Advanced Endoscopy Fellowship

University of California, Davis
4150 V Street, Suite 3500
Sacramento, California 95817
(916)734-7183 (V)
Website


1 Position Available

Program Type: Both ERCP & EUS

Authorized Administrative Official: Lindsay Macomber (email)

Program Director: Shiro Urayama, MD (email)
Program Director Phone: (916)734-7183

Duration: 1 Year

Inclusive Dates of the Program: 7/15/2025 to 7/14/2026

Program Website: www.ucdmc.ucdavis.edu/internalmedicine/gastro/

Accepts applicants from outside of North America? No

Accepts applicants with J1 visas? No

Accepts applicants with H1B visas? No

Accepts applicants with E3 visas? No

Supervised Procedures

Procedure		 Faculty Involved in AEF Training Total Annual Volume Annual Volume with hands-on AEF Involvement
ERCP 4 538 267
EUS 3 260 215
Other (specify)
ERCP DUCT STENT, EMR/ESD 		2 167 41

Unsupervised Trainee Activities

Procedure		 Value
General GI procedures (per year) 250
Inpatient service (weeks/year) 2
Ambulatory clinics (per year) 48
Committed time for research (days/month) 4

Program Reporting Summary

The ASGE Training Committee requested that each AEF program voluntarily submit an annual report summarizing their advanced endoscopy procedure volume. You can view the provided report below.

Requirements for Application

  1. Standard ASGE Application Packet
    • ASGE Application
    • Post-Undergraduate Education
    • USMLE Scores
    • Certification of Completion of Residency
      1. Prior to appointment in the advanced endoscopy fellowship, fellows should have completed a three-year ACGME-accredited gastroenterology fellowship
      2. Fellows from non-ACGME-accredited programs must have completed at least three years of gastroenterology education prior to starting the fellowship
    • Personal Statement
    • Curriculum Vitae
    • 3 Letters of Reference

Additional Information about Program

CURRICULUM FOR FELLOWSHIP TRAINING
UC DAVIS MEDICAL CENTER
DIVISION OF GASTROENTEROLOGY AND HEPATOLOGY

Advanced Endoscopy Fellowship

Overview: Statement of Purpose
This is a one-year training for the 4th year advanced training in the UC Davis GI program, geared towards a structured training of the individual with advanced endoscopy procedures including EUS and interventional endoscopy – including standard ERCP.

Teaching Location
UC Davis Health, Sacramento, CA

FACULTY
Shiro Urayama,MD,Advanced Fellowship Director

FACULTY EXPERIENCE
Faculty are experienced in EUS and interventional endoscopy including ERCP, endoscopic mucosal resection, transmural pseudocyst drainage, celiac plexus block, photodynamic therapy, cyro and thermal ablative therapies, and endoscopic stent placement. They are recognized regionally, nationally and internationally for their expertise.

OTHER ANCILLARY SUPPORTS
A strong radiology department provides a full range of imaging services including ultrasound scan, CT scan, Magnetic Resonance Imaging, contrast radiology, vascular studies and isotope scanning, which complement the training in advanced endoscopy for the management of patients with pancreaticobiliary diseases and GI cancers.

Surgery departments including GI surgery and surgical oncology are staffed with experienced surgeons. The GI faculty and fellows work closely with surgeons and radiologists in a team approach to the management of the many patients with pancreaticobiliary diseases and GI cancers.

EDUCATIONAL PURPOSE
Advanced endoscopic procedures including endoscopic ultrasound, ERCP and endoscopic mucosal resection are not part of the standard ACGME accredited training program and are not required for ABIM board certification. However, the need for physicians trained in these procedures is increasing. The objective of this program is to provide training in these procedures to individuals who have previously completed an ACGME accredited training program in gastroenterology.

NUMBER OF FELLOWS
1 per year.

FUNDING
Trainees will be paid according to the number of post-graduate years of training as outlined in the UCDMC Resident Policy and Procedure Manual. The fellow will be paid from Division operating funds and therefore will be required to have 2 half days per week of his/her own template as stated below under Structure of Program. Revenue from these 2 half days will help support salary.

