Electives - Gastroenterology

Clinical Gastroenterology - Hepatology & Nutrition

Elective Number: 1605 (arranged)

Rotation Supervisors: Dr. Carl Berg

Designated Signer: Amy Harris

Evaluation should be given to: Attending on service

Duration: 4 weeks

Report to: GI Fellow on DHC Service

Time to Report: 8:00 am

Place to Report: Endoscopy suite

Typical Day: 8:00 am - 5:00 pm

Attendance: Attendance at elective activities is mandatory.

• Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
• Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
  • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: 4

Course Description: Students will participate in an externship which is designed to provide an in-depth experience in Clinical Gastrointestinal Medicine with a spectrum of patient care ranging from in-patient consultations to out-patient clinic visits. The students will have the opportunity to see consults on this service, evaluate the problems, and present these cases on daily consultation rounds with the attending physician as well as have input from rotating medical residents and the fellows who are training in Gastroenterology. With the evolution of liver transplantation, there is a very active liver consult service. There is also the opportunity to observe liver biopsies being performed as well as reviewing the pathology. The students will also be involved in out-patient clinic activities under the direction of the GI faculty members. This will give them exposure to different patient problems throughout Gastroenterology and liver disease and an opportunity to observe the management styles of the different attendings.

Students will also have the opportunity to observe all endoscopic procedures taking place in the Endoscopy Suite including colonoscopy and polyp removal, upper endoscopy and diagnosis of Helicobacter pylori, gallstone removal with biliary pancreatic duct cannulation, Laser treatment, endoscopic ultra sound and gallstone lithotripsy. In addition, students will have an experience in diagnosis and management of GI emergencies such as GI bleeding and acute abdomen. The students will also have the opportunity to observe all other gastrointestinal diagnostic tests that are being performed on patients for which they are the consultant. These include a range of tests for gastrointestinal motility, electrical recordings of the stomach, gastric acid studies, and esophageal pH monitoring as well as radionuclide studies of the gastrointestinal tract. The student will participate fully in all conference activities that are taking place within the GI Division ranging from a Physiology Conference every week, and Endoscopy, Liver, and Research in Progress conferences. In addition, there is a monthly Journal Club, GI radiology conference, and GI pathology conference. Dr.Berg will meet with the students on a regular basis to review the teaching and learning experiences on an individual basis during the elective.

A new development in the Gastroenterology rotation is the addition of the Internal Medicine Nutrition Support Service. This consult service is separate from the standard Gastroenterology consultation. This particular consult service relates to nutritional problems of in-patients in the Medical Intensive Care Unit and throughout the hospital. Here the student will be working with a nutritionist in the GI Division, as well as with a GI fellow who will answer the consults together with the medical student. There is regular rounding by an attending physician. There is a Core Curriculum that is available from the nutritionist who runs the service and all aspects of nutrition assessment, enteral versus parenteral feeding techniques, and specifics of caloric needs are discussed in detail on this elective. This is probably the only in-depth experience in nutrition and is something that we feel should be an important component of the choice to have a Gastroenterology elective. There will be no night call, weekend call or weekend rounds.