protocols, whereas the inpatient liver service provides an opportunity to tend to the care of patients awaiting liver transplantation and to serve as a consulting physician for patients with complications of chronic liver disease. Formal gastroenterology, research, surgical, radiology, and pathology conferences are held weekly. Fellows play a major role in the organization and selection of topics for discussion at all departmental conferences