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Fellow’s Continuity Clinic

Overview

  • Fellows will have their own patients to follow throughout the length of the training program.
  • Fellow’s Continuity Clinic will be one half-day session per week, and will be fully supervised by an Attending.
  • Long-term continuity clinic will give the fellows experience as the primary (consultant) caregiver, and place a greater emphasis on development of skills in Communication and Professionalism competencies, as well as the Practice-Based Learning and Improvement and Systems-based Practice competencies.
  • Long-term Continuity clinic also provides the fellow with a greater length of follow up for those patients with chronic and/or remitting illnesses, such as cirrhosis or inflammatory bowel disease.

Principal Teaching/Learning Activities

  • Fellows will see from 2-3 new outpatient consults per session, and 4-6 follow up visits.
  • Fellows will perform complete history and physical examinations, review laboratory data including actual Radiology studies, formulate differential diagnoses, and formulate a plan or set of recommendations, including timing of intervention and/or follow up.
  • After presentation and review with the Attending physician, the fellow will document the encounter in the medical record.
  • The Attending physician supervises every encounter, and is ultimately responsible for the patient care.  Nonetheless, the role of the Attending physician in the Fellow’s Longitudinal Clinic is more one of oversight and guidance.
  • In 2017, an educational series of lectures in the form of modules, designed specifically for gastroenterology fellows, was introduced as part of the weekly clinic teaching content.

Problem Mix/Patient Characteristics/Types of Encounters

  • The Fellow is exposed to a wide variety of consultative questions which fully embrace the complete lists of clinical disorders and clinical problems as contained in the outline of the ACGME Specific Program Content within Program Requirements for Residency Education in Gastroenterology.
  • All patients are ambulatory outpatients referred by a primary care physician in almost all instances.