Objectives

Introduction To The Advanced Therapeutic Endoscopy Fellowship At The University Of Alberta (UAH)

Program Director: Dr. Sergio Zepeda-Gomez

"The Division of Gastroenterology is committed to providing exemplary patient care and education in an atmosphere of compassion and scholarly inquiry while preserving the dignity and rights of the patients and their families."

The advanced therapeutic endoscopy program focuses mainly in endoscopic retrograde cholangio-pancreatography (ERCP) and endoscopic ultrasound (EUS) training. The fellows will also be actively participating in other diagnostic and therapeutic procedures such as enteral stenting, endoscopic mucosal resection (EMR), videocapsule endoscopy (VCE), balloon-assisted enteroscopy (BAE) and double-balloon-ERCP (DBE-ERCP) procedures. The program also involves active participation in research in diagnostic and therapeutic endoscopy.

Candidates for the Advanced Therapeutic Endoscopy Fellowship must have completed two years of Gastroenterology Subspecialty training. Our goal is to produce a consultant sub-specialist who is an expert in the field of advanced endoscopy and is competent in managing most of the clinical problems presented in the field. With our Division's strong commitment to academic medicine, our objective is to train physicians who have sound academic tools in addition to technical skills. To accomplish this, clinical research is expected with a commitment to undertaking a research project with the aim of publishing a paper as well as one or two abstracts from related or other projects.

Although the Advanced Therapeutic Endoscopy Fellowship at the University of Alberta is a one-year program, there is sometimes an option to continue as a research fellow with more exposure to balloon-assisted enteroscopy and videocapsule procedures for an additional year. To attain the stated objectives, the trainee will work in close collaboration with the therapeutic endoscopy group at the UAH: Dr. Gurpal Sandha (EUS, ERCP, Spyglass), Dr. Sergio Zepeda-Gomez (ERCP, DBE-ERCP, BAE) and Dr. Richard Sultanian (ERCP, complex polypectomies). Other experienced endoscopists involved in the program include Dr. Gurpal Sandha (EUS), Dr. Brendan Halloran (BAE) and Dr. Vincent Bain (ERCP).

Selection Criteria

Candidates are selected based on the following:

  • Previous endoscopy experience (skill evaluation)
  • Knowledge in endoscopy
  • Letters of recommendation
  • CV
  • Research interest and experience
  • Communication skills (written and oral)
  • Fit for program

Objectives Of The Advanced Therapeutic Endoscopy Fellowship At The University Of Alberta General Objective

The Advanced Therapeutic Endoscopy Fellowship at the University of Alberta is committed to providing trainees with the training they require to become clinical experts in the field of therapeutic endoscopy.

Specific Objectives

At the successful completion of training, the trainee should be:

  • Able to recommend specific advanced endoscopic procedures to the patient, which are appropriate for the clinical situation.
  • Intimately familiar with specific indications and contraindications of advanced endoscopic procedures.
  • Intimately familiar with diagnostic and therapeutic alternatives to advanced endoscopic procedures.
  • Able to recognize situations, which require antibiotic prophylaxis prior to endoscopy and the impact of general medical illness on the ability to carry out endoscopic procedures safely.
  • Skilled in performing conscious sedation and be familiar with drugs most commonly used for conscious sedation.
  • Able to recognize the risks and potential complications of conscious sedation and be prepared and able to perform resuscitation if necessary.
  • Able to perform specific procedures safely, competently and expeditiously and recognize and manage potential complications.
  • Able to correctly interpreting endoscopic and related radiographic findings. • Integrating endoscopic findings or therapy into overall management plan.
  • Able to recognizing personal and procedural limits and know when to request help.
  • Able to produce accurate and comprehensive endoscopy reports.
  • Be aware of endoscopic tools and accessories.

The Training Period

Trainees in advanced therapeutic endoscopy will acquire their skills under the supervision of expert endoscopic staff. Training will follow a natural progression as trainees accrue more technical expertise and confidence with time. Initially a trainee may observe a procedure, followed by first attempting only the diagnostic or less technically demanding aspects of a procedure. As experience grows, the trainee will progress to performing the entire procedure and attempting therapeutic interventions. The procedure, at all times, will be under supervision of the responsible staff endoscopist irrespective of the trainee's proficiency.

Evaluation Of Training

The Advanced Therapeutic Endoscopy fellowship program is not accredited by the Royal College of Physicians and Surgeons of Canada. There are no in-training evaluations and the Royal College does not have a certification examination at the end of training. Formal evaluations are completed at the mid-way point of the fellowship (6-month mark) and at the end of the fellowship (1-year mark) and are submitted to the Postgraduate Medical Education office (PGME) of the University of Alberta. A Certificate of Training, provided by the University of Alberta, will be conferred upon the successful completion of this fellowship.

Rotation Schedule

  • 1 year fellowship with integrated research
  • Alternating weeks of EUS/Double Balloon Endoscopy and ERCP/ video capule
  • 4 weeks vacation

Week 1

  • AM: EUS
  • PM: Endoscopy- Double Balloon

Week 2

  • AM: ERCP
  • PM: Video Capsule