The goal of our fellowship program is to train the best academic and clinical gastroenterologists to meet the future needs of our profession in patient care, teaching, and research. We are dedicated to training physicians who can lead our profession in this changing era of health care and research.
The primary means of training is on-site care of patients with digestive disease disorders over the three-year fellowship program in a supervised setting, which enables independent thought and evaluation of patients. Our fellows are exposed to patients in the in-patient and out-patient settings. To be certain that the full spectrum of digestive diseases is encountered by each fellow in a setting with optimal supervisory expertise, rotations are established in inpatient and outpatient hepatology, inpatient and outpatient gastroenterology, consultative gastroenterology, endoscopy, GI diagnostic laboratory, clinical nutrition and inflammatory bowel disease.
Our commitment is to train young physicians to a high level of clinical, academic, and systems competence, becoming professional leaders throughout their career in this rapidly changing field. Our goal is that our graduates excel in the six core competencies described by the ACGME:
- Patient Care
- Medical Knowledge
- Practice Based Learning and Improvement
- Interpersonal and Communication Skills
- Systems Based Practice
As delineated below, our curriculum offers excellent training in all of these core areas. By mastering these competencies, our graduates will be leaders throughout their career.
Each fellow is paired with a Staff Physician Adviser. The role of the adviser is to provide career counseling, ensure that each resident is developing well clinically, operating at the requisite skill level and filling leadership positions. More subtly, their role is to demonstrate a model for professionalism.
Research and Professional Development
A major thrust of the fellowship program is to train fellows in the techniques of clinical investigation. All fellows spend at least nine months performing clinical research. This experience will involve exposure to the research process by selection of a scientific question, protocol design and critique, IRB and regulatory processes, data collection, statistical analysis, and presentation. Fellows present their initial protocol to the center that they have chosen to work in for open critique and then provide their final protocol to the entire Department for further discussion.
Fellows travel to present research at national conferences is supported and fully funded, allowing you to make national contacts among leaders in the field. Activity in research ensures our fellows are not only up to date in their medical knowledge, but advance the field of Gastroenterology and Hepatology.
Gastroenterology Inpatient Service
The overall educational goal of this rotation for fellows is to develop skills in the management of the hospitalized patient with GI disease in a cost-effective and expedient manner. The fellow serves as a junior consultant for residents, interns, and medial students and helps assure that quality care is rendered to all patients on the service. A significant component of the learning experience comes from working closely with all patients admitted to the GI hospital service and being aware of ongoing developments throughout the day including diagnostic, therapeutic, social, and administrative details of patient care.
Hepatology Inpatient Service
The overall educational goal of this rotation for fellows is to develop skills in the management of the hospitalized patient with liver disease in a cost-effective and expedient manner. The fellow serves as a junior consultant for residents, interns, and medical students and helps assure that quality care is rendered to patients on the service. A significant component of the learning experience comes from working closely with patients with liver disease requiring inpatient care including patients: 1) with complications of chronic liver disease, 2) undergoing liver transplant evaluation, 3) awaiting transplantation, 4) with fulminant hepatic failure, 5) admitted for complications related to transplantation, and 6) inpatient hepatology consultations.
The overall educational goal of this rotation for fellows is to develop consultative skills in the management of the hospitalized patient who presents with or develops liver symptoms or disease, and evaluation for transplantation.
Gastroenterology Consult and Acute Bleeder Service
The overall educational goal of this rotation for fellows is to develop consultative skills in the management of the hospitalized patient who presents with or develops GI symptoms or disease. The consult service is also responsible for emergency endoscopy of all patients with GI bleeding in the ICUs during regular working hours. Therefore fellows on the consult service will learn how to perform emergency endoscopies in the ICUs under the supervision of the attending physician.
The overall educational goal of this rotation for fellows assigned to the endoscopy rotation work directly under the supervision of different faculty doing endoscopy. No procedures are performed unsupervised. Fellows maintain a log of all cases they perform during their fellowship. Training will first emphasize diagnostic upper endoscopy, and conscious sedation. This will be followed by esophageal dilatation, therapy of upper GI bleeding, emergency upper endoscopy, percutaneous gastrostomy, diagnostic colonoscopy, and polypectomy.
Training in therapeutic ERCP along with other advanced procedures such as endoscopic ultrasonography, photodynamic therapy, placement of self-expandable metallic stents, endoscopic tumor ablation and mucosal resection with the ultimate goal of obtaining credentialing in these procedures is not the goal of the three year curriculum and is obtained only after successful completion of a fourth year advanced therapeutic endoscopy.
