Academic Programs | Gastroenterology and Hepatology | Department of Internal Medicine | UC Davis Health

Three fellows are selected each year based upon their clinical abilities and potential to become outstanding gastroenterologists and hepatologists. In the first year of the program, all trainees develop the clinical and procedural skills necessary to become competent as a sub-specialist in gastroenterology. Experience is gained in both the inpatient and outpatient setting with an emphasis on maintaining continuity of care.

Simulator training and hands-on demonstrations are provided to first year fellows prior to the start of clinical rotations as an introduction to endoscopy.  Procedures in which first year trainees become proficient include upper endoscopy, esophageal dilation, hemostasis, endoscopic treatment of varices, capsule endoscopy, colonoscopy and polypectomy. Continuity clinics include hepatology and general gastroenterology.

During the second year of training, protected time is provided for research. Those fellows with academic interests may be afforded more time for research or considered for the K30 Mentored Clinical Training Program which confers a Masters Degree in Medical Sciences. Under the guidance of a faculty mentor, each trainee is expected to develop a research proposal tailored to their interests and future goals. In addition, trainees gain experience with esophageal and anorectal manometry, pH studies, and chromoendoscopy.  Continuity clinics during this year are focused on gastrointestinal motility, inflammatory bowel disease, and nutrition.

The third year of training allows advanced training in endoscopic procedures, hepatology, nutrition, small bowel disorders, inflammatory bowel disease, motility and other areas of interest. Fellows are encouraged in this final year to pursue interests that align with their individual career goals.

Throughout the three years, trainees spend the majority of their time at UC Davis Medical Center (UCDMC), a 625-bed, university-based, tertiary medical center. UCDMC serves over 33 counties, covering a 65,000 square-mile area. Here, fellows have the opportunity to see a diverse patient population with complex and rare conditions.  In addition, fellows also rotate at the Sacramento Mather VA Medical Center.  The Mather VA is a tertiary inpatient and outpatient facility caring for United States military veterans with often complex chronic diseases and disabilities. Specialty care provided includes general gastroenterology, hepatology (pre/post-transplant), inflammatory bowel disease, and advanced endoscopic procedures such as endoscopic ultrasound and ERCP. Fellows perform procedures at both of these technologically advanced centers. Call is divided among all nine fellows. Fellows are responsible for night and weekend call at both UC Davis Medical Center and the Sacramento Mather VA Medical Center.

Throughout the year, one half-day per week is devoted to education of the trainees. Weekly board review, journal review, pathology rounds, radiology conference, and clinical case conference occur during this time.  In addition, weekly endoscopy conference, biweekly GI Grand Rounds, monthly Journal Club, and quarterly morbidity and mortality conference are also offered through the year.

Curriculum for Fellowship Training UC Davis Medical Center Division of Gastroenterology and Hepatology

The Division of Gastroenterology and Hepatology is committed to providing trainees an educational experience in a nurturing environment that provides the opportunity to learn the clinical and procedural skills necessary to become a competent physician in the treatment of gastrointestinal diseases. The Division recognizes that each trainee has individual strengths, weaknesses and goals. The Curriculum is developed to provide educational opportunities for all types of learners; encompass the knowledge and skills required of all gastroenterologists; and remain flexible in its structure to allow trainees to pursue advanced knowledge and skills related to their career goals.

Teaching Locations

University of California Davis Medical Center
VA Mather Medical Center

Educational Purpose

Providing care to patients with complex and advanced gastrointestinal and liver-related diseases that is beyond the training that is provided by an Internal Medicine residency. Specific knowledge of gastrointestinal and liver diseases, diagnostic methods, treatment modalities and specialized procedural skills are necessary to provide care to these groups of patients. The purpose of this fellowship is to train physicians to become competent in the practice of gastroenterology.

Goals and Objectives

Develop competency in the care of gastrointestinal and liver related illnesses in the inpatient setting.

