A competency based development of knowledge and skills in Gastroenterology through clinical experience, bedside teaching, didactic conferences and readings to achieve competence, proficiency and the foundation for mastery. Clinical Information and Didactics - The inpatient consultation team consists of a faculty preceptor, a fellow, residents on rotation and students performing their clerkship.
- Policies:
- Residents attend all conferences, with the exception of GMC time conflicts.
- Residents will not see more than 3 new consults per day.
| Monday | Tuesday | Wednesday | Thursday | Friday | AM | 7:30 am Morning Report | 7:30 am Grand Rounds | 7:30 – 8:30 am GI Fellow’s Conf (Galter 4-133) No clinic | 7:00 – 8:00 am GI Education conf. (Galter 8-234) | 7:30 – 8:30 am Hepatology Conf . (Transplant conf. room, Galter 17th floor) | PM |
| 3:30 – 4:30 pm GI Oncology Patient Mangement Conf. (Feinberg 3rd floor – Conf Room C) | 1:00 – 2:00 pm Residents Conf. (Galter 4-133) | 5:00 -6:00 pm Med-Surg GI conf. (Galter 4-206) |
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- Wednesday Resident’s Conference Topics:
- Week 1- Screening in Gastroenterology
- Week 2- Work up of Abdominal Pain
- Week 3- Alteration of Bowel Habits
- Week 4- Gastrointestinal Bleeding
- Thursday GI Educational Conference:
- Week 1- Journal Club presented by faculty
- Week 2- Visiting Speaker
- Week 3- State of the Art Presentation by the Fellows
- Week 4- Visiting Speaker
- Contact Numbers:
- Dr. John Pandolfino (Clerkship Director) 695-4729
- Dr. Terrance Barrett (Division Chief) 503-0293
- Dr. Ikuo Hirano (Fellowship Director) 695-4036
- Judy McGowan (Division Secretary) 694-4065
Click here Click here. Practice Based Learning and Improvement PGY1: Incorporate regular chart review and patient follow up to learn from your clinical care. Teach and mentor students. PGY2/3: Incorporate evidence based medicine into clinical decision making. Review the latest research pertaining to your your patients. Teach and mentor students and interns. Systems Based Practice PGY1: Work in a multi-disciplinary team to provide high quality coordinated care. Ensure accurate and timely documenation through the use of the electronic medical record. PGY2/3: Use knowledge and skills in quality improvement and patient safety to deliver safe and effective care. Apply team leadership skills in appropriate settings. Practice cost effective medicine with an awareness of health care economics and patient insurance status. Interpersonal Skills and Communication PGY1: Use effective listening skills with patients and health care providers. Elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills. PGY2/3: Develop interpersonal and communication skills necessary to run an effective clincal team in the ambulatory. Role model and teach effective communication techniques. Professionalism PGY1: Carry out your professional responsibilities in a timely manner. Adhere to the ethical principles of a patient-centered practice. Be sensitive to a diverse patient population and health care staff. PGY2/3: Understand how biases influence clinical care, patient-physician interactions and health team interactions. Role model and provide feedback to students and interns the principles of humanism in medicine. Patient Care and Medical Knowledge PGY 1 Level - Evaluate and manage patients presenting with Gastrointestinal Bleeding.
- Resuscitate and triage patients with active gastrointestinal bleeding.
- Choose the appropriate diagnostic test to localize the bleeding site.
- Interpret endoscopic and radiographic studies used in the evaluation of gastrointestinal bleeding.
- Recognize endoscopic stigmata of bleeding risk for peptic ulcer disease and esophageal varices.
- Interpret angiographic studies of the abdomen and tagged RBC scans.
- Determine the most effective treatment for the various causes of GI Bleeding
- Peptic ulcer disease
- Variceal bleeding
- Diverticular bleeding
- Assess the patient presenting with acute abdominal pain.
- Differentiate surgical emergencies from medical causes of abdominal pain.
- Recognize peritoneal signs.
