Advanced Endoscopy Fellowship

The principal goal of the Case Western Reserve University/University Hospitals Cleveland Medical Center Advanced Endoscopy Fellowship Program at University Hospitals Cleveland Medical Center, in collaboration with Case Western Reserve University, is to develop academic endoscopists who use high levels of endoscopic skill to diagnose and treat a variety of clinical disorders. The academic endoscopist is involved in research throughout his or her professional career, especially the development of new techniques and application of endoscopic methods to solve clinical problems. The academic endoscopist also has a crucial role in training others to perform endoscopic procedures.

Highly Competitive Advanced Endoscopy Fellowship Position

The Advanced Endoscopy Fellowship Program is a competitive position, usually attracting 30 to 40 applications per year. Candidates are ranked according to objective criteria. The highest-ranked individuals are invited for interviews. Fellows in our program are encouraged to apply for this position, and many of our own fellows have been selected.

Routine and Advanced Instructional Program Components

The program of instruction is divided into two categories of procedures: routine and advanced. The advanced trainee performs all routine types of procedures under the supervision of our advanced endoscopy physicians. Advanced procedures are performed together with a limited number of experienced endoscopists, which include:

• Amitabh Chak, MD
• Ashley Faulx, MD
• Brooke Glessing, MD
• Gerard Isenberg, MD
• John Dumot, DO
• Richard Wong, MD

Routine and Advanced Procedures

The division of procedures into routine and advanced is usually determined after the first three weeks, during which time the advanced trainee's level of endoscopic proficiency is assessed. However, the advanced category usually includes therapeutic ERCP, sphincter of Oddi manometry and laser procedures, including the following:

• Endoscopic ultrasonography (various indications)
• Esophageal prosthesis insertion
• Photoablation of cancers
• Photodynamic therapy
• Small bowel enteroscopy

The ability to instruct other physicians in the performance of endoscopic procedures is a special skill that the advanced trainee must acquire. Technical ability with an endoscope does not automatically make a good teacher. The successful teacher possesses additional levels of knowledge and ability that is built upon patience, confidence and dedication.

Routine Category Procedures

To help the advanced trainee develop these skills, routine category procedures are frequently performed with a fellow in the traditional, hands-on method of instruction. The advanced trainee also presents several lectures on endoscopic topics and is asked to assist in the Journal Club for fellows.

Advanced Endoscopic Research

Endoscopic research is an integral part of the Advanced Endoscopy Fellowship Program. Research projects are developed by members of the endoscopic research group, which consists of six full-time faculty members, including five advanced endoscopists and a biomedical engineer.

The advanced trainee develops his or her own research projects and participates actively in ongoing projects of the group members. These include the following:

• Endoscopic outcomes
• Endoscopic ultrasonography
• Gastrointestinal bleeding
• Gastrointestinal oncology
• Optical coherence tomography

Based on the experience of individuals who have completed this program, most of the advanced trainees assume between three to five major projects. Fellows are also encouraged to work on research projects with members of the Endoscopic Research Group during their three years of training.