Clinical Instructor - Medicine (Gastroenterology)(Fellowship in Advanced Endoscopy and Pancreatology)

University of Miami•Miami, FL

25d

About The Position

The Division of Gastroenterology at the University of Miami, Miller School of Medicine is offering a one year Advanced Endoscopy and Pancreatology Fellowship Educational Goals : The Advanced Endoscopy & Pancreatology fellowship offers hands-on experience in advanced endoscopic techniques applied to general GI, oncology and pancreatic disorders. This fellowship is designed for physicians who are planning a career in gastroenterology as an investigative and consultative therapeutic endoscopist with a focus in pancreatic diseases and disorders. Fellows will receive advanced training in Diagnostic and therapeutic endoscopy, focusing on endoscopic ultrasound (EUS), Endoscopic Retrograde Cholangiopancreatography (ERCP), Balloon Enteroscopy, Endoscopic Mucosal Resection and Barrett’s Ablation. The fellow will be immersed in gastrointestinal disorders in both non-cancer and cancer patients, and the endoscopic, diagnostic, and therapeutic modalities. The fellowship will emphasize the applications of modern diagnostic and therapeutic procedures in gastroenterology and pancreatology. Clinical Experience: This advanced endoscopy fellowship will consist of a one year fellowship at the University of Miami Hospital, University of Miami Hospital and Clinics/Sylvester Cancer Center, and Jackson Memorial Hospital. Fellows will have hands-on endoscopy experience, time for corresponding evaluation of inpatient consults, and dedicated research time for both clinical and translational research associated in advanced endoscopy and the associated corresponding medical conditions requiring these procedures. The Fellow will participate as the primary endoscopist during the procedures. The Fellow will also gain clinical exposure to pancreatic diseases and disorders in the outpatient and inpatient setting, and will attend interdisciplinary University of Miami Pancreas Center meetings to better understand pancreatology, advanced endoscopy, and the application of these novel diagnostic and therapeutic modalities into the clinical arena.

Responsibilities

Learn basic and advanced indications for endoscopic ultrasound with or without fine-needle aspiration biopsy (EUS FNA) in gastroenterology
Learn indications and techniques for performing endoscopic retrograde cholangiopancreatography (ERCP)
Learn the interplay between EUS and ERCP as complimentary technologies to approach pancreatobiliary diseases
Understand and learn clinical and endoscopic management of pancreatic disorders including acute pancreatitis, chronic pancreatitis, pancreatic pseudocysts, pancreatic cysts, cystic neoplasms, and pancreatic neoplasms.
Learn about gastrointestinal manifestations of patients undergoing treatment for different types of cancers not limited to the gastrointestinal tract
Understand the management of dysplastic Barrett’s and early esophageal cancer, using radiofrequency, EMR, and cryoablation
Fellows will learn to identify and understand the patient’s true needs, encompassing compassionate, respectful, and culturally competent care
Deliver optimal care in a cost effective manner
Learn to respect patient’s desire and wishes regarding their care particularly when dealing with terminally ill cancer patients
Develop optimal patient/physician relationship
Learn to direct appropriate patient care between the Gastroenterology Service, Oncology and Surgery
Discuss complications, benefits and limitations of different endoscopic procedures
Detailed review of patient’s medical history including prior diagnostic tests, therapeutic procedures, chemotherapy and/or radiation treatments, and appropriate indication of different endoscopic procedures
Develop the ability to be a leader and coordinate the care of oncological patients with the surgical team, oncologists and other healthcare workers
Learn scientific method of problem solving and use evidence based decision
Demonstrate an open and detailed approach to patient care, performing patient-specific literature search to improve his/her own knowledge applying to patient management
Develop a wide knowledge base and apply to the diagnostic and treatment of gastroenterology patients
Develop an attitude of caring from humanistic and professional values particularly in terminally ill patients
Develop the endoscopic skills to manage and understand gastrointestinal problems in gastroenterology, pancreatology, and oncology patients
Learn the utility of ancillary tests such as cytology, imaging tests and basic molecular pathology applied to the diagnosis of gastrointestinal cancer
Demonstrate competent oral and written communication skills, including chart documentation
Medical record keeping to ensure optimal longitudinal care among different medical specialties
Ability to work effectively as a consultant and leader to other healthcare providers treating chronic pancreatic disorders, mucosal lesions, and cancer patients.
Ability to effectively interact with patients, families and other healthcare providers irrespective of their social, economic or cultural background.
Ability to apply knowledge to communicate with colleagues, other fellows and nurses on service and in general with all range of socioeconomic and cultural backgrounds
Demonstrate commitment to self-improvement in all instances
Demonstrate commitment to carry out professional responsibilities with adherence to ethical principles
Able to identify patient’s needs that supersedes self-interest
Respect for patient privacy and autonomy
Respectful attitude when interacting with patients or families from other cultures, religions, sexual orientation, age groups, gender, terminally ill oncological patients and those with disability
Develop the sense of accountability to patients, society and the profession
Completion of assigned conferences (presenting cases during Gastroenterology, Pancreatic, Advanced Endoscopy, and Hepatobiliary conferences)
Enhance knowledge by appraisal and integration of medical literature into patient care
Improve knowledge of basic anatomy of Endoscopic ultrasound, including use of teaching materials such as demonstrational DVDs and online resources
Demonstration of the ability to investigate and evaluate standards of care of patients by constant review of scientific data
Ability for the fellow to self-identify strengths and areas for improvement to continually improve care and practice
Set learning and improvement goals in basic and advanced endoscopic procedures
Improve knowledge by attending gastroenterology, pancreatic, and hepatobiliary multidisciplinary conferences. Apply the data learned to improve patient care
The fellow will understand how to work as part of a larger healthcare deliver system and will learn efficient standards of care
Ability to call effectively and use other resources and community support such as social workers, home health agencies, etc.
The fellow will gain exposure to the importance of cost-conscious care and risk-benefit analysis in patient and population based healthcare
Be a patient advocate
Able to coordinate patient care within the health care delivery setting
Identify system errors and develop solutions
The Fellows will be exposed to a great variety but not limited to malignant and premalignant conditions of the GI tract. The following conditions, diagnostic and therapeutic modalities will be incorporated into this fellowship: Endoscopic ultrasound- staging of GI malignancies, evaluation of submucosal lesions, tissue acquisition of pancreatic masses and cysts. Latest application of interventional EUS. Pancreatic diseases- evaluation and management of acute pancreatitis, pancreatic cysts, acute recurrent pancreatitis, chronic pancreatitis, pancreatic pseudocysts, and pancreatic cancers. Biliary disorders- endoscopic retrograde cholangiopancreatography in patients with biliary disorders, pancreatic cancer and bile duct tumors. Barrett’s esophagus- Management of dysplastic, non-dysplastic, and cancer in patients with Barrett’s esophagus. The Fellow will be exposed to the latest endoscopic techniques of mucosal resection and ablation techniques including radiofrequency ablation. Palliation of GI cancers- Learn when to palliate GI symptoms in oncological patients: placement of endoluminal stents (biliary, esophageal, duodenal and colonic) and control of GI bleeding Colonoscopy - advanced and complex polypectomy techniques. GI manifestations in oncological and non-oncological patients- narcotic bowel, refractory vomiting, partial bowel obstruction, dysphagia, ileus, abdominal pain, and diarrhea.