Medical Education

NewYork-Presbyterian Brooklyn Methodist Hospital

Gastroenterology Fellowship Program

Advanced Endoscopy Fellowship Program

The increased need for training dedicated to endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS), as well as the large number of advanced endoscopic techniques now available has led to the development of the upper level fellowship dedicated to advanced endoscopy at NewYork-Presbyterian Brooklyn Methodist Hospital. This one-year, clinical fellowship in advanced endoscopic procedures is directed towards structured training of the individual in his or her fourth year of fellowship training.

Program Description

The primary purpose of the program is to provide outstanding training in advanced therapeutic endoscopy. A key feature of the program is the ability to provide wide experience in advanced endoscopy by combining the endoscopic experience with the facilities and resources available to the trainee. The trainee will accumulate significant procedure experience in ERCP and EUS since over 800 of these procedures are performed at NewYork-Presbyterian Brooklyn Methodist Hospital annually. Endoscopic mucosal resections, endoscopic submucosal dissection, radiofrequency ablation (RFA) for Barrett's esophagus and stent placements are also performed at the hospital.

The program provides one-on-one mentoring of a physician who has completed a three-year Accreditation Council on Graduate Medical Education-accredited general gastroenterology fellowship. It is designed for recent gastroenterology fellowship graduates who wish to become proficient in ERCP, EUS and other new modalities not covered in detail in standard training programs. The training curriculum focuses on advanced endoscopic techniques to manage a variety of complex GI diseases including pancreaticobiliary, esophageal, gastric and colorectal malignancies. By the end of the year, trainees will demonstrate competency in advanced procedures including ERCP, EUS, EMR, luminal stenting, RFA, and cyst drainage.

The trainee will come to understand the anatomy, physiology, and pathophysiology of the biliary tract and pancreas, as well as the multi-layered aspect of the lumenal gut and the anatomic relationship of various internal structures. The fellow will also be introduced to the use of appropriate diagnostic and therapeutic studies for these disorders. He or she will have the opportunity to get hands-on experience performing ERCP and EUS, on both inpatients and outpatients, with appropriate supervision by an experienced therapeutic endoscopist.

Facilities and Resources

The nature of the training provided by this program will expose the trainee to patients from a diverse patient population. Trainees in this program will see patients at NewYork-Presbyterian Brooklyn Methodist Hospital and at affiliated physician offices throughout the area. In addition, trainees are encouraged to be involved in ongoing research activities and to develop independent research projects leading to presentation at regional and national meetings as well as publications in peer-reviewed journals.

General Goals and Objectives

The advanced endoscopy curriculum will focus on endoscopic management of complex gastrointestinal pancreatic and biliary diseases including the staging of GI tract luminal malignancies. For this purpose, the majority of procedures will involve ERCP and EUS as well as advanced endoscopic resection and palliation techniques. Competency assessment will adhere to the most recent American Society of Gastrointestinal Endoscopy (ASGE) guidelines.

The trainee will develop endoscopic skills and will also be encouraged to explore additional areas of interest such as clinical research.

Key objectives include:

  • Developing detailed knowledge of the risks, indications, and contraindications of invasive procedures.
  • Performing endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, and ultrasound directed biopsies with supervision.
  • Gaining competency in other advanced endoscopic techniques which include but are not limited to the following: endoscopic mucosal resection, endoscopic submucosal dissection, enteroscopy, luminal prosthesis, mucosal radiofrequency ablation, and pseudocyst drainage. Guidelines for these procedures have not yet been established by the ASGE and are therefore, subject to the discretion of the principle educator.
  • Gaining experience in the performance and management of patients undergoing these procedures.
  • Developing skills in interdisciplinary management and appropriate integration of other services, specifically surgery and interventional radiology, is a requisite part of training.
  • Developing skills in clinical research related to these procedures.

Overview

NewYork-Presbyterian Brooklyn Methodist Hospital
Advanced Endoscopy Fellowship Program

Program Director Mukul Arya, M.D.
Training in ERCP, EUS, and other advanced techniques
Length of program One year
Position title of fellow Advanced Endoscopy Fellow
Number of first year clinical positions One
% Clinical activity time 85
% Research activity time 10
% Teaching time 5
Accepting applications from outside North America Yes.
Accepting applicants with JI, O, or H1 visas J1 Visa only
Additional requirement Must have a valid New York State license.

Application Information

Applicants must have completed academic gastroenterology fellowship training within three years of the application process. Applicants for the Advanced Endoscopy Fellowship Program may request an application from:

Mukul Arya, MD
Director, Advanced Endoscopy
NewYork-Presbyterian Brooklyn Methodist Hospital
Division of Gastroenterology
506 Sixth Street, B312
Brooklyn, NY 11215
[email protected]