Advanced Fellowship in General and Transplant Hepatology
Introduction
As the field of general hepatology continues to develop and expand steadily, and as more cases of liver transplantation are being performed, the need for qualified hepatologists to manage patients with chronic liver diseases as well as those with liver transplants has dramatically increased. Thus, there is a great need for in-depth training to acquire additional knowledge and skills in this particular sub subspecialty of Gastroenterology. In November 2006, the American Board of Internal Medicine started to offer the certifying examinations in Transplant Hepatology, now recognized as a distinct discipline. Eligibility for such certification requires certification in Gastroenterology and completion of one-year training in advanced hepatology with focus on liver transplantation in an ACGME-accredited training program.
Program Description
The University of Chicago Advanced Fellowship in General and Transplant Hepatology provides a broad practical and scholarly exposure to clinical problems and in-depth research training in areas of liver diseases and liver transplantation. The program has a long and consistent history of graduating physicians that are scholarly clinicians as well as prominent clinical investigators and became ACGME certified in Transplant Hepatology in 2007. Direct and continuous contact and supervision by and with full-time faculty including senior and junior members offers a personal approach to the trainee’s educational, clinical and scientific development. The training program utilizes the extensive clinical, endoscopic, and research facilities found at the University of Chicago Medical Center. Because of the University of Chicago’s reputation as a top rated referral center and our location in the heart of the City of Chicago, there is a broad exposure to common liver conditions, as well as unusual and difficult to manage clinical cases. The University of Chicago Liver Transplant Program is United Network for Organ Sharing (UNOS)-approved and remains in good standing as a liver transplant center.
The General and Transplant Hepatology fellowship is closely associated with the fully ACGME-accredited three-year fellowship leading to board eligibility for Gastroenterology. The duration of training will be 12 months.
The Hepatology Service at the University of Chicago is comprised by faculty members, research associates, clinical nurses, and research nurses engaged in the delivery of state of the art care to patients with liver conditions and to liver transplant candidates and recipients, as well as in the exploration of new modalities of therapy to be used in various liver diseases and in liver transplantation and advancement of the understanding of the pathophysiology and outcomes of different liver diseases. During this period, the trainee will become proficient in the management of acute and chronic liver conditions, including end-stage liver disease and its complications. They will also become proficient in the evaluation and care of liver transplant candidates as well as in the management of liver transplant recipients and their potential complications. Opportunities to initiate or participate in ongoing research activities in Hepatology as well as Liver Transplantation are available.
The University of Chicago is an equal opportunity, affirmative action employer and applications are encouraged from minority groups and physically disadvantaged individuals.
Resources:
Program Director:
Anjana Pillai,MD
Associate Professor of Medicine
apillai1@medicine.bsd.uchicago.edu
FAX: (773) 834-1288
Affiliated Faculty:
Andrew Arohsohn,MD, Associate Professor or Medicine
Michael Charlton,MD, Professor of Medicine
Sonali Paul,MD, Assistant Professor of Medicine
Gautham Reddy, M.D., Associate Professor of Medicine
Helen S. Te, M.D., Professor of Medicine
Venue:
The University of Chicago
Any other hospitals where liver donor organs will be procured from
Education Program
Pre-requisites for Program
Completion of residency training in Internal Medicine
Completion of, or enrollment in, a three year fellowship training in Gastroenterology
Valid Illinois Medical License (application may be pending)
Appropriate visa requirements if non-U.S. citizen or immigrant
Education Goals
The Advanced Fellowship in General and Transplant Hepatology affords the applicant focused training in clinical care and/or clinical or translational research in Hepatology and Liver Transplantation. This training is intended to further the sub-specialty training in Gastroenterology and serve as a “third tier” educational experience for Gastroenterology Fellows intending to focus careers on Hepatology.
