Gastroenterology Core Rotation for Spokane Internal Medicine Residents

Welcome!

The four weeks on your GI core rotation should be an interesting and stimulating time. In addition to routine gastroenterology problems you can expect to see a number of unusual cases referred for endoscopic ultrasound or other special procedures.

The endoscopy units at Deaconess and Sacred Heart Medical Center will be your home base from which you will depart to see new consults.

Residents will be primarily responsible for managing the inpatient consultation service, and presenting these patients to me. The resident's duties will include rounding on all prior consult patients, seeing all new consults, formulating a tentative plan, reporting on all patients to me, and acting as liaison to the inpatient medical services.

Educational Objectives and Expectations

"It is much simpler to buy books than to read them and easier to read them than to absorb their contents." William Osler.

Although you will be exposed to a wide variety of problems, four weeks are just not enough time to give you a systematic overview over the entire field of Gastroenterology without a systematic reading program. This is your principal opportunity to gather factual knowledge while having the opportunity to test and further your understanding of the subject matter and management strategies in a daily dialogue with a subspecialty attending. See here how important Gastroenterology is for your Internal Medicine Board Exam.

You will be required to read "Mayo Clinic Gastroenterology and Hepatology Board Review" from cover to cover. This book is an excellent overview of the field and can be easily finished within a four week period if you pace yourself. There are 439 pages which include multiple-choice board review questions. You will be permitted to do part of your reading between consults or procedures in the endoscopy unit. Since we move a lot, bring a briefcase or back pack.

A copy of the Board Review will be available for you to use. Please don't make any marks in it. At the end of the rotation you will be given 15 MC questions from the book to answer. There will be no score but your answers will help me in your evaluation.

In addition to your core readings you are required to read and research about patients you have seen in consultations or in the endoscopy unit. I will help you pick suitable topics. I hope that you will spend at least one hour per day on www.uptodate.com. You will be given a logon and password for the site. Your progress will be tracked!

Conferences

The GI resident is required to attend one Oncology case conference (Tumor Board) per week. Tumor Boards are held on Thursday mornings at 7.00 am at Sacred Heart and on Fridays at 12.30 pm at Deaconess. You will find that these interdisciplinary conferences are highly interesting. Gastroenterology is a specialty with a fair number of important cancers: Esophagus, Stomach, Liver, Pancreas, Bile Ducts, Colon and Rectum. In addition, GI endoscopists are involved in the diagnosis of lung cancer and other mediastinal tumors when they perform transesophageal ultrasound guided FNA biopsies (Endoscopic Ultrasound).

Medical Student Rotations

I welcome applications from interested medical students for a clinical rotation. The minimum time acceptable is three weeks. Please get in touch with me as soon as you can, especially if you are not from the University of Washington, so that we can take care of the paperwork.

Resident and Student Evaluations

I promise to do your evaluation online on the last day of your rotation. If you are a resident it is your duty to arrange for your mini-exam (15 multiple choice questions) the day prior to the last day of your rotation.

Research Rotations and Electives: Get published!

Those students or residents who I know from a previous rotation are eligible to apply for a research or elective rotation. I take this very seriously. At the end of a research rotation should be a finished product: A case report, a review of the literature, a lecture, etc.

I will make sure that your project can be reasonably accomplished in the time available. You may have to put some finishing touches to a paper, to give one example, several months after your rotation is over. If you don't have anything to show for your research rotation at the end of four weeks you cannot expect a good performance evaluation. On the other hand if you work hard, I will support your fellowship application or be otherwise your advocate.