Clinical, Academic And Scholarly Content

Community & Rural Experiences

Community and rural experiences are not routinely provided, but can be done during elective time. The Ottawa Hospital is uniquely situated so as to provide primary GI services as well as advanced GI diagnostics and therapeutics. We generally prefer that trainees seek advanced electives so that if they choose to work in a community setting they can bring that expertise to that rural community. However, we are flexible and if a rural elective is identified with a reasonable volume of GI patients that also fulfills the objectives of our program then we would have no hesitation in allowing it.

Increasing Professional Responsibility

Gastroenterology is a unique speciality that combines cognitive and procedural aspects. The Fellows knowledge builds during the residency and with this comes the trust of the attending Staff and increasing reliance on the residents’ management plan.  A gastroenterologist also has to be technically proficient at diagnostic and therapeutic endoscopy and multiple other bedside procedures. The technical and academic proficiency of residents varies considerably. The Staff takes over endoscopy only if the resident can’t continue or an issue of patient safety or comfort arises. However, in their last 6 months of training all residents are capable of the consultancy and procedural skills to act as junior staff persons.  They are given the opportunity to act independently through completion of consultations, deciding on the appropriate investigations and management – including whether or not admission is required and the timing of endoscopy if this is needed. If an endoscopy is required the resident completes the entire procedure.

As with surgery, all endoscopic procedures have to be done in the presence of an attending gastroenterologist. However, the attending takes on an increasingly more back seat role as the residents become increasingly proficient.

In their second year, fellows rotate as Chief Resident.  This exposes them to administrative duties and allows them to take charge of junior fellows and Internal Medicine/Surgery Residents rotating in GI.  In general all GI residents take charge of our busy consult service during their rotations.  They supervise and guide rotating internal medicine and general surgery residents.

Academic Half Day

In 2006, a formal academic half day was implemented.  This replaced the previous academic half day equivalent which consisted of a number of sessions spread out over the course of the week.

Attendance at academic half day is mandatory for all GI fellows.  It is held every Friday morning and is approximately 3 hours in length.  Each half day is attended by one staff physician who is responsible for presenting a topic and for facilitating the half day.  The site for half day rotates between the General and Civic.

The first component of academic half day is a didactic one hour round given by a staff physician.  The topics have been chosen well in advance by the program director.  This allows fellows to review the topic before it is presented at half day.  The topics are chosen so that in a two year cycle, the majority of important topics in gastroenterology will be covered.

The second component of half day is a review of a journal article.  The goal is to review a recent article of importance to gastroenterology.  This task is assigned to a GI fellow who is responsible for reviewing and critically appraising the article.  The GI Staff in attendance is responsible for facilitating discussion of the article.

The third component of half day is a clinical case review.  This task is assigned to a GI fellow.  The fellow presents a case they recently encountered.  The case should be chosen to stimulate discussion on a particular topic.  In addition to presenting the case, the fellow reviews literature pertaining to questions raised by the case.  Again, the GI Staff in attendance is responsible for facilitating discussion.

This round is held each Tuesday at noon in the Civic Amphitheatre.  It is sometimes presented by a GI fellow.  At other times a resident in internal medicine or general surgery presents.  The round is a thorough review of a common topic in gastroenterology.

The round is teleconferenced so that staff, fellows and residents at both the General and Civic Campus may attend.

Inflammatory Bowel Disease(IBD) Rounds:  Mandatory for GI Residents

IBD is a common disorder seen by gastroenterologists.  As such it is important that GI fellows be expert in its management.  To facilitate this, IBD rounds are held each Thursday at the General Campus.  The round is case based.  Cases are chosen to highlight important issues in the management of IBD.

Mortality and Morbidity Rounds: Mandatory for GI Residents

This is held on the first Friday of each month.  It is presented by a GI fellow.  A Staff person is assigned to mentor the fellow in choosing an appropriate case.  The fellow is expected to review the case as well as the literature pertaining to issues arising from the case.  It is hoped these rounds will prompt thoughtful discussion leading to improved quality of future care.

Ottawa GUT Club: Not mandatory for Residents but strongly encouraged

This City wide evening session is held monthly, and involves a one hour presentation by a visiting professor.  Occasionally a GI Fellow may be asked to present.

Divisional Journal Club: Not mandatory for Residents but strongly encouraged

This evening session is organized once monthly.  Two recent journal articles of interest are reviewed, critically appraised and discussed.  Both GI Staff and Fellows present articles.

Preparation for Royal College exams with Staff:  Mandatory for GI Residents

Feature Staff meets with our fellows for a question and answer session designed to help them prepare for the types of questions that will be encountered on the Royal College Exam.  This occurs as part of Academic half Day.

Clinical Epidemiology Rounds:  Mandatory for GI Residents

These rounds have been organized by Dr. Michelle Turek and are presented every other month to fellows from all subspecialty programs.  Our fellows are strongly encouraged to attend.

Liver and Pancreas Board Rounds : Residents are encouraged to attend-Tuesdays

Multidisciplinary Rounds involving Gastroenterolgists, hepatobiliary surgeons, radiologist and pathologist.  Cases are chosen and discussed in order to create plan of management.

GI Practice and Review:  Mandatory for GI Residents-With Staff

Pathology Rounds:  Mandatory for GI Residents

Dr. Marginean and Dr. Nguyen are dedicated GI pathologists with a strong interest in education.  They periodically present at Half Day and do case based discussions with residents. They also sometimes present at Tuesday Divisional rounds.  These events are interactive with the GI Resident presenting a case and then the Pathologist presenting findings.