The curriculum of the Advanced GI – Foregut Surgical Fellowship Program is designed to provide fellows with an immersion in the study and practice of diseases of the GI tract and abdominal cavity such that knowledge and skill-based confidence will achieve expert status by the end of the experience.

Patient Care:

• Fellows will be expected to perform preoperative assessment of patients and demonstrate an understanding of the management options, indications, contraindications, and complications associated with the recommended procedure.
• Fellows should demonstrate understanding of and ability to order, integrate and interpret perioperative testing and evaluation of all organ systems as related to advanced GI surgery.
• Fellows will demonstrate intraoperative decision-making that minimizes complications and demonstrates an awareness of the limitations of his/her technical skills.
• Fellows will demonstrate knowledge of anatomy of the GI tract and the abdominal cavity, including as viewed through MIS access, both normal and abnormal.
• Fellows will demonstrate knowledge of a variety of approaches (both operative and non-operative) to a given GI tract disease and exhibit reasoning to arrive at the correct procedure for a given patient.
• Fellows will demonstrate expertise in interpreting anatomic and physiologic studies of the GI tract and abdominal cavity relevant to their areas of expertise.

Fellows will demonstrate fundamental MIS competency relevant to their area of expertise. These would include some or all of the following:

Basic Skills:

• Preoperative preparation (positioning, knowledge of necessary equipment, bowel prep); evaluations of cardiopulmonary system, age, body habitus
• Exposure
• Retraction
• Tissue handling
• Camera navigation
• Two-handed manipulation
• Port-site placement
• Alternative access techniques
• Use of angled scopes
• FLS completion
• Vascular control and algorithm for control of bleeding
• Knot-tying ability, both hands, intracorporeal and extracorporeal
• Decision to convert a laparoscopic procedure to an open operation

Advanced Skills:

• Intraoperative ultrasound
• Suturing
• Stapling
• Intracorporeal anastomosis
• Adhesiolysis
• Running of bowel
• Demonstrates knowledge of energy sources
• Placement and fixation of prosthetic material

Fellows will acquire skill in diagnostic flexible endoscopy relevant to their area of expertise.

Medical Knowledge:

• Fellows will be expected to demonstrate understanding of the anatomy, physiology and pathologic conditions of the entire GI tract, abdominal cavity, abdominal wall, and solid organs in the abdominal cavity and retroperitoneum.
• Fellows will demonstrate an understanding of the surgical and nonsurgical options for managing pathologic conditions of the entire GI tract, abdominal cavity, abdominal wall, and solid organs in the abdominal cavity and retroperitoneum.
• Fellows are expected to be able to appropriately order, read, and interpret diagnostic tests and images.
• Fellows are expected to have basic FLS certification; to have knowledge of two or more journals delving into Advanced GI Tract Surgery and MIS The specific medical knowledge expectations appear in the curricula of the specific subspecialty fellowships in advanced gastrointestinal surgery.

Research

Protected research time is provided to allow fellows to take advantage of the ample research opportunities available to them within our larger research program. Fellows work alongside well-established postdoctoral investigators and other research fellows and are actively involved in research. Fellows are expected to initiate clinical research protocols with the goal of producing data that will be published in respected peer-reviewed journals and presented at national/international meetings.