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Academic ClinicianDescription of ProgramThe Division of Gastroenterology & Hepatology at the University of North Carolina at Chapel Hill offers a fellowship (subspecialty residency) program in Gastroenterology and Hepatology that accepts one - three new fellows each year beginning in July. This is a program that has as its goal the preparation of individuals broadly trained in gastroenterology and hepatology for academic careers in either the clinical or basic sciences. Applicants to both the clinical and research fellowship positions must have completed an internal medicine residency program from an accredited US institution. Effective January 1, 2004, UNC Hospitals accepts residents who have been issued a J-1 visa and who hold a current ECFMG certificate. H1-B visas are not sponsored at UNC Hospitals after December 31, 2003. Because of funding considerations, applicants to our program must be either US citizens (by birth or naturalization) or hold a permanent immigrant visa status (green card). We do not accept the EAD (Employment Authorization Document). M.D. fellows elect either a clinical or research academic track. Our program is nationally recognized and highly competitive; each year we receive an average of 375 applications. Our Division continues to remain committed to raising our profile and maintaining our current status as one of the best GI divisions in the US. Our faculty members serve at the highest levels of many national organizations, including the American Gastroenterological Association, the National Commission for Digestive Diseases, and the Crohn's and Colitis Foundation of America. We published more thatn 200 papers in peer-reviewed journals last year, received more that $12 million in grant funding, and completed more than 12,000 procedures. Our patient satisfaction surveys are consistently high. With 180 division members, we are ranked #5 in grant funding from our School of Medicine. Clinical TrackThe clinical track is a three-year program for fellows who intend to enter clinical academic practice upon completion of the training program. The emphasis is on clinical gastroenterology with the opportunity for more formal clinical research training. Currently a first-year clinical fellow spends time on each of the following rotations: 1) adult GI consultations, 2) endoscopy, 3) adult liver consultations, and 4) outpatient clinic, with minimal time allotted for research activities. In the second year, in addition to the aforementioned rotations and research time, fellows do rotations in nutrition and biliary work. In the third year the clinical fellow has extensive biliary exposure and continues consultative and outpatient clinic work and endoscopy. The minimal exposure to biliary work during the second year helps to prepare for the extensive work encountered during the third year. Funding for the clinical fellowship program is from the Division of Gastroenterology & Hepatology. Clinical fellows are paid by the Department of Medicine but in accordance with the GME pay scale because, as subspecialty residents, they are appointed through our Housestaff Office. Currently, for a PGY-4, the yearly salary is $46,500, for the PGY-5 $47,500, and for the PGY-6, $48,500. Research TrackApplicants who are interested in research training should apply directly to those programs. We offer research training in Digestive Disease Epidemiology and Basic Science. For more information about the Epidemiology Training Program CLICK HERE. For more information about the Basic Science Training Program CLICK HERE. The research track is a three - four year program for those who plan to pursue a research career. The research track includes 18 - 24 months of clinical rotations as described above. All fellows must complete 18 months of clinical gastroenterology training to be permitted to sit for the GI board exam. Funding for the research fellowship is from Institutional Public Health Service fellowships. Salaries from federal sources carry a year-for-year payback that requires the fellow to work in an academic setting after completion of training. Salary is commensurate with experience and determined by pay scales. Research fellows on training grants are paid according to the current NIH pay scale. Other ProgramsThe optional fourth-year endoscopy fellowship offers advanced training in diagnostic and therapeutic ERCP and EUS procedures. There is only one slot per year, with preference given to a UNC GI fellow who wishes to do an additional year of training. There is a prerequisite of three years of GI training from an accredited US program. The slot is taken for 2007; however, there may be a slot available for 2008. If you are interested, we ask that you submit a letter of intent, an updated curriculum vitae, proof of completion or near-completion of a GI training program, and three letters of recommendation. These items need to come to the fellowship program administrator. At present, we do not offer a hepatology fellowship program per se, although hepatology composes an integral part (30%) of our clinical fellowship program. The ABIM has approved a one-year hepatology/liver transplant fellowship program, after having drawn up a preliminary course curriculum in conjunction with the AASLD and ACGME. This would be an accredited program, and potentially qualifying programs are in the process of applying for accreditation of this fellowship. This fellowship would require three years of GI fellowship training prior to entering into the program. We do plan to offer such a fellowship; however, because of internal