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Electives - Gastroenterology

GI Luminal Consult Service

Elective Number: 1605

Rotation Supervisors: Dr. Neeral Shah

Evaluation should be given to: Dr. Shah

Coordinator: Leslie Stewart (MLS5D@hscmail.mcc.virginia.edu)

Duration: 2 weeks

Available: all rotations

Report to: Attending & Fellow on-service

Time to Report: 8:00 am

Place to Report: Page GI Fellow Luminal Consult - PIC#1245

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: 2

Course Description: Students will participate in an elective which is designed to provide an in-depth experience in clinical luminal gastrointestinal medicine service with a spectrum of patient care of in-patient consultations. 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. When the consult service is not as busy, the student is encouraged to observe endoscopies in the endoscopy suite on the 1st floor of the main hospital.  Rounds for the consult service will occur between the hours of 8am and 5pm, but depend on the timing of any outpatient appointments the attending must see and the need for urgent/emergent inpatient procedures.

Students will have the opportunity to observe all endoscopic procedures 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 have the opportunity to 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 tumor board, and GI pathology conference.

Students can also use the iOS app that was developed based on inpatient and consult patients from the GI service. This app is available at the Apple Store and is called CaseQ. If students are interested in using this app to help bolster their learning, please contact Dr. Shah for the required PIN code for the Liver and Luminal GI cases.

Learning Objectives:
1. Recognize common clinical presentations and cardinal manifestations of diseases encountered on the luminal GI consult service.
2. Obtain a detailed history from a patient with gastrointestinal issues.
3. Demonstrate a focused physical exam for common gastrointestinal disorders.
4. Differentiate the indications for upper GI endoscopy, colonoscopy, and ERCP,.
5. Distinguish and select the most appropriate diagnostic testing for patients with luminal gastrointestinal issues.
6. Develop succinct and accurate oral presentations with consultation notes for patients with gastrointestinal disorders.
7. Formulate an appropriate differential diagnosis by incorporating history with available test results.
8. Formulate the initial steps in a treatment plan for the working diagnosis.
9.Develop communication and interpersonal skills with professionalism in working relationships with patients, families, and primary provider teams.