Gastroenterology Rotation for 4th Year Students

To meet the objectives in strengthening knowledge, skills, attitude and behavior while managing patients on GI consult service.

1. Knowledge:
• The student should demonstrate ability to evaluate and manage patients with the following conditions:
• GI Bleeding (upper and lower)
• Jaundice (hemolytic vs. hepatocellular vs. cholestatic)
• Abdominal pain (parietal vs. visceral)
• Hepatic encephalopathy
• Diarrhea (acute and chronic)
• Colon cancer
• Liver cirrhosis and portal hypertension.
• Understand the pathology, diagnosis and treatment of the conditions being managed while reading necessary texts and articles simultaneously making evidence based care decisions.
• The student should become competent in performing and accurately recording complete history and physical with assessment, differential diagnosis and plan independently.
2. Skills:

The student

• Should be able to accurately perform and record history and physicals with assessment, differential diagnosis and plan independently.
• Should be able to interpret liver function tests and pancreatic enzymes.
• Should develop skills to interpret abdominal CTs with the help of the attending physician.
• Should learn colon cancer screening guidelines.
• Should be able to recognize acute abdomen.
• Should know the indications and contraindications of upper GI endoscopy, ERCP and colonoscopy.
• Should be able to learn effective communication skills with patients and families using appropriate language and avoiding jargon and medical terminology.
3. Behavior:

The student should be

• Able to provide compassionate and empathic patient care in acute and chronic care settings.
• Sensitive to the diverse factors affecting patients and their health care beliefs and needs including race, culture, income and ethnicity.
• Develop effective communication skills with the staff including other physicians, nurses, respiratory therapists and social workers for better patient care delivery. 
4. Attitudes:

The student should be able to

• Practice and respect patient privacy and confidentiality while maintaining highest standards of professionalism.
• Discuss procedure indications and risks.

• Adult patient care with above described disease mix aiming at two inpatients per day.
• Case presentation during rounds with complete assessment, differential diagnosis and plan.
• Participate in procedures in the GI lab such as colonoscopy, UGI endoscopy as well as ERCP, abdominal paracentesis etc. 
• Evaluate patients in GI clinic with the help of the attending.
• Maintain patient log seen by the student to assess meeting the above mentioned objectives.
• Read core topics in Harrison’s Textbook Of Internal Medicine.
• Attendance in morning reports and journal clubs.
• Mandatory attendance in noon conferences.
• Write consultation notes with assessment and plan.

Review of student’s case presentations, documentation, professionalism and counseling skills during management rounds and conferences.

End of rotation evaluation forms.

Student satisfaction assessment once every two weeks with appropriate feedback to assure individual needs are met.

The student will be  

• Responsible for patient managed by him/her under the guidance of senior resident/attending.
• Responsible for communication with the primary team as well as consultants wherever indicated.
• Demonstrating highest standards of professionalism with patients and colleagues.

The student should sit with the 4th year director at the end of the rotation to discuss and fill out an evaluation form.