Gastroenterology Fellowship Program
The Gastroenterology Fellowship Program at the Medical College of Wisconsin (MCW) has a proud history of training over 120 physicians who have gone on to distinguish themselves in academic gastroenterology and clinical practice throughout the USA and the world. MCW graduates have attained high professional honors directing academic Divisions of Gastroenterology and being named Presidents of National Societies of the American Gastroenterological Association and American Society of Gastrointestinal Endoscopy.
Educational Tracts
The MCW Gastroenterology Fellowship Program offers comprehensive training in the field of Gastroenterology and Hepatology. The MCW Gastroenterology Fellowship Program is accredited by the ACGME and offers fellowship training in two tracts: the standard Clinical Track and the Academic Track (NIH-sponsored clinical investigator track).
Both the Academic and the Clinical Tracks provide training in gastroenterological consultation, GI procedures and direct patient care at Froedtert Memorial Lutheran Hospital (FMLH), Zablocki Veterans Administration Medical Center (VAMC) and St. Joseph’s Hospital (SJ) in Milwaukee Wisconsin. All Division faculty are involved to varying degrees in this program. Close collaboration exists with the Departments of Radiology, Surgery, and Pathology at FMLH as well as the Pediatric Gastroenterology Service at Children’s Hospital of Wisconsin.
The Academic NIH-sponsored Clinical Investigator Track additionally provides a multidisciplinary, interdepartmental and intellectually stimulating environment in which the trainees will have the opportunity to learn a full range of state-of-the-art research techniques necessary for research using human subjects, intact animal and whole organ preparations, cellular and molecular approaches. More importantly, it offers trainees the necessary knowledge and skills to formulate hypotheses and design the appropriate study to test these hypotheses utilizing the learned techniques. The aim of this training grant is to train both M.D. and Ph.D. graduates for a research career in academic gastroenterology. Physicians in the NIH-sponsored Clinical Investigator track will receive 18 months of clinical and 18 months of research training. The research may focus on GI motility, aerodigestive-GI tract interaction or neurogastroenterology/brain-gut with a particular opportunity to utilize the technique of functional MRI (fMRI). They will fully participate in the clinic conferences, seminars and didactic clinical training offered the clinical fellows. Upon completion of the fellowship program, all fellows (M.D.’s) will be GI board eligible.
The goal of both training programs is to develop trainees not only with “state of the art” skills in Gastroenterology and Hepatology but also the habits of critical inquiry necessary for continuing intellectual growth in the years ahead. In this spirit, the program prepares its graduates for successful careers whether it be in clinical practice, academic teaching or in pure research endeavors. We recognize that these career paths overlap to an increasing degree. Success therefore, is heavily based on the spirit of continued inquiry.
How to contact us
If you would like more information about the MCW Gastroenterology and Hepatology Fellowship Program, please contact Ms. Rebecca Klug, the Fellowship Coordinator at (414) 456-6766 or GIFellow@mcw.edu.
Applications
The MCW Gastroenterology Fellowship Program participates in the NRMP match program and the ERAS system for all applicants regardless of whether applicants are applying to the Academic Clinical Investigator or Clinical track. The Universal Application Form may be obtained from the ERAS Web site. Applications should be submitted in ERAS. Applicants should preferably indicate whether they are interested in the Academic Clinical Investigator or Clinical track in their application.
Principles of Selection
Selection of the candidates is based on the principles of excellence. While individuals are selected based on merit and achievement, an effort is made to select individuals of diverse backgrounds. The level of performance expected from each fellow requires a full-time effort. While the program extends over three years, appointments are subject to annual review. Candidates for the Academic Clinical Investigator track must have a desire for research inquiry and commitment to pursuit of a career in academics. While previous research in GI motility, aerodigestive-GI tract interaction or neurogastroenterology/brain-gut interactions would be desirable for applicants for this track, it is not mandatory. Applicants for the Academic Clinical Investigator track must however be committed to developing a research career in one of these areas of inquiry.
Clinical Experience
Froedtert Memorial Lutheran Hospital (FMLH) is one of the two primary teaching hospitals of the Medical College of Wisconsin (MCW), and is part of the complex that includes a Level I Trauma Center, the Eye Institute, Children’s Hospital of Wisconsin, and the Medical College of Wisconsin. FMLH currently has a total of 519 adult inpatient beds. The Chief of the Gastroenterology & Hepatology Division (Dr. Reza Shaker) and the Fellowship Program Director (Dr. Kia Saeian) are located at FMLH. It is mainly at this location where Gastroenterology & Hepatology Fellows gain experience with transplant patients (kidney, liver, pancreas, bone marrow, heart, lung). The Hepatology Program (Drs. Rajiv Varma, Jose Franco, Kia Saeian, Samer Gawrieh), the MCW Dysphagia Institute, the Pancreatico-Biliary Center, the IBD Center (Dr. David Binion) and Motility Programs are based at FMLH as well.
Zablocki VA Medical Center (VAMC) is the second primary teaching hospital of MCW, located approximately five miles from FMLH. This is a large Dean’s Committee VA Hospital, staffed by full-time faculty in all departments. Full gastroenterology services including ERCP and EUS, are provided on site at the VAMC.
St. Joseph’s Hospital – Milwaukee (SJ), is a large general hospital approximately six miles from FMLH. The Gastroenterology & Hepatology Fellow(s) rotate to this hospital for 3-6 months, generally during their second or third fellowship year. They are mentored there by fine gastroenterologists who are on our clinical faculty and were trained in our program; two of the six were members of our full-time faculty for three years and another has held various offices in the ASGE and ACG.