ELIGIBILITY AND SELECTION CRITERIA
Applicants will have successfully completed an ACGME accredited three-year gastroenterology fellowship program prior to enrollment in the program. Candidates must have experience in standard biliary endoscopic techniques and should have a strong interest in an academic career.

EDUCATIONAL GOALS AND OBJECTIVES
Overall training will focus on understanding the pathogenesis, clinical manifestations and complications of pancreaticobiliary diseases and GI cancers as well as the role of different imaging and therapeutic modalities in the management of such patients including the indications and contraindications for endoscopic procedures and the assessment of the outcome of the endoscopic intervention. Furthermore, the trainee will be expected to formulate a research protocol and complete a project at the end of the year.

PRINCIPLE TEACHING METHODS
1. Didactic teaching
The trainees will receive regular weekly didactic teaching of diagnostic and therapeutic endoscopy EUS/ERCP & interventional procedures. Also available is 6 months of lectures/talks on practical issues related to different therapeutic endoscopy procedures of which three months are focused on ERCP and EUS related techniques.

2. Clinical Training
The advanced endoscopy fellow will see patients in GI clinics for initial workup of the problems, and subsequently schedule and conduct EUS and interventional endoscopic examinations under the supervision of the faculty director. The fellow will see the patients on follow-up in the respective GI clinics for further management as indicated. They will also be responsible for communication with the referring physicians.

In addition, the fellow will actively participate in EUS/ERCP and interventional endoscopic inpatient consultation service and discuss the management of the patients with the respective attending. They are also responsible for coordinating the care of the patients before, during and after the special procedures.

3. Hands-on EUS/ERCP and Interventional Endoscopy Experience
The fellows will receive hands-on training in performing EUS/ERCP and interventional endoscopic procedures under the direct supervision of the Advanced faculty team.

4. Endoscopic Research
Within the first month of the training, the trainees will be expected to have formulated a research topic for academic involvement for the duration of the year. IRB protocols will be submitted in applicable cases and proceed with the research component. The trainees will be expected to complete a project and be ready to submit for a publication.


STRUCTURE OF THE PROGRAM
Weekly activities of the fellow will include 1 half-day of doing General GI Procedures on trainee's own procedure template. Revenue from this half day of General GI procedures will fall under trainee's name for Division Revenue and Salary support; 2 half-days Outpatient Clinic,one of which will be with the Director on his template in clinic and the 2nd half day will be on trainee's own clinic template and will fall under trainee's name for Division Revenue and Salary support. There will also be 5 half-days performing Advanced Procedures under the supervision of the Advanced Endoscopy director or other advanced faculty. Two half-days per week will be assigned for research. The fellow may also be assigned 2 weeks of General GI inpatient service during the year.


RESPONSIBILITIES OF THE FELLOW
To be physically present at UCDHS from no later than 0800 until no earlier than 1700 unless attending a conference or clinic.

To see and evaluate all inpatient consultations involving advanced endoscopic procedures.

To discuss all patient care issues with the GI attending.

To communicate to the referring physician and/or other medical team members both verbally and in notes the assessment and recommendations developed in collaboration with the GI attending.

To evaluate the appropriateness and risk of each procedure.

To discuss the risks, benefits and alternative options with the patient and to obtain informed consent from all patients scheduled prior to scheduling any procedure.

To communicate to the GI Endoscopy nursing staff the indication, priority and special considerations of each patient scheduled for procedures.

To completely document the procedure, findings, impression and plan in a timely fashion and to communicates this information to the appropriate individuals.


RESPONSIBILITIES OF THE FACULTY
A faculty attending will supervise the Fellow for all advanced procedures. The assigned faculty is expected to do the following:

Meet with the fellow to discuss his/her expectations.

Be available to discuss cases at all times

Provide an environment conducive to learning

Respond to questions appropriately

Engage in informal discussions and provide formal discussions that are pertinent to patient care

Provide a written evaluation of the Fellow quarterly.