By the completion of the program, the fellow will be able to:

• Demonstrate mastery of gastroenterology and hepatology knowledge in the areas outlined by the ACGME and published by the American Gastroenterology Association.
• Demonstrate competency in endoscopic skills including EGD, colonoscopy, hemostasis, polypectomy, dilation and removal of foreign objects.
• Demonstrate professionalism in attitudes with colleagues and peers, empathy in patient care and abilities to interact with other health care providers.
• Develop competency in the care of gastrointestinal and liver related illnesses in the outpatient setting
• Demonstrate knowledge of the approach to various gastrointestinal illnesses including general gastroenterology, inflammatory bowel disease, motility and liver disease through the presentation of cases.
• Demonstrate competency in the performance of endoscopic procedures, liver biopsies and paracentesis.
• Demonstrate professionalism in attitudes with colleagues and peers, empathy in patient care and abilities to interact with other health care providers.
• Develop the ability to access medical information, critically assess new information and present a synthesis of this information to an audience of peers.
• Demonstrate the ability to access literature using computer databases.
• Demonstrate the ability to critically review clinical trials and investigations.
• Demonstrate the ability to present information to peers in small group discussions and didactic lectures.

Teaching Methods

A variety of teaching methods are used throughout the training program, including experiential learning, didactic lectures, group discussions, self-directed learning, oral case presentations and videotape review. Experiential learning occurs in research, outpatient and inpatient settings and is structured in specific rotations.

Outpatient experience occurs in continuity clinic rotations of 6-month duration throughout the training and include General GI, Hepatology, IBD, Nutrition, Biliary, Pancreatic and Motility clinics.

Inpatient and research rotations of 2-4 week duration include GI Consultations, Liver Consultations, VA Mather Consultations, ERCP and Research.

Details of the methods and venues used in each rotation are given in individual rotation curriculum. Teaching venues include:

• Teaching Rounds
• Endoscopy Rounds
• GI Grand Rounds
• Journal Review
• Board (Pathophysiology) Review
• Pathology Conference
• Radiology Conference
• Clinical Case Conference
• Journal Club
• CQI

Methods of Evaluation

Assessments of the six core competencies will be made throughout the training period. Specific milestones must be reached at each period of training in order to progress and complete the training program, i.e. be deemed competent in the practice of Gastroenterology. Progress will be reviewed with each fellow on a semi-annual basis with the Program Director. Remediation of any deficiencies will be addressed at that time and a corrective plan of action developed.

The following list outlines the tools used to assess competencies throughout the training program.

Evaluation Tools:

• Interpersonal and Communication Skills 
• Medical Knowledge
• Patient Care 
• Practice Based Learning 
• Professionalism 
• Systems Based Practice
• Faculty Clinical Evaluations
• Staff Evaluations
• Patient Evaluations
• Student Evaluations  
• AGA In-Service Exam
• Research Proposal and Presentation     
• Case Presentation 
• Publications  
• Grand Rounds Presentation 
• Procedure Logs  
• Journal Club Presentations 
• Faculty Research Evaluations    
• Duty hour Compliance     
• Medical Records Compliance     
• Semi-Annual Performance Summary     
• Program Evaluation          
• Complaints/Praise 
• CQI  

Interim Benchmarks for Competency:

• Faculty Clinical Evaluations 
  A mean overall score not less than 6.0 on a scale of 9 in the prior 6 months of training
  No mean score in any competency area of less than 5.0 on a scale of 9 in the prior 6 months of training
• Nursing Evaluations
  No mean score in any area of less than 2.0 on a scale of 5 in a year of training
• Patient Evaluations
  A mean overall score not less than 3.0 on a scale of 5 in a year of training
  No mean score in any area of less than 2.0 on a scale of 5 a year of training
• AGA In-Service Exam
  Score not less than one standard deviation below the mean score of all fellows of the same year of training on the AGA Gastroenterology Training Exam (GTE).
• Research Presentation (2nd and 3rd year only)
  Submit a research proposal including background, hypothesis, aims, methods, and references.
  Present the research proposal and final progress.
• Case Presentation
  Present at least 4 cases in a year.
• Publications (2nd and 3rd year only)
  Present at least 1 abstract at a national meeting including American College of Gastroenterology, American Gastroenterology Association, and American Society for Gastrointestinal Endoscopy or American Association for the Study of Liver Disease.
• Procedure Log
  Maintain a procedure log in the format indicated by the Program Director.
  Document performance of the minimum number of procedures required according to AGME and ASGE guidelines (whichever is greater), prior to assessing competency
• Journal Club Presentations
  Present one review of an original article and attend at least 80% of meetings.
• Faculty Research Evaluations
  No less than a mean overall score of 7.0 on a scale of 9 in the prior 6 months of training
  No mean score in any area of less than 5.0 on a scale of 9 in the prior 6 months of training
• Duty hour Compliance
  Complete all surveys for duty hour compliance during the prior 6 months of training
  No violations of duty hours in the prior 6 months of training
• Medical Records Compliance
  No suspension of privileges for medical records violations in the prior 6 months of training.
• Semi-Annual Performance Summary
  Satisfactorily address any deficiencies identified in the most recent summary.
• MS 2 Study Section Participation
  Participate in a MS2 Study Section for IMD420 B course
• Complaints/Praise
  Satisfactorily address any complaints or letters from faculty, support staff or patients
• CQI
  Present all cases involved in to CQI
  Attend 80% of CQI meetings