Education Activities
The Advanced Fellowship in General and Transplant Hepatology will combine inpatient and outpatient clinical experience in general and transplant hepatology as well as clinical and/or translational research opportunities. This fellowship will incorporate, under a single program umbrella and under the supervision of the faculty; 10 months of inpatient and outpatient liver transplant and/or hepatology experience, 2 months of dedicated research time and 4 weeks of vacation interspersed within the rotations. In addition, attendance at a weekly continuity clinic and transplant clinic will be maintained. A keen intellectual environment will be promoted by the attending staff devoted to patient care and teaching, and further fostered with educational conferences and lecture series. There will be ample opportunities to sharpen skills in endoscopic procedures.
Inpatient hepatology/liver transplant service
The fellow will serve 4-6 monthly rotations of either the hepatology or liver transplant service. During these rotations, the fellow will have responsibility for the care of approximately 6-10 inpatients, some of which will be ICU patients. Inpatient rounds are performed each day by a team of physicians including a transplant surgeon or a hepatologist, clinical transplant nurse coordinators, a PharmD, a social worker, a dietitian, residents and medical students. During these rotations, the fellow will have primary responsibility for interfacing between the attending physician/s and the care of the patients. The fellow (along with the residents and students) will be expected to acquire clinical data, develop a diagnosis/treatment plan, and execute the plan under the guidance of the service attending physician. The fellow will assist with the didactic and bedside teaching of residents and medical students and guide them in the care of advanced acute and chronic liver disease. In addition, the fellow will observe at least 3 liver transplant procedures and 3 organ procurement calls. The fellow will be required to observe the selection and management of at least 3 multiple organ donors. Each of the surgical experiences will be maintained in a written log which will be verified and documented by the attending surgeon. The fellow will have adequate exposure to the clinical and ethical decisions involved in at least 5 cases of living-related liver transplantation.
Research
Two months will be dedicated to clinical or translational research. The trainee will continue his outpatient continuity clinics (pre- and post-transplant) during this period, but will maintain at least 75% fully protected time. Opportunities to continue research work will be available during the Ambulatory Hepatology rotations as well.
Outpatient clinics / Ambulatory Hepatology
Two intense clinics will form the nucleus of the continuous outpatient experience: a surgical or medical post-transplant clinic and a general hepatology clinic. They will participate in 2 half-day clinics per week; the general hepatology clinic throughout the year, and a combination of the surgical post-transplant clinic (first six months of fellowship) and the medical post-transplant clinic (second six months of fellowship). In the surgical clinic, the trainee will work closely with the transplant surgeons caring for immediate post-liver transplant patients within 3 months of liver transplantation. New liver transplant candidates are also seen in this clinic. In the medical clinic, patients are typically referred back 3 months after transplantation, and many patients continue to receive their primary care in this setting for many years.
During the Ambulatory Hepatology rotations, the trainee will participate in an additional half day of general hepatology clinic, where initial evaluation for newly found liver problems, treatment of common liver diseases, and management of end-stage liver disease and its complications in both transplant and non-transplant candidates are being carried out.
Procedures
The hepatology fellow will continue to perform select liver biopsies and selected endoscopic procedures. In addition, the fellow will have opportunities for the performance of large volume paracentesis and the management of post-transplant wound care.
Conferences
Weekly conferences include GI/Hepatology Grand Rounds, Fellow Clinical Didactics and Academic Skills Conference, Liver Tumor Board, Liver Transplant Selection Committee Meeting and GI Research Conference. A Liver Pathology Conference alternates every two weeks. There is also a monthly Hepatology journal club and Liver Telehealth Clinical Case Conference. All conferences are well-attended by attending staff and are mandatory for fellows.
Evaluation Process
Trainees will be evaluated by evaluation forms. Research Projects will be assessed according to scientific merit with expectation for publication of original research, case reports/series, and/or systematic review.
How to Apply:
Visit the AASLD Transplant Hepatology Fellowship Application System.
Celina Canchola
Fellowship Coordinator
University of Chicago Medical Center
5841 S. Maryland Avenue, MC 4070
Chicago, IL 60637
ccanchola@medicine.bsd.uchicago.edu