Our inpatient service is very busy and fast paced, which can be tiring but fulfilling.  We ensure our fellows are always well supported and not overwhelmed.  We expect that our first year fellows run the inpatient service with direct supervision and support from the attending on-call.  As fellows advance, they assume increased responsibility.  By the time our fellows graduate, we expect they are the primary team leader with the attending in a supporting role.

• The day starts with pre-rounding and signout from the overnight nursing and resident team
• The inpatient team generally begins rounds at 9:00 am 
• Throughout the day the GI fellow is managing the inpatient service including performing urgent/emergency procedures, completing consults from other services, fielding phone calls from community providers and emergency departments
• After typical business hours, the on-call service fellow takes home call, triaging questions from parents, the emergency department, and community providers.    
• First year: approximately 25 weeks of inpatient service
• Second year: approximately 12 weeks of inpatient service
• Third year: approximately 8 weeks of inpatient service
• Weekday call starts on Monday morning at 8:00 am and ends on Friday afternoon at 5:00 pm
• Weekend call starts on Friday afternoon at 5:00 pm and ends on Monday morning at 8:00 am

Among the unique qualities of our program is strong outpatient experience.  Fellows see patients two-half days per week, where they are assigned new patients who they follow throughout their training.  Though there is always appropriate supervision, the fellow is the primary provider for their patients, not the attending.  Fellows are expected to take full ownership of their patients, follow up test results, manage disease exacerbation and questions or concerns from families.  There is true continuity in our continuity clinic.  Building rapport and long-term relationships with patients and their families is cited by our fellows as among the most gratifying components of their fellowship experience.

• Each fellow attends two, half-day continuity clinics per week
• Fellows precept with an attending for all patients

We have a busy endoscopy unit with ample opportunity for fellows to become proficient long before they graduate.  Fellows are routinely exposed to the following procedures: upper endoscopy, colonoscopy, foreign body removal, polypectomy, esophageal dilation, Bravo capsule placement for reflux monitoring, and wireless capsule endoscopy placement for small bowel imaging.  Other procedures include 24-hour multichannel intraluminal impedance monitoring, g-tube maintenance and trouble-shooting, point of care intestinal ultrasound, point of care intestinal ultrasound for liver evaluation, and hydrogen breath testing interpretation.  Fellows graduate from our program with confidence in their procedural skills.   

• When off-service, fellows generally scope one day per week according to a fellow-organized calendar
• When on-service, fellows are responsible for all inpatient, consult, and emergency cases

Pediatric GI Conferences

• Tuesday: Pediatric Morbidity and Mortality   
• Thursday morning: Adult GI Grand Rounds
• Thursday (9-10 am): Inpatient Conference. Discuss all consult and GI-service admissions.
• Thursday afternoon: Pediatric GI Academic Half Day.  Conferences include Inpatient Management, IBD Management, Interesting Case Conference, Liver Conference, Journal Club, State of the Art Didactics, and Pathology. 
• Friday: Pediatric Grand Rounds.  Weekly presentations by invited guest speakers distinguished in their field directed towards faculty, fellows, and residents.

Multidisciplinary Conferences

• GI-Radiology Conference (1 time per quarter)
• GI-Surg Conference (2 times per year)
• GI-Allergy Conference (2 times per year)
• GI-NICU (2 times per year)