changes within our Liver Center over the last year, we will not be able to apply for accreditation in order to begin the program in 2008. We no longer offer a combined adult/pediatric GI fellowship program. We no longer offer a motility post-doctoral fellowship. We no longer sponsor observerships but do allow residents from other US training programs to rotate through our GI program. Facilities and PatientsAll of our clinical services are based at UNC Hospitals. UNC Hospitals (UNCH) consists of North Carolina Memorial Hospital, UNC Women's and Children's Hospital, and the UNC Neuropsychiatric Hospital. These hospitals are contiguous and are located on a health affairs campus that includes schools of Medicine, Dentistry, Public Health, Pharmacy and Nursing. The health affairs campus is adjacent to the University of North Carolina main campus. UNCH is an acute care and referral hospital with 688 licensed beds. There are approximately 150 adult medicine beds, including intensive care units. The UNC Health Care System is a not-for-profit integrated health care system owned by the state of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. UNC Health Care is comprised of UNC Hospitals, which is ranked among the top 50 in the nation in six specialties by U.S. News & World Report and ranked one of the country’s 41 best on the Leapfrog 2007 Top Hospitals list; the UNC School of Medicine, a nationally eminent research institution; community practices; home health and hospice services in seven central North Carolina counties; and Rex Healthcare and its provider network in Wake County. UNC Health Care also manages Chatham Hospital in Siler City, NC. The impact of digestive diseases is great in terms of economic impact on society, total days of illness in adults, admissions to hospitals and in numbers of surgical procedures performed. The prevalence and significance of gastrointestinal illness is illustrated by the following facts:
The GI Division performs more than 12,000 endoscopic procedures each year and over 1,000 GI-Liver consultations per year. The Nutrition Support Service consults on two to three new patients per week and follows approximately ten patients at any one time, including patients on total parenteral nutrition and on tube feeding. Consultations in GI, liver, and nutrition encompass all phases of clinical gastroenterology and nutrition. There is a 12-bed, NIH-funded General Clinical Research Center available for clinical research. Fellows spend one half-day per week in a faculty-supervised GI Clinic where they have the opportunity to perform outpatient consultations and to participate in long-term follow up of patients with gastrointestinal disease. The fellows and faculty of our Division take part in over 13,000 outpatient visits per year in various GI Clinics. There are approximately 3,400 new patients coming to the adult GI Clinics each year. The Diagnostic and Treatment Center consists of a 9,000 square foot area located in the basement of UNC Hospitals. In any given year, we perform an average of 5,000 colonoscopies, 3,500 upper GI endoscopies, 700 flexible sigmoidoscopies, 500 ERCPs, 250 esophageal dilatations, 250 esophageal manometric studies, 150 sphincterotomies, 100 PEGs, 75 esophageal banding procedures, 200 video capsule endoscopies, and 100 small bowel enteroscopies. Additionally, our Hepatology Section performs approximately 300 liver biopsies per year. Our GI Motility Unit offers esophageal and anorectal manometry and biofeedback. We have also added a low compliance balloon system to assess visceral sensation thresholds for research and clinical evaluation of patients with functional GI disorders. We now have a free-standing state-of-the-art biofeedback lab. Conferences and SeminarsThere are a number of formal and informal clinical and research teaching activities within the Division:
Weekly GI Grand Rounds and monthly Journal Club meetings involve participation of both faculty and fellows. All fellows regardless of track are required to attend a composite of 85% of the four following educational conferences: weekly pathophysiology seminar, clinical case conference (GI Grand Rounds), research seminar, and monthly Journal Club. ClinicsEach clinical fellow has one half-day per week of continuity clinic. In this clinic, fellows see three new patients and 2 - 6 return patients. This clinic is precepted by a GI attending. In addition, fellows participate in the following subspecialty clinics: esophageal clinic, general liver clinic, hepatitis clinic, IBD clinic, IBS clinic, motility clinic/lab, and pancreaticobiliary clinic. ResearchFor clinical fellows it is expected that at the end of the first year a project mentor will be chosen and the outline of a research project will be developed. The mentor will help identify the resources required to carry out the research project. During the second year the fellow is expected to carry out the research project and during the third year continue further work on the project or a new project and write the project up for publication. It is hoped that preliminary work from the research project will be submitted in abstract form either to the AGA or ACG. Summary of Rotations Year 1 Year 2 Year 3 Faculty, with Special Area of InterestFor a listing of clinical faculty members and their areas of interest, please visit our 'For Patients' section, where a listing is provided under Clinical Providers. For a listing of research faculty members and our various Centers, please visit our 'Research' section, where such a listing is provided under Research Faculty. CURRENT FELLOWS
Alfred S. Barritt, M.D. |
