Welcome
The one-year Advanced Endoscopy Fellowship at McMaster University offers advanced training in ERCP and EUS. This fellowship is designed for physicians who are planning a career in Gastroenterology or General Surgery as an investigative and consultative therapeutic endoscopist in biliary and pancreatic disorders. Fellows can select to focus on only ERCP or EUS during this one-year fellowship.
Clinical care: Fellows would be expected to perform at least 800 procedures, including 600 ERCPs and/or 200 EUS. Fellows will perform all outpatient and inpatient consultations in which an ERCP or EUS is requested or indicated. The expectation is that the fellow should be intimately familiar with the entire clinical case, and will have to present the case to the attending physician performing the ERCP or EUS. The fellow will perform the procedures under the close supervision of a skilled faculty preceptor. The fellow is responsible for all of the necessary preparation for the patient, including issues in the management of antibiotic prophylaxis and anticoagulation, and arrangements for General Anesthesia when appropriate. The fellow will follow-up on the patient post-procedure under the supervision of the faculty preceptor. The fellow is responsible for completing the procedure notes to the referring physician.
Education: Fellows will participate and present cases at the weekly Hepatobiliary-pancreatic (HBP) Rounds and regional rounds. Fellows are also expected to participate in the academic half-day of Gastroenterology or General Surgery.
Research: Fellows will participate in clinical research to include both a prospective research project and case studies, under the guidance of one of the faculty proctors. The fellow will be expected to submit at least one abstract for presentation for Digestive Disease week and submit a minimum of one paper for publication, including at least one original report and/or a review article.
Certification Outcome
The successful completion of the fellowship will grant a Fellowship McMaster Certification.
Entry Requirements
The fellowship program is designed for graduates of a Gastroenterology or General Surgery residency training program in Canada, the United States or the equivalent abroad. Fellows are expected to meet the competent performance of all core endoscopic procedures in endoscopy and colonoscopy in Gastroenterology or General Surgery. Recent graduates are required to submit an application form and comply with McMaster University Postgraduate Medical Education requirements for residents and fellows.
Application Deadline
9-month deadline before the start date of July 1.
Goals of Training
- Learn the proper indications, contraindications, special needs, and procedural preparations for core Gastroenterologic procedures, as well as ERCP or EUS.
- Recognize and respond to the complications of diagnostic and therapeutic ERCP or EUS.
- Achieve procedural technical competence in the performance of ERCP or EUS.
- Correlate visual and pathologic findings at endoscopy/ERCP/EUS with clinical conditions.
- Learn how to safely administer conscious sedation to provide patient comfort during procedures, and when General Anesthesia is appropriately indicated.
Length of Training
One year.
Funding
Applicants are required to have salary support commensurate with the level of training prior to the start of the fellowship year.
Curriculum Highlights
Fellows generally see patients for the evaluation and therapy of biliary and pancreatic diseases. The majority of therapeutic cases involve either sphincterotomy with common bile duct stone extraction, biliary stenting of biliary or pancreatic neoplasms, biliary stenting of post-operative bile duct leaks, mechanical lithotripsy and single-operator cholangioscopy guided endoscopic electrohydraulic lithotripsy of large bile duct stones, and EUS guided sampling of pancreatic masses or adenopathy.
Supervision & Feedback
Fellows require training to a level of competence deemed to be sufficient for independent practice, and mere exposure to a specific number of procedures is insufficient to guarantee competence. Our program will provide exposure to ERCP/EUS to each fellow. We reserve the right to identify which trainee, if any, possesses sufficient skill to be considered competent for independent practice based on an objective assessment of procedural skills.
Fellow’s performance is evaluated by faculty on a weekly basis using the Formative DOPS ERCP (PDF).
Fellows will also be expected to keep a log of all procedures performed with a documented success rate of GRADE 1 ERCP > 80% and serious complications < 5%.