- Choose the appropriate diagnostic tests in the evaluation of abdominal pain.
- Radiographic versus Endoscopic evaluation.
- Review the pathophysiology of the various causes of acute abdominal pain and how this affects treatment.
- Peptic Ulcer Disease
- Pancreatitis
- Gallstone disease
- Diverticulitis
- Surgical emergencies
- Appendicitis
- Bowel Obstruction
- **distinguish mechanical obstruction versus ileus
- Colon Cancer Screening
- List the ACP, AGA, ACG, NCI guidelines for colon cancer screening and understand the logic behind screening intervals and the modalities used.
- Risk stratify patients based on family history and medical history.
- Discuss and defend the different screening options available for patients seen on the consult service.
PGY 2 Level - Alteration of Bowel Habits
- Compare the pathophysiology of inflammatory, secretory and osmotic diarrhea.
- Determine the type of diarrhea using history and lab evaluation.
- Differentiate small bowel versus large bowel diarrhea.
- Define the role of stool studies in this work up.
- Determine when endoscopy is necessary.
- Review the pathophysiology of Constipation.
- Manage patients not responding to initial fiber supplementation.
- Differentiate colonic inertia from pelvic outlet problems.
- Inflammatory Bowel Disease
- Contrast Ulcerative Colitis and Crohn’s disease.
- Determine disease severity and indications for inpatient management.
- List appropriate medical treatment for outpatient and inpatient management of inflammatory bowel flares.
PGY 3 Level - GERD
- Manage patients with severe GERD requiring proton pump inhibitor therapy.
- Determine when patients should be referred for pH monitoring.
- Functional Gastrointestinal disease
- Contrast functional bowel disease (Functional Dyspepsia and Irritable Bowel Disease) from organic causes of abdominal pain.
- Nutrition
- Determine the most appropriate mechanism for nutritional support in both inpatients and outpatients.
- Enteral versus TPN.
- Indications and contraindications for PEG placement.
Upper GI bleeding:
- Barkun A. Consensus Recommendations for Managing Patients with Non-Variceal Upper Gastrointestinal Bleeding. Ann Intern Med. 11/18/2003. Vol139, pp843-857
- Lau et al. Effect of Intravenous Omeprazole on Recurrent Bleeding after Endoscopic Treatment of Bleeding Peptic Ulcers. NEJM 8/3/00 Vol 343 pp. 310-316
- Chan et al. Clopidogrel versus Aspirin and Esomeprazole to Prevent Recurrent Ulcer Bleeding. NEJM 1/20/05 vol352 pp 238-244
- Chan F. et al. Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial. Lancet 1/5/02 vol 359 pp 9-13.
- Lanza et al. A guideline for the treatment and prevention of NSAID-induced ulcers. Members of the Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. Am J Gastroenterol. 1998, vol 93. pp 2037.
Lower GI bleeding:
Eisen GM. An Annotated Algorithmic Approach to Acute Lower Gastrointestinal Bleeding. Gastrointestinal Endoscopy. 6/2001. Vol 53, issue 7, pp 864- ( This article can not be directly linked. Once in the Gastrointestinal Endoscopy journal via the above link, search by entering the author's name (Eisen G M) and the year (2001). Click on Search and scroll down until you reach the article.) Obscure GI Bleeding:
Leighton JA. Obscure GI Bleeding. Gastrointestinal Endoscopy. Nov 2003. Vol 58 issue 5, pp650-55. Ulcerative Colitis:
Kornbluth A. Ulcerative Colitis Practice Guidelines in Adults (update). Americal College of Gastroenterology, Practice Parameter Committee. Am J Gastroenterol July 2004. Vol 99, issue 7. pp1371-1385. Crohn's disease:
Egan LJ. Advances in the Treatment of Crohn's Disease. Gastroenterology. 2004, vol 126, pp1574-1581.
Collection by Dr. John Rice For an extended list of references with direct article links, sign in to the Galter Health Library website at: http://www.galter.northwestern.edu/guides/expand/resident-reading-lists | 