Curriculum Review and Revision

The curriculum should be evaluated by faculty and fellows annually and revised at least every three years. The responsibility for curriculum review and revision will be delegated to the Curriculum Review Committee composed of the Program Director and the Associate Program Director.

Clinical and basic research projects are part of the training program for fellows on both the Research and Clinical Tracks.  Successful completion of a research project including publication is required for graduation from the fellowship program. Fellows choose their research project, which may include clinical or basic research under the guidance of a faculty mentor. The fellow and mentor conceptualize the project during the first year of fellowship.  Fellows are encouraged to present research results at local research conferences and national meetings, and submit manuscripts for publication.

Many faculty within the division are extramurally funded, including NIH, providing a variety of opportunities for research. In addition, several faculty outside of the Division of Gastroenterology and Hepatology work on related topics and have mentored past fellows.

Research opportunities within the Division include:

• Clinical Trials  
• Advanced Endoscopy
• Alcoholic Liver Disease
• Hepatitis C
• Inflammatory Bowel Disease
• Liver Fibrosis
• Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis

Research opportunities outside the Division may include:

• GI Malignancies
• Intestinal Motility
• Health Disparities

The Division of Gastroenterology and Hepatology at UC Davis is ACGME approved for 9 fellowship positions, and generally takes 3 first year fellows each academic year.

• Applicants should have completed three years of training in Internal Medicine in the United States or Canada by the time they enter the fellowship training program. Applicants choosing the ABIM Research Pathway will also be considered.
• Applicants must be board certified or eligible in Internal Medicine, and must possess a California Physician's license before the starting date of the fellowship program.
• Applicants should apply to the UC Davis Gastroenterology Fellowship Program through The Electronic Residency Application Service (ERAS). All positions will be selected using the National Residency Matching Program (NRMP).
• The program does not currently sponsor J-1 or H-1B visa applicants.

Required documents for a complete application:

• ERAS application (all application materials must be received through ERAS)
• Curriculum Vitae
• 3 or more letters of recommendation
• MSPE (Dean's letter)
• Medical school transcripts
• USMLE transcripts
• ECFMG (if applicable)
• Personal statement

For questions, please contact:

Corinne Baumer
Division of Gastroenterology and Hepatology
4150 V Street, Suite 3500
Sacramento, CA 95817
cbaumer@ucdavis.edu

Sample General GI/Hepatology Fellow Schedule

Sample Rotations By Year

** Can be substituted for IBD, hepatology, motility or other interests as approved by the Division

• Christopher Bowlus, M.D. - Professor and Chief
• Anthony Albanese, M.D. - VA Northern CA Health Care System
• Amar Al-Juburi, M.D. - Associate Professor
• Maneesh Dave, M.D., M.P.H - Associate Professor
• Sarah Flores, M.D. - VA Northern California Health Care System
• Juan Carlos Garcia, M.D. - Professor and Clinical Medical Director
• Asha Gupta, M.D. - Assistant Professor
• Lien Le, M.D. – Assistant Professor
• Randy Lee, M.D. - VA Northern CA Health Care System
• Joseph Leung, M.D. - Professor  Emeritus and Chief of Gastroenterology at VA Northern CA Health Care System
• Shilpa Lingala, M.D. - VA Northern California Health Care System
• Valentina Medici, M.D. - Associate Professor
• Vikrant Rachakonda, M.D. – VA Northern California Health Care System and UC Davis Health Associate Professor
• Marmy Shah, M.D. - VA Northern California Health Care System
• Homayoun Shojamanesh, M.D. - VA Northern California Health Care System
• Jesse Stondell, M.D. - Associate Professor and Fellowship Program Director
• Cecilia Terrado, M.D. - Professor
• Shiro Urayama, M.D. - Professor and Advanced Endoscopy Fellowship Program Director
• Anastasia Waechter, M.D. - Staff Physician
• Andrew Yen, M.D. - VA Northern California Health Care System
• Teaching Locations
• University of California Davis Medical Center
  VA Mather Medical Center