Clinical Nutrition Service
The overall educational goal of this rotation is to provide our fellows with the tools which they need to provide their patients with appropriate and adequate nutritional support. This will be done by having each fellow rotate on the Nutrition Support Team in the first, second, and third years of training. During the first year, fellows will develop the skills to be facile in the management of nutritional support in hospitalized patients. This includes identifying patients with protein calorie malnutrition; assessing the protein and calorie needs of these patients; learning the techniques of both enteral and parenteral feeding along with the complications of these therapies; and learning how to monitor the adequacy of these interventions. The fellow should be available during their rotation to participate completely with the Nutrition Support Team and all of it’s activates including inpatient rounds, and morning conference/journal club. During the second and third year, the fellows spend 2 weeks on the inpatient service and 2 weeks in outpatient clinics with exposure to the intestinal rehabilitation program, obesity clinic, and bariatric surgery clinic.
The Cleveland Clinic’s Department of Gastroenterology & Hepatology is the recipient of a Ruth L. Kirschstein National Research Service Award (NRSA) T32 grant from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). This grant is shared with the Department of Gastroenterology at University Hospitals, Case Western Reserve University in Cleveland. The overall primary goal of this T32 training program is to prepare post-doctoral (MD and MD/PhD) fellows for careers as independent investigators in academic digestive diseases-related research.
In this interdisciplinary program, productive, well-funded senior faculty members with exceptional mentoring credentials are recruited from different departments and research centers within Cleveland Clinic's Digestive Disease Institute and Lerner Research Institute.
The T32 program is a fully ACGME-accredited GI fellowship training program, which offers the opportunity for concentrated, in-depth basic, translational or clinical research training in specific areas of investigation. Commitment to a minimum of 2 years en-block research period is expected from the NIDDK and required by the Department. This research-intense time is followed by 2 to 3 years of clinical training in gastroenterology, hepatology and nutrition. Depending on specific situations, clinical training may precede research training. Trainees are encouraged to pursue coursework leading to advanced degrees (MS, MPH). Cost associated with tuition and fees for such coursework can be requested from the NIDDK and must be requested in advance and justified listing the specific courses to be taken. A series of didactic lectures, research seminars, visiting professorships, journal clubs, formal course work and attendance at scientific meetings will supplement this intensive and structured research experience. Admission into the program includes both, the research and the clinical portion of the training, leading to clinical board certification.
The program offers opportunities with the following basic or clinical research training units:
- General gastroenterology
- Inflammatory bowel disease
- Liver diseases
The T32 faculty members are fully committed to this educational program and are available to discuss the fellows’ research interests and options so that each fellow may receive a customized training program that best fits his/her professional expectations.
Fellows will be selected to enter this highly competitive T32-sponsored training program after finishing their Internal Medicine residency and before the start of their clinical training in our GI fellowship. The T32 grant principal investigator, Claudio Fiocchi MD, and the Department of Gastroenterology Selection Committee selects the T32 awardees based on personal credentials, formal recommendations, evidence of academic interest, and a commitment to research and outstanding potential for a successful academic career. The number of GI fellow positions varies between 1-2 per year.
Claudio Fiocchi, MD
Director, T32 Fellowship Program
What are you looking for in an applicant?
One to two fellows are selected each year based on personal credentials, formal recommendations, evidence of academic interest, and a commitment to research and outstanding potential for a successful academic career. Prior peer-reviewed publications and a scientific track record are desirable, but not essential. In addition, we are seeking individuals able to proficiently work in a clinical environment that offers a high volume patient load, challenging clinical cases, and a high quality advanced patient care environment. We seek promising physician-scientists as demonstrated by leadership abilities, academic productiveness, knowledge base, and positive personal qualities among applicants from diverse backgrounds. The T32 training grant at Cleveland Clinic is a highly competitive fellowship.
What is your application process?
Cleveland Clinic has minimum requirements for fellowship application and employment, all of which are required in the standard ERAS application. We have no secondary application form. We review every submitted application completely and carefully, and a selected group is offered on-site interviews.
What are your NRMP program codes?
Gastroenterology AAMC ID: 1968144Fo
What are your fellows' employment benefits?
Residents are Cleveland Clinic employees with NIH standardized salaries and generous benefits.
What VISAs are supported by Cleveland Clinic?
For graduate medical education purposes (fellowship), Cleveland Clinic will accept H-1B temporary worker or J-1 exchange visitor (alien physician category – sponsored by the ECFMG) visas. Cleveland Clinic does not sponsor immigrant (permanent resident) petitions for research or clinical trainees (residents, clinical fellows, clinical research fellows, research fellows or postdoctoral fellows).
Cleveland Clinic's Center for Multidisciplinary Simulation has, flexible endoscopy, upper endoscopy , colonoscopy, and ERCP simulators to enhance the clinical learning experience.
| ||Upper Endoscopy ||Colonoscopy |
|Average Number of Procedures ||600-800 ||300-500 |
Board Pass Rates
For Cleveland Clinic's Gastroenterology Fellowship Program, cumulative first time board passage rates 2012 is 90%.
