Attending's Clinic

Overview

• Each fellow is assigned to participate in a half-day clinic session per week for one attending preceptor for 4-6 months before changing preceptors.
• This provides a longitudinal exposure to most outpatient consultative experiences in which a consultation, procedure, and two or three follow up visits may complete the patient problem episode
• Allows for a breadth of exposure to different attending preceptor styles of interaction, patient populations, patterns of relationships with referring physicians, etc.
• Attendance at the attending’s clinic takes precedence over all other clinical activities including Endoscopy, Research, ERCP, Hepatology and other Electives.

Principal Teaching/Learning Activities

• Fellows will see from 2-4 new outpatient consults per session, and 4-8 follow up visits
• Fellows will perform complete history and physical examinations, review laboratory data including actual Radiology studies, formulate differential diagnoses, and formulate a plan or set of recommendations, including timing of intervention and/or follow up
• After presentation and review with the Attending physician, the fellow will document the encounter in the medical record
• The Attending physician will supervise every fellow’s patient encounters. 

Problem Mix/Patient Characteristics/Types of Encounters

• The Fellow is exposed to a wide variety of consultative questions that fully embrace the complete lists of clinical disorders and clinical problems as contained in the outline of the ACGME Specific Program Content within Program Requirements for Residency Education in Gastroenterology
• In the first year of fellowship, the Attending Clinic assignment will be with a General Gastroenterologist
  • Patients with a wide variety of General Gastroenterology problems are seen, including inflammatory bowel disease and motility disorders
• In the second year of fellowship, the Attending Clinic assignments will be with a Hepatologist or IBD doctor
• In the third year of fellowship, time will be split between 2 areas
  • 8 months of the year will be spent in an Advanced Endoscopy outpatient clinic, where patients with a wide variety of complex pancreatico-biliary and oncologic problems are seen
  • 4 months are spent in a clinic with an Inflammatory Bowel Disease specialist