Department of Medicine

Gastroenterology Residency Training Program

This program is an academically oriented 2-year training program dedicated to the training of outstanding clinical gastroenterologists, clinical teachers and investigators. Although the core training program consists of 2 years, most residents planning an academic or urban community career will go on to pursue a third year of training. The program utilizes the resources of two large tertiary centres, the University of Alberta Hospital (UAH) and the Royal Alexandra Hospital (RAH). This provides excellent exposure to a large and diverse array of gastrointestinal and hepatologic disorders. In addition, there is a close clinical and academic interaction with members from the departments of Surgery, Diagnostic Imaging, Pediatrics and Pathology.

The two core years consist of clinical gastroenterology/hepatology training. The third year may consist of basic or clinical/translational research, additional clinical training in hepatology/liver transplantation, inflammatory bowel disease, nutrition or therapeutic endoscopy, or Masters studies in Public Health, epidemiology or medical education. Career counseling and mentoring occur early in the core program, and continues throughout to help residents in their decision and preparation for the third year of training, if further training is desired.

In the clinical training program, the residents spend time on a busy consult service. Following assessment by the resident, the case is reviewed with the consultant at the bedside and a general discussion relative to the patient ensues. Investigations and management plans are made and the resident follows these through, including the performance of endoscopy under the supervision of the consultant. Both UAH and RAH have GI specialty wards. When on rotation on the ward, the resident will care for patients with various GI disorders, and supervise and teach internal medicine residents. We believe GI training is superior on a GI specialty ward compared to general medical wards with GI consultation

We have a well-equipped and busy endoscopy unit where over 7000 procedures are performed annually. A second large endoscopy unit is situated at the RAH site performing a similar number of procedures annually. Residents will perform diagnostic and therapeutic procedures including: gastroscopy, colonoscopy, sigmoidoscopy, esophageal dilatation, variceal banding or injection, polypectomy and other therapeutic procedures (e.g. BICAP, PEG). Diagnostic ERCP will not be offered in isolation from therapeutic procedures in the biliary tract such as papillotomy and stent or nasobiliary drain insertion. Not all candidates are expected to undertake this additional training. UAH is a major liver referral centre and liver transplants have been performed here since 1989. Training in hepatology and liver transplantation will be obtained through spending 4 months on the liver rotation. Additional elective time is available which may be spent in GI, radiology, pediatric GI or individualized electives tailored to ones career plans (e.g. clinical nutrition in the regional Nutrition Program, GI oncology at the Cross Cancer Institute, serving Northern Alberta, GI motility or research)

In their individual longitudinal ambulatory continuity clinic, residents see new and follow-up patients. Faculty consultants are available at clinic sessions where diagnostic and management problems are discussed with emphasis on best and cost effective practice. The UAH and RAH are two of the best-equipped tertiary care hospitals nation-wide. The physical structure of the UAH is impressive and many would argue unequaled. Major clinical and research additions are scheduled for both UAH and RAH in the next 2-5 years. Between UAH and RAH, there are approximately 1500 hospital beds.

The gastroenterology residents are busy with their clinical responsibilities, but considerable emphasis is placed on protected time for their attendance at regular teaching sessions. These include weekly clinical/pathological conferences and liver rounds. At these conferences, all aspects of clinical gastroenterology and hepatology are discussed in detail. A mastery of clinical skills relative to gastroenterology is considered essential and practice oral examinations are provided on a regular basis (6-8 per year). A weekly academic half-day comprises of journal club, pathophysiology sessions, exam review, clinical vignettes and sessions covering the CanMED goals.