To all the GI Fellows and Graduates out there-
Could you weigh in on the Pros vs Cons of a couple of things:
1. Call structure: Whole week+weekend vs qX weekday+qX weekend?
2. Inpatient scoping: Alternate-day scoping split between two fellows while on inpatient GI consults vs Only dedicated scoping 1-2 months/first year
Thanks
I am always skeptical for programs in which you scope for 2-3 months a year...there is a very famous BRAND NAME program that advertises that as a virtue . "our scope numbers are lower than what you ll see at other places , but we teach you so well that doing 1 scope here is like doing 10 elsewhere." . Don't fall for such nonsense. I would avoid places in which you don't scope for months at a stretch.
cognitive aspects of GI are not that hard to learn... when you graduate you need to be able to do 15-20 procedures a day with good results... i'd say any program with colon numbers <400 and egd numbers < 750 should be ranked lower regardless of "brand" ..
call schedule etc makes less difference-
real questions to think about
1) ERCP/ EUS number ,
2) comfort in doing colonoscopies at end of 2nd and third year .... how many inject/lift / piecemeal polypectomiesdo they do... or do they just sent them to advance.... did they do 50-100 colons without attendings touching a scope...
3) how good are the third years with difficult bleeder... like bleeding dieulafoy or ulcer in fundus... are they able to apply clips in fundus retroflexed postion... are they able to put a bearclaw if they see a pumping vessel in d2...or they freakout and send the patient to IR...
4) time spend doing prior auths for ibd patients
5) comfort with surveillance colons for ibd and ability to suspected dysplasia by third years..
6) terminal ileum intubation rate mid-third year...
7) comfort will variceal banding : believe it or not there are programs including big brands where they do few of those because they are done by hepatology service..
8) ability to treat hepc and read fibroscans (piece of cake but you need exposure , will generate extra revenue for practice , plus if you send those patients else-where they may not come back).
u are going to read and go to conferences and learn cognitive aspects from lectures... and cognitive aspects are not as hard as constructing an euler-lagrange equation for an nth dimensional space or differential geometry needed to understand general relativity... anyone can understand them... what you need to learn in fellowship is scoping...and you need to be darn good at it...everything else is bull****...