Medical College of Wisconsin Gastroenterology Fellowship Program

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 website. 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.

Additional Application Information

US Medical Graduates (Please provide the following in your ERAS Application)

• Common application form

USMLE Transcript (Steps 1, 2 and 3)

• Complex scores (DO)
• MSPE
• At least three letters of recommendation (one has to be from your current program director)
• Medical School Transcript
• Personal Statement
• CV

International Medical Graduates (Please provide the following in your ERAS Application)

• Common application form
• USMLE Transcript (Steps 1, 2 and 3)
• MSPE
• At least three letters of recommendation (one has to be from your current program director)
• Medical School Transcript
• ECFMG Status Report
• Personal Statement
• CV
• J-1 visa candidates (visa has to be sponsored by the ECFMG)
• H1-B visa candidates

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.

The MCW Gastroenterology Fellowship Program offers comprehensive training in the field of Gastroenterology and Hepatology. The 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 Hospital, Clement J. Zablocki VA Medical Center, and St. Joseph Regional Medical Center 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 Froedtert Hospital as well as the Pediatric Gastroenterology Service at Children’s 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 animals, 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 MD and PhD graduates for a research career in academic gastroenterology. Physicians in the NIH-sponsored Clinical Investigator track will receive 24 months of clinical and 24 months of research training. The research may focus on GI motility, aerodigestive-GI tract interaction, or neurogastroenterology/brain-gut.

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.

The fellowship will be a period of intensive learning. Professional growth will be in direct proportion to individual efforts. The objective of the program is to prepare competent consulting gastroenterologists with expertise in all fields of gastroenterology including pancreaticobiliary diseases, Hepatology, and motility disorders. This program will also train all standard GI procedures. Fellows that are interested in advanced procedures are encouraged to complete an additional year of training in this field.

Froedtert Hospital 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 Wisconsin, and the Medical College of Wisconsin. Froedtert Hospital currently has a total of 519 adult inpatient beds. The Chief of the Gastroenterology and Hepatology Division (Dr. Reza Shaker) and the Fellowship Program Director (Dr. Daniel Stein) are located at Froedtert Hospital. It is mainly at this location where Gastroenterology & Hepatology Fellows gain experience with transplant patients (kidney, liver, pancreas, bone marrow, heart, lung). The MCW Dysphagia Institute, the Pancreatico-Biliary Center, the Inflammatory Bowel Disease and Motility Programs are based at Froedtert Hospital as well.

Zablocki VA is the second primary teaching hospital of MCW, located approximately five miles from Froedtert Hospital. 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 Zablocki VA.

St. Joseph's Hospital - Milwaukee is a large general hospital approximately six miles from Froedtert Hospital. 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.

Patient care activities include inpatient consultations, outpatient clinics including “Continuity Clinics” and hands-on training in the technical aspects of gastroenterological procedures. The consultation service at Froedtert Hospital and Zablocki VA consists of residents and senior medical students rotating through Gastroenterology and Hepatology as well as a fellow who coordinates consultation rounds.

The Clinical Track fellows spend approximately 18 months at Froedtert Hospital; assignments include inpatient consults endoscopy, inpatient hepatology, liver transplant, GI manometry, Continuity Clinic, and referral clinics of senior faculty. Approximately 12 months are spent at Zablocki VA while six months are spent at St. Joseph's Hospital.

Outpatient Continuity Clinics are conducted at Froedtert Hospital and Zablocki VA 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 the review. Additionally, fellows learn the interpretation of manometric, gastric/pancreatic secretory studies, and breath hydrogen tests.

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.

GI Clinical Conference
This conference is held once a week and is one of the central events of the Gastroenterology and 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
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.
  
  
• Core Series Conference
  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 subspecialist and clinical investigator. The fellows have an opportunity to meet world-renowned investigators during and after these sessions.

Weekly Board Review and Didactics
Board review and lectures are given by faculty members on a rotating two-year curriculum that is adjusted annually based on in-service training exams results.

Other Conferences
The following conferences are held at Froedtert Hospital:

• Complication Report Conference
• Fellow’s Breakfast: Fellowship Program Feedback Session Q&A
• Foregut Conference
• Pancreaticobiliary Conference
• Inflammatory Bowel Disease Conference
• Liver Pathology Conference
• Liver Tumor Conference
• Medical Grand Rounds at Froedtert Hospital are broadcasted to the Zablocki VA
• Pancreaticobiliary Conference

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 each year.

• GI Update/DDW | Held every fall
• AASLD Meeting Review | Held the first Saturday in December
• Liver Update | Held every spring