Program Description | Curriculum | Faculty | Application Process

Program Description
The Beth Isarel Medical Center ERCP Fellowship program is a one-year, unaccredited fellowship program for gastroenterologists wishing to develop into a first-rate gastroenterology consultant and therapeutic endoscopist capable of independent clinical management and research activity in pancreaticobiliary diseases. The fellowship is a 12 month sub-specialty training which will include ambulatory procedures, inpatient hospital care and ongoing research activity at the Beth Israel Medical Center. The fellowship will provide the opportunity for the trainee to provide excellent patient care as they achieve cognitive knowledge and procedural skills and gain supervised practical experience as a therapeutic pancreaticobiliary endoscopist. This training will also allow appropriate breadth and depth of training to pursue careers in academic medicine and/or clinical practice.

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Curriculum
The fellow will be directly involved in performing diagnostic and therapeutic ERCP, endoscopic ultrasound and therapeutic upper and lower endoscopy under the direct supervision of attending physicians Drs. Siegel, Cohen and Kasmin. Additionally, the fellow will assist the attending physicians in directing the inpatient care of any patients requiring post-procedure hospital treatment, including but not limited to the management of procedure-related complications and follow-up study and/or therapy. Finally, the fellow will evaluate and treat with the attending physicians any new inpatient general gastroenterology consultations generated on hospitalized patients.

In addition to the aforementioned educational instruction, the fellow will also be encouraged to attend weekly Gastroenterology Grand Rounds at Beth Israel Medical Center Petrie Division, NYSGE monthly conferences and the Annual NYSGE meeting. The fellow will also be expected to present lectures at the former two conferences.

Finally, under the guidance of the attending physicians, the fellow will be responsible for generating an original research project or participating in a previously identified research study relating to the diagnosis and/or treatment of pancreaticobiliary diseases. The intention of such endeavor will be to present the research findings in a formal setting to his or her peers at a major society meeting, and ultimately submit a written paper for formal acceptance to a peer-reviewed journal.

Objectives
Over the course of the academic year and under the direct instruction of the aforementioned attending physicians, the fellow will be expected to become experienced, knowledgeable and competent in the management of the following clinical conditions.

• The fellow should be competent in the evaluation and management of hepatobiliary diseases, including but not limited to cholangitis, choledocholithiasis, benign and malignant biliary stricture, post-cholecystectomy injury and Sphincter of Oddi dysfunction. Fellow should be capable of performing diagnostic and therapeutic ERC in the appropriate settings, including biliary stenting (plastic and SEMS), cytology brushing and aspiration, crystal analysis, balloon dilation, sphincterotomy (wire-guided and pre-cut), stone extraction (balloon and basket extraction as well as mechanical lithotripsy) and Sphincter of Oddi Manometry. The fellow should understand the indications for and be able to successfully execute prophylactic temporary biliary and pancreatic stenting. The fellow should be able to recognize and manage procedural complications, including but not limited to pancreatitis, perforation, cholangitis and bleeding. The fellow should demonstrate competence in interpreting and acting upon US, CT, MR and cholangiographic imaging modalities. He or she should know the limitations of endoscopic therapy in the management of biliary diseases and understand and acknowledge the indications for referral to surgery and interventional radiology.
• The fellow should be competent in the evaluation and management of pancreatic diseases, including but not limited to acute and chronic pancreatitis, biliary pancreatitis, pancreatic strictures, pancreatic neoplasms (benign and malignant), pancreas divisum and Sphincter of Oddi dysfunction. The fellow should be capable of performing diagnostic and therapeutic ERP in the appropriate settings, including pancreatic stenting (short-term prophylaxis and longer-term therapy), cytology brushing and aspiration, sphincterotomy (wire-guided and pre-cut), Sphincter of Oddi Manometry and endoscopic pseudocyst-enterostomy. The fellow should understand the indications for and be able to successfully execute prophylactic temporary pancreatic stenting. The fellow should be able to recognize and manage procedural complications, including but not limited to pancreatitis, perforation and bleeding. The fellow should demonstrate competence in interpreting and acting upon US, CT, MR and pancreatic imaging modalities. He or she should know the limitations of endoscopic therapy in the management of pancreatic diseases and understand and acknowledge the indications for referral to surgery, interventional radiology and pain management services.
• The fellow should be capable in the evaluation and management of submucosal gastrointestinal masses, including but not limited to esophageal, gastric, pancreatic, duodenal and anorectal lesions. The fellow should demonstrate appropriate cognitive ability in formulating differential diagnoses of such lesions, and competently performing endoscopic ultrasound when deemed necessary. He or she should be familiar with indications for fine needle aspiration.
• The fellow should be capable of performing endoscopic ultrasound examination on mucosal-based lesions in the upper and lower gastrointestinal tracts, including pre-operative staging on lesions deemed not amenable to endoscopic therapy. Additionally, he or she should be capable of identifying those lesions that are amenable to endoscopic removal, and subsequently performing such endoscopic therapy successfully (i.e., endosocpic ampullectomy and ablative therapy for ampullary adenomas).

Requirements and Responsibilities
The fellow will be responsible for making rounds on all hospitalized patients on a daily basis, and discussing and implementing the management plans with their respective attending physicians. Prior to all ambulatory endoscopic procedures, the fellow will be responsible for interviewing and examining each patient and preparing them for their subsequent examinations. The fellow will be actively involved in each endoscopy, and will admit or discharge each patient depending on their post-procedure disposition. Any new emergency or inpatient consults that may arise during the work day will also be seen by the fellow and discussed with the attending physicians. Finally, the fellow will be involved in any interdisciplinary actions (i.e., interventional radiology, surgery, pain management) that may need to be undertaken on any of the subsequently admitted ambulatory patients or otherwise hospitalized patients.

Faculty

Application Process

1. Filled Application Form (we accept universal application form from www.gastro.org)
2. Curriculum Vitae
3. Personal statement
4. Three letters of recommendation (LOR).

Please submit your documents to:
Franklin Kasmin, MD
60 East End Avenue Ofc
New York, NY 10028
Telephone: (212) 734-8874