Research Facilities
Our Division has years of strong research productivity that has been heavily influenced and directed by the fellows. Digestive diseases research at the Medical College of Wisconsin is marked by close collaboration between investigators of different disciplines. This collaboration is reflected in the creation of the Digestive Disease Center (DDC) that unites all MCW digestive system investigators. The expertise and laboratories of all members are available for the research training of our Gastroenterology & Hepatology Fellows. The MCW Dysphagia Institute is another multi-disciplinary unit that combines faculty from Gastroenterology & Hepatology, Otolaryngology, Radiology and Neurology. Fellows have access to numerous databases and the internet through dedicated computers in the research areas.
FMLH
A large laboratory suite for motility research in human subjects is available. Instrumentation available includes a fluoroscope, radioisotope counters, an instrumentation workshop and extensive computer capacity. In addition, The Clinical Research Center offers a well-trained, experienced staff for special patient studies, many supported by NIH funds. Access to world class functional MRI technology and expertise further enriches the research experience.
MACC FUND RESEARCH CENTER (MFRC) and adjacent Allen Bradley Medical Science Laboratory (ABMSL)
Animal experiments in esophageal, biliary and intestinal motility are conducted in special laboratories in the ABMSL. Laboratories for molecular biology research are located in the MFRC.
VAMC
Research laboratories are also available at VAMC for motility research.
The Clinical Track fellows spend approximately 18 months at FMLH; assignments include inpatient consults (60-80 per month), endoscopy, inpatient hepatology and liver transplant, GI radiology, GI manometry, Continuity Clinic and referral clinics of senior faculty. In addition, fellows rotate through Children’s Hospital of Wisconsin Clinics during this time. Approximately 12 months are spent at VAMC while six months are spent at SJ.
Outpatient Continuity Clinics are conducted at FMLH and VAMC on alternating weeks. The fellows participate in these clinics throughout their three years of fellowship with an assigned attending for an entire year. During their three-year tenure, fellows will develop a patient clientele of their own (through the Continuity Clinics) that they follow in close consultation with faculty members.
All technical procedures are performed by fellows under direct staff supervision. The active participation by the fellow in the procedures increases with his/her training and clinical expertise. Clinical assessments, documentation of procedural findings and evaluation of histopathology are included as part of the fellowship. Critique of technique, interpretation, and dictated reports is regularly provided by the faculty during review. Additionally, fellows learn the interpretation of manometric, gastric/pancreatic secretory studies and breath hydrogen tests.
Conferences and Seminars
GI Clinical Conference
This conference is held once a week at 5pm on Mondays and is one of the central events of the Gastroenterology & Hepatology Division Fellowship Program. The cases presented reflect current patient problems encountered in our teaching hospitals. In addition to fellows and faculty, active participants in this conference include members of the Departments of Radiology, Surgery and Pathology.
GI Academic Conference (6:15pm Monday Evenings)
A detailed schedule is prepared at the beginning of the academic year. The following activities occur at this time:
Clinicopathologic Conference (CPC)
Each fellow will discuss one CPC per year. A faculty member will be designated as mentor for the fellow’s presentation. Protocols are prepared by a GI faculty, are intended to be a problem-solving exercise for the fellow, and are typically given to the fellow one week prior to the conference.
Journal Club
Each of three fellows will present one article of interest from selected journals. A faculty mentor is assigned for each presentation.
Seminars
Each fellow will give one seminar each year on a specific topic of gastroenterology or hepatology physiology or pathophysiology. The fellow is expected to present an in-depth review of the current thinking on the assigned topic.
Digestive Disease Research Seminar
These are formal lectures given by investigators of note from within or outside our division. These are selected to round out education as a sub-specialist and clinical investigator. The fellows have an opportunity to meet world-renowned investigators during and after these sessions.
Didactic Lectures
These lectures consist of a lecture series, structured in a three-year cycle, which covers the topics of required knowledge for a gastroenterologist as outlined by the ACGME Program “Requirements for Education” in Gastroenterology & Hepatology, but additionally covers gastric secretory studies, practice economics, public policy, a primer on molecular genetics, and critical appraisal of the literature.
In addition, pathology and radiology teaching sessions, a monthly fellows' clinical journal club held in local restaurants which includes textbook and Board review sessions, The Research Methods Workshop and Biostatistics Workshop are scheduled at designated times.
Departmental GI Teaching Conferences: These conferences are held at FMLH and VAMC. They are given by staff attendings for the housestaff on two separate occasions (once at FMLH and once at VAMC).
Other Conferences
The following conferences are held at FMLH:
Pancreaticobiliary Conference – Every other Friday morning.
Inflammatory Bowel Disease Conference - Once a month on the 2nd Wednesday at noon.
Liver Pathology Conference – Once a month on the 2nd Tuesday at noon
Liver Tumor Conference – Every other Monday morning.
Medical Grand Rounds are held every Friday at 8:00 a.m. at FMLH and are broadcasted to the VA Medical Center.
National Meetings
Fellows are given a choice to select either the annual Digestive Disease Week (DDW) or the annual meeting of the American Association for the Study of Liver Diseases (AASLD) for travel this year.
Research Training
All fellows, whether clinical or academic, are required to actively participate in research. During the first fellowship year, the fellow selects a faculty mentor and a specific research project. For the clinical fellows, time is allotted for research during the fellowship, in blocks or intermittently, depending on the specific requirements of the project. This generally takes the form of 6 months over 3 years. If more time or block time is required, accommodations are made on an individual basis. For academic fellows, 18 months is allotted. Each fellow is expected to submit his/her research results for presentation at a national meeting e.g. (AGA, AASLD).