Rotations

The Case Western Reserve University/University Hospitals Cleveland Medical Center Gastroenterology Fellowship Program offers significant inpatient and outpatient rotations for fellows to engage in during their training.

Gastroenterology Fellowship Program Inpatient Rotations

There are three Gastroenterology Fellowship Program inpatient rotations, including:

  • Gastroenterology consultation service
  • Hepatology consultation service
  • Inpatient gastroenterology service

Gastroenterology Consultation Service

Gastroenterology consultation service fellows work closely with a gastroenterology attending to see patients with acute gastrointestinal and pancreaticobiliary diseases hospitalized on the non-GI medical teams, surgical services, University Hospitals Seidman Cancer Center, obstetrics and gynecology service and occasionally, University Hospitals Rainbow Babies & Children's Hospital. Where possible, fellows are encouraged to perform endoscopic procedures on the patients for whom they performed consultations. Two fellows are assigned to this service to help ensure a manageable workflow and allow time to perform endoscopy.

Hepatology Consultation Service

The hepatology consultation service fellows at UH Cleveland Medical Center work with a faculty hepatologist to see inpatients with compensated and decompensated liver disease, including patients awaiting liver transplantation and post-transplant patients.

Inpatient Gastroenterology Service

The inpatient gastroenterology service fellows at UH Cleveland Medical Center work with a team including:

  • Gastroenterology attending
  • Liver attending
  • Medical students
  • One or two residents
  • Two to four interns

The leading-edge team cares for patients with a wide spectrum of illnesses including:

  • Biliary tract disease
  • Cirrhosis
  • Gastrointestinal bleeding
  • Hepatitis
  • Inflammatory bowel disease
  • Pancreatic disease

During this rotation fellows are expected to serve as an educator to the team and, where possible, perform endoscopic procedures on the patients.

Gastroenterology and Hepatology Consultation Service

The gastroenterology and hepatology consultation service at the Louis Stokes Cleveland VA Medical Center fellows work with a faculty member and see a wide variety of inpatient consultations; they also perform endoscopic procedures on the inpatients.

Gastroenterology Fellowship Program Outpatient Rotations

There are six Gastroenterology Fellowship Program outpatient rotations, including:

  • Ambulatory gastroenterology rotation
  • Community gastroenterology rotation
  • Endoscopy rotation
  • Endoscopy service
  • Inflammatory bowel disease rotation
  • Liver outpatient rotation

Endoscopy Rotation

In the endoscopy rotation, fellows are assigned to work with specific faculty members at UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center to perform endoscopic procedures on outpatients. The specific procedures will vary depending on the case mix and the fellows' level of training. During this rotation, fellows also develop skills in the following:

  • Breath hydrogen testing
  • Capsule endoscopy
  • Interpreting esophageal manometry
  • pH testing

Endoscopy Service

Fellows in the Louis Stokes Cleveland VA Medical Center endoscopy service perform endoscopic procedures on outpatients under the direct supervision of a faculty member, with the specific procedures depending on the case mix and the fellows' level of training. Fellows will also attend a supplemental outpatient clinic to see semi-urgent consultations.

Liver Outpatient Rotation

Fellows in the liver outpatient rotation are assigned to work with specific faculty members at UH Cleveland Medical Center and the Louis Stokes Cleveland VA Medical Center. Fellows will attend pre- and post-liver transplant clinics, general hepatology clinics and viral hepatitis clinic.

Inflammatory Bowel Disease Rotation

Fellows in the inflammatory bowel disease rotation at UH Cleveland Medical Center work closely with IBD faculty attending outpatient clinics at University Hospitals and a satellite ambulatory facility, In addition, fellows gain experience in performing outpatient endoscopic procedures on patients with inflammatory bowel disease.

Ambulatory Gastroenterology Rotation

In the ambulatory gastroenterology rotation, fellows attend a variety of specialty-focused and general gastroenterology clinics at both UH Cleveland Medical Center and satellite facilities.

Community Gastroenterology Rotation

Fellows in the community gastroenterology rotation work with faculty members at an ambulatory surgical center and affiliated community hospital and perform outpatient endoscopic procedures.

Gastroenterology Fellowship Program Outpatient Clinics

At the beginning in the first year, all fellows attend two half-day continuity clinics, including one at UH Cleveland Medical Center and one at the Louis Stokes Cleveland VA Medical Center. Both clinics are closely supervised by faculty members and provide an opportunity for fellows to develop a panel of patients as well as see new consultations. Clinic duties are suspended while on inpatient rotations.

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