Our Facilities Strong Memorial Hospital at the University of Rochester Medical Center, has approximately 750 beds. Strong is the only hospital campus in which the activities of the fellowship are conducted. The Division of Gastroenterology is based in the outpatient facility attached to the hospital. This houses the professional faculty offices and clerical support areas, and an extensive 6-room endoscopy suite dedicated to gastroenterology, with one room functioning as an independent suite for ERCP. Endoscopic equipment was upgraded in 2009 to the most current line of Olympus video equipment with Image Manager software, and the ERCP suite features state of the art digital image management. There is a large 10-bed recovery area. A seventh room is dedicated to esophageal pH and manometry testing, with equipment and personnel to perform other physiologic tests in diagnostic gastroenterology, such as hydrogen breath testing, secretin stimulation assay, gastric acid analysis, and ano-rectal manometrics. Adjoining rooms are available for outpatient clinical consultations. (Outpatient consultations also occur in an off-campus office suite which provides 12 exam rooms, 4 state-of-the-art endoscopy suites, and also houses our video-capsule endoscopy equipment). The gastroenterology fellows have a dedicated fellow's office, complete with personal computers, and a fully stocked fellow library of texts and reference materials. The unit also provides an expansive conference room for the educational program. Nearby, an extensive 4,000 sq. ft. laboratory complex is occupied by the research personnel of the gastroenterology division, and also includes another fellow's office for their research endeavors. There is an emergency department with over 40 acute care beds, trauma unit, self-contained radiology suite, observation unit, and adequate facilities to comfortably support endoscopic procedures when needed. Extensive experience is obtained in consultation and procedural intervention in the emergent and urgent care setting. Intensive Care Units include Medical Intensive Care, Surgical Intensive Care, Burn Unit Intensive Care, Cardiac Care Unit, Post-Cardio-Thoracic Surgery Unit, and Respiratory Rehabilitation Units. These units all house a variety of critically ill patients with special requirements for hemodynamic support, respiratory support, cardiac support, and often anticoagulation. They provide extensive experience in consultation and procedural intervention in the critically ill under a host of adverse clinical circumstances. The Department of Surgery (pertinent to gastroenterology training) has numerous surgical subspecialists and subdivisions in general gastrointestinal surgery, gastrointestinal oncologic surgery, biliary and pancreatic surgery, thoracic surgery, and liver transplantation. We enjoy a close relationship with our surgical colleagues, including a monthly GI-surgical joint conference, exchange of speakers between Medical and Surgical Grand Rounds, and a working relationship in a Multidisciplinary Oncology Board, and a Multidisciplinary Nutrition Support Clinic. The Department of Radiology is extensive, with facilities for ultrasound, CT scan, MRI, nuclear medicine, angiography, and a dedicated interventional radiology department providing support when needed (for gastroenterology) in terms of percutaneous cholangiography, biliary stent placement, percutaneous gastrostomy, and therapeutic angiography for hemostasis. The Department of Pathology provides personnel with dedicated special interests in GI and liver pathology, and joint conferences are provided monthly as well. Conferences are facilitated by a teaching video microscope, which allows any number of attendees to view the images simultaneously and under direction by the pathologist. In Pediatrics, there are three full-time pediatric gastroenterologists. The pediatric GI faculty and fellows regularly attend our clinical and literature review conferences. The adult GI fellowship program sponsors a didactic curriculum in pediatric conferences for our trainees. Pediatric gastroenterology has their own fellowship training program, and the adult program hosts the pediatric fellow for a month each year. Strong also supports a large multidisciplinary nutrition support team, with dedicated pharmacists, dietitians specializing in various intensive care settings, and nurse practitioners specializing in home parenteral nutrition support. Physician participation on the team is provided by an attending gastrointestinal surgeon, an attending gastroenterologist, and a pediatric gastroenterologist. Our program sponsors 4 weeks of a dedicated rotation in nutrition support for our fellows, which includes weekly hospital ICU rounds, nutrition support clinic, intensive instruction in TPN formulation and calculations, management of home TPN formulations and patient assessment, and supervised nutrition support consultations in the intensive care settings. In addition to the experience provided by a large general medicine and surgery patient mix, there are several additional areas of excellence in patient care at Strong Memorial which provide additional exposure and experience for the gastroenterology trainee. There is a large hematology/oncology division which provides extensive exposure to the diagnosis and management of all the gastrointestinal and hepatic solid tumors, as well as providing experience in caring for the gastrointestinal and hepatic complications of primary hematologic malignancy, including the complications of bone marrow transplantation. A weekly tumor board meeting includes participation from our attending faculty who perform ERCP and endoscopic ultrasound, pancreatico-biliary and oncologic surgeons, oncologists, and geneticists when applicable. The Division of Infectious Diseases includes a subdivision dedicated to the care of patients with HIV, and this provides our trainees with exposure to the gastrointestinal and hepatic complications of this illness. Lastly, extensive clinical activity in solid organ transplantation currently includes programs in kidney, liver and heart transplantation, also providing a unique breadth and depth of exposure for the gastroenterology trainee to the special needs and considerations of these populations as well.