Advanced Endoscopy Fellowship Program

Advanced Endoscopy Fellowship Program

The increased need for training dedicated to endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS), as well as the large number of advanced endoscopic techniques now available, has led to the development of the upper-level fellowship dedicated to advanced endoscopy at NewYork-Presbyterian Brooklyn Methodist Hospital. This one-year clinical fellowship in advanced endoscopic procedures is directed towards structured training of the individual in their fourth year of fellowship training.

Program Description

The program's primary purpose is to provide outstanding training in advanced therapeutic endoscopy. A key feature of the program is the ability to provide wide experience in advanced endoscopy by combining the endoscopic experience with the facilities and resources available to the trainee. The trainee will accumulate significant procedure experience in ERCP and EUS since over 800 of these procedures are performed at New York-Presbyterian Brooklyn Methodist Hospital annually. Endoscopic mucosal resections, endoscopic submucosal dissection, radiofrequency ablation (RFA) for Barrett's esophagus, and stent placements are also performed at the hospital.

The program provides one-on-one mentoring of a physician who has completed a three-year Accreditation Council on Graduate Medical Education-accredited general gastroenterology fellowship. It is designed for recent gastroenterology fellowship graduates who wish to become proficient in ERCP, EUS, and other new modalities not covered in detail in standard training programs. The training curriculum focuses on advanced endoscopic techniques to manage various complex GI diseases, including pancreaticobiliary, esophageal, gastric and colorectal malignancies. By the end of the year, trainees will demonstrate competency in advanced procedures, including ERCP, EUS, EMR, luminal stenting, RFA, and cyst drainage.

The trainee will understand the anatomy, physiology, and pathophysiology of the biliary tract and pancreas, the multi-layered aspect of the lumenal gut, and the anatomic relationship of various internal structures. The fellow will also be introduced to the use of appropriate diagnostic and therapeutic studies for these disorders. They will have the opportunity to get hands-on experience performing ERCP and EUS inpatients and outpatients, with appropriate supervision by an experienced therapeutic endoscopist.

Facilities and Resources

The nature of the training provided by this program will expose the trainee to patients from a diverse patient population. Trainees in this program will see patients at NewYork-Presbyterian Brooklyn Methodist Hospital, our Center for Community Health (CCH), and affiliated physician offices throughout the area. In addition, trainees are encouraged to be involved in ongoing research activities and develop independent research projects, leading to presentation at regional and national meetings and publications in peer-reviewed journals.

General Goals and Objectives

The advanced endoscopy curriculum will focus on endoscopic management of complex gastrointestinal pancreatic and biliary diseases, including the staging of GI tract luminal malignancies. For this purpose, most procedures will involve ERCP, EUS, and advanced endoscopic resection and palliation techniques. Competency assessment will adhere to the most recent American Society of Gastrointestinal Endoscopy (ASGE) guidelines.

The trainee will develop endoscopic skills and will also be encouraged to explore additional areas of interest, such as clinical research.

Key objectives include:

• Developing detailed knowledge of the risks, indications, and contraindications of invasive procedures.
• Performing endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and ultrasound-directed biopsies with supervision.
• Gaining competency in other advanced endoscopic techniques, which include but are not limited to the following: endoscopic mucosal resection, endoscopic submucosal dissection, enteroscopy, luminal prosthesis, mucosal radiofrequency ablation, and pseudocyst drainage. The ASGE has not yet established guidelines for these procedures and are therefore, subject to the discretion of the principal educator.
• Gaining experience in the performance and management of patients undergoing these procedures.
• Developing skills in interdisciplinary management and appropriate integration of other services, specifically surgery and interventional radiology, is a requisite part of training.
• Developing skills in clinical research related to these procedures.

Application Information

Applicants must have completed academic gastroenterology fellowship training within three years of the application process.

Requirements for Application:

We adhere to the recommendations of the ASGE Advanced Endoscopy Match.