Morbidity and Mortality Conference
Each month the fellows report cases for the M&M conference. The conference faculty moderator selects cases for presentation based on their teaching merit, and moderates the discussion. The fellow who managed the patient presents the case and pertinent literature while focusing on clinical decision making, reasons for any complications and alternative management options., The main focus of the conference is improving clinical decision making to improve patient care.
Case Management Conference
Each fellow presents 30-minute management conferences at regular intervals throughout the academic year. This is a brief presentation that addresses diagnostic or management dilemmas that are debated amongst faculty and fellows. This conference is considered by many to be the highlight of our conference schedule.
State of the Art Conference
Each fellow presents a comprehensive, one-hour presentation on a specific topic of his/her choice using an extensive review of the literature. The fellows work with a faculty mentor in the development and synthesis of their presentation.
Gastroenterology Didactic Series
The academic year begins with a didactic core curriculum that reviews important topics in gastroenterology, hepatology and nutrition. Throughout the course of the academic year, distinguished faculty from the Digestive Disease Institute and other departments are invited to speak to fellows and faculty in various areas of interest.
Fellows Conference Series
This weekly series consists of four multidisciplinary areas:
- Radiology Rounds, designed to improve fellows ability to interpret basic radiology studies and determine which tests are applicable in specific clinical situations.
- Research Methodology helps fellows review the basic principles of clinical epidemiology and statistical design in order to critically interpret literature and elements of statistical design criteria.
- Pathology allows fellows to improve their ability to review and interpret histological specimens in an organ-based fashion from a variety of pathological conditions.
- Nutrition conference reviews the fundamentals of nutrition in a variety of pathological states including understanding concepts pertaining to parenteral and enteral nutrition, and obesity.
Board Review Conference
Fellows have a weekly board review conference based on ACG/AGA curriculum.
Gastroenterology Journal Club
A journal club is held monthly. Articles are selected by faculty around a theme, and presented in a critical fashion by the fellows. Topics are rotated month to month.
Each subspecialty holds its own conferences (IBD, Liver Transplant, HPB, Intestinal Transplant, Clinical Nutrition, etc.) These conferences are made available to all fellows that wish to attend.
These one-hour seminars by esteemed Cleveland Clinic and visiting faculty are diverse presentations aimed at faculty, fellows, and residents. Presentations are on a broad range of topics, including clinical topic updates, world health, surgical history, etc. These are held monthly for Internal Medicine, General Surgery, and Transplant Center.
Dian Chiang, MD
Cleveland Clinic, OH
Binu John, MD
Cleveland Clinic, OH
Yinghong (Mimi)Wang, MD
Cleveland Clinic, OH
Karen Kim, MD
Tasneem Ahmed, MD
Xiao SuoLiang, MD
Benjamin Levitsky, MD
Mohammed Qadeer, MD
Francisco Marrero, MD
Lake Charles, LA
John Edmison, North Carolina
Ilche Nonevski, MD
Anajana Pillai, MD
Cleveland Clinic was founded in 1921 by George Crile Sr., a general and endocrine surgeon; Frank Bunts, a neurosurgeon; William Lower, an urologist; and John Phillips, an internist. It was a new kind of medical center: a physician-led, not-for-profit, integrated hospital and group practice, equally dedicated to patient care, research, and education. Cleveland Clinic quickly became a world renowned training hospital, medical school and research institute, known for offering the most advanced medical care.
Cleveland Clinic's main campus consists of 41 buildings and more than 85 operating rooms, with constant expansion and renovation. The Gastroenterology offices are on the third floor and fifth floor of the A building (desk A30 and A50) in the Digestive Disease Institute.
Q3: New, State-of-the-art Endoscopy Unit
The Digestive Disease Institute’s advanced endoscopy unit, located in Glickman tower on Cleveland Clinic’s main campus, emphasizes both safety and quality. The 15,000-square-foot facility was built to improve both access and patient experience. The expansion doubled the number of therapeutic endoscopy suites for performing endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS) and deep enteroscopy. Specialized fluoroscopic equipment will allow for the next generation of 3-D cholangiography, which is available at only a handful of units nationally. The unit was designed to improve patient satisfaction and features private recovery rooms with TVs and seating for family members. It will help maximize communication between patients and caregivers and enable close interaction with the staff from other specialties, including anesthesiology, hepatobiliary surgery, colorectal surgery, thoracic surgery, oncology and radiation oncology, during treatment.
” This expansion will increase our ability to handle additional volume to speed up diagnosis and treatment of patients.” – John Vargo, MD, MPH
Cleveland Clinic is a large facility, how do I find my way around?
While Cleveland Clinic has a large campus, it is easily walkable from the visitor parking garages and the two on campus hotels: the InterContinental Hotel and the InterContinental Suites. Cleveland Clinic is immediately adjacent to the University Circle Neighborhood, home of the Case Western Reserve University, the Cleveland Orchestra, and the Cleveland Museum of Art. Cleveland Clinic is centrally located and accessible from the downtown, east, and west side residential neighborhoods.