In the first year of the program, half of the time is spent in Integrated Consultation, Ambulatory Care, and Endoscopy (I-C/A Endo). The remaining time is split between Gastroenterology Clinical Teaching Units (GI CTU) and Inpatient Consults, in addition to one block of Radiology.
During the second year of the program, residents again concentrate in I-C/A Endo and GI CTU, but also have one research block and one elective.
The program provides instruction in all aspects of endoscopic intervention. Residents acquire competence in the cognitive and technical aspects of upper endoscopy, colonoscopy, and sigmiodoscopy. Senior residents are offered additional training in endoscopic retrograde cholangiopancreatography (ERCP) and usually perform 70-90 cases under supervision. PGY4 residents focus on core skills while PGY5 residents undertake more complex procedures, such as dilations, enteral stenting, complex polypectomy, and achalasia pnuemtaic dilations.
The GI CTU enables residents to act as junior consultants under attending supervision. They are involved in decision-making and patient care in complex and seriously ill cases. Residents perform all of the inpatient procedures, including on those patients seen by the consult service, and are expected to execute formal nutrition assessments for cases requiring nutritional support.
Residents gain ambulatory care experience by attending up to five half-day clinics each week. These include two general GI clinics and two specialty clinics (Liver, Hepatitis, IBD, Motility, and Pediatric GI). An Urgent Clinic is added in the PGY5 year.
The Hotel Dieu Hospital motility lab is a busy unit performing upper and lower motility and fully supported by faculty.
In order to acquire the professional skills and knowledge to enable effective consultation, up to eight months is provided on the Inpatient Consultation Service. Resident supervise a team that includes internal medicine senior residents and triage all inpatient consultations, routine and emergent, and review the cases with the responsible attending. Consults are formally recorded with a management plan and residents are expected to follow up all consults through to resolution of the identified problems.