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Inpatient/Consult: 
This is a collaborative consultation service between Texas Tech Physicians and UMC Physicians. We cover the hospital consults year-round. Our program does not have a primary admitting service. Thus, GI is always a consultative service. Our goal is to provide prompt consultation to expedite patient care. Our inpatient team consists of fellows, residents, medical students, advanced practice providers (APP) and the supervising physician. We strive to provide adequate autonomy and supervision to our fellows and residents. It is expected that a fellow will also provide adequate supervision and teaching to our residents and medical students. Currently, there are two fellows in the rotation taking general and advanced GI consults. A third fellow may be added in the future and would be dedicated to advanced GI consults. We are promised to provide our fellows with diverse experiences with endoscopy and a wide range of general and advanced GI disorders.  

Our inpatient call schedule is friendly to a fellow’s well-being and learning. We comply with the ACGME work hour requirements. During the week one fellow takes after-hour consultations and this alternates between the two inpatient fellows for the entire month. Our weekend call begins on Saturday and ends on Monday morning. Weekend call is one every 6 weeks. Our hospital provides anesthesia support for almost all cases we perform. In addition, we are fortunate to have anesthesia availability on Sunday which allows us to take care of acute/emergent GI cases to expedite patient care and support our hospital system. Our main OR is also available 24/7 for any case that needs to be added on afterhours or if could not be accommodated in endoscopy suite. We are proud of our teaching friendly team all around.  

Outpatient rotation:  
During this rotation, fellows are assigned with six half day endoscopy blocks and four half day ambulatory clinic (faculty clinic) blocks with a supervising physician in each work week. The faculty clinics include both general GI clinics with exposure to bread-and-butter GI disorders, inflammatory bowel disease, GI dysmotility etc. and advanced GI clinics with exposures to various advanced endoscopy related cases such as achalasia, gastroparesis, evaluation for resection of large colon polyps by EMR or ESD, endoluminal stenting, various biliary and pancreatic disorders, and evaluation for EUS, ERCP and other EUS guided therapies.  This rotation provides a fellow with ample exposure to a wide range of GI disorders and endoscopy experiences. Fellows will also learn how to interpret high resolution esophageal manometry, pH monitoring/ Bravo study, and Video capsule endoscopies.  

Elective rotation:  
This rotation is an open-ended rotation and created keeping fellows future practice interests in mind. This rotation can be customized based on a fellow’s future training preferences such as advanced endoscopy (AE), motility disorders, IBD and transplant hepatology. If a fellow wants to pursue an advanced endoscopy fellowship, this block assures at least six months of advanced endoscopy rotation to prepare the fellow for the AE fellowship. Fellows can also just choose to do all outpatient rotation if his/her desire is to be a general gastroenterologist. The program is very flexible in this regard. Our collaboration with regional liver transplant centers will provide a fellow with a good exposure to transplant hepatology and may facilitate a future fellowship if so desired. If a fellow elects to undergo dedicated IBD training or motility training, the program/GME will facilitate at least one month of away rotation. If a fellow chooses any of these tracks, the program leadership must be informed in advance to facilitate the process. The program leadership understands the intricate relationship between GI and other supportive services such as IR/body radiology, Pathology, bariatric surgery, colorectal surgery and hepatopancreatic biliary surgery; and thus, one month (½ day block, each day excluding weekends) each year is dedicated towards this ambulatory rotation to enhance fellow’s understanding on GI radiology, pathology, bariatric, colorectal, and hepatic pancreatic and biliary surgeries.  

Hepatology/Transplant Hepatology Rotation: 
The program understands that a strong knowledge in core hepatology is indispensable in GI fellowship training. Our practice provides good experience in general hepatology. However, to provide fellows with a dedicated hepatology and transplant hepatology experience, the program is actively working on establishing an away rotation with regional liver transplant centers where the program expects that a fellow will rotate at least for three months during the fellowship training.  

Continuity Care Clinic: 
Each fellow will have one half day of continuity care clinic per week. The program’s goal is to allow the fellows sufficient autonomy to boost their confidence in evaluating and managing their patients longitudinally with minimum faculty supervision necessary. A fellow typically evaluates seven to eight patients per clinic. When on inpatient rotation, one fellow (7 am to 4 pm) gets clinic cancelled for the week, and the other inpatient fellow (4 pm to 7 am) ends the clinic by 4 to ensure work life balance of our fellows.  

Research:  
Ours is a newly accredited program. We aim to provide our fellows with the best scholarly opportunities possible. The program fosters clinical and or basic research and any scholarly activities a fellow can come up with. Fellows are required to produce at least one, preferably three, scholarly activities during their fellowship training in the form of either a case report, or case series or abstract at a national or international conference or prospective or retrospective research study or meta-analysis and systemic reviews. A fellow is assigned a total of four months of dedicated research time during the fellowship training. The school of medicine established clinical research institute (CRI) to foster research with full support needed. Fellows are encouraged to utilize this support early in their research planning. It is also possible to assign a fellow during this research rotation with an outpatient endoscopy block whenever available and possible to keep the fellows’ endoscopy skills sharp.