Provide verbal feedback to the Fellow during and at the end of each quarter.


EDUCATIONAL CONTENT
Specific Goals of the Curriculum

Fellows will have formal instruction and clinical experience in the evaluation and management of the following disorders:

Diseases of the esophagus, including esophageal cancer

Gastrointestinal and pancreatic neoplasms

Gallstones and cholecystitis

Hepatobiliary neoplasms

Gastrointestinal neoplastic disease

Biliary and pancreatic diseases


TECHNICAL AND OTHER SKILLS
Fellows will learn the indications, contraindications, complications, limitations, and where applicable the interpretation of the following diagnostic and therapeutic techniques and procedures:

Imaging of the digestive system, including:
Ultrasound
1 Computed tomography
2 Magnetic resonance imaging
3 Vascular radiography
4 Nuclear medicine

Percutaneous cholangiography

Gastric, pancreatic, and biliary secretory tests

Pancreatic needle biopsy

ERCP and EUS


ENDOSCOPIC SKILLS
Fellows will gain competence in the performance of the following procedures. A skilled faculty member will be available to teach and to supervise all procedures. The performance of these procedures must be documented giving indications, outcomes, diagnoses, and supervisor(s).

Luminal and extraluminal EUS/ERCP & interventional endoscopic procedures:
•Esophageal, gastric, and rectal cancer staging
•Pancreaticobiliary tumor diagnosis & staging including EUS-guided fine-needle aspiration
•Posterior mediastinal mass evaluation including staging of lung cancer
•EUS-guided pseudocyst drainage and celiac plexus block/neurolysis
•ERCP and intraductal ultrasonography
•Endoscopic mucosal resection and Endoscopic Submucosal Dissection
•Photodynamic radiofrequency, cryo-therapy
•Endoscopic stent placement
Endosuturing


METHODS OF EVALUATION
Trainees will receive a quarterly evaluation of their performance both in terms of their clinical skills as well as progress with their technical skills in conducting the different diagnostic and therapeutic procedures.

The fellow’s progress will be evaluated in several ways:
•Verbal feedback from the attending physician
•Written evaluation by the attending

Evaluations will be based upon:
•Observed clinical practice
•Evidence of independent study and thought
•Interactions with patients and staff
•Interactions with colleagues, residents, students and faculty


ASSESSMENT OF COMPETENCY
The following areas will be evaluated to determine the progress of each fellow at the end of each quarter:


PATIENT CARE
Clinical skills - obtains accurate and complete information though medical interviews, physical examination, medical records review; performs procedures safely and considerately
Patient management skills - synthesizes the case and combines the scientific and clinical fund of knowledge; demonstrates sound clinical judgment; incorporates patient preference; able to integrate patient care


MEDICAL KNOWLEDGE
Knowledge base in Internal Medicine and Gastroenterology
Interest in learning and the mechanism of disease
Applies an open-minded and analytical approach to acquiring knowledge
Accesses and critically evaluates current medical information and scientific evidence


PRACTICE BASED LEARNING AND TEACHING
Critiques own performance
Receptive to constructive criticism
Learns from errors
Uses errors to improve patient care on both a personal and system-wide level
Uses information sources effectively to support patient care decisions and to educate self, patients and other physicians


INTERPERSONAL AND COMMUNICATION SKILLS
Develops a good working relationship and rapport and communicates clearly with other physicians, health professionals and patients
Presents cases concisely and in a well-thought out manner
Maintains comprehensive, timely and legible medical records


PROFESSIONALISM
Demonstrates respect, compassion and integrity in working with patients, families, colleagues and other health professionals regardless of their background
Adheres to principles of confidentiality, scientific and academic integrity and informed consent
Recognizes and identifies deficiencies in peer performance in a constructive manner
Takes responsibility for patient care; acknowledges mistakes


SYSTEM-BASED PRACTICE
Able to work with and within the local, regional and national medical system to deliver optimal patient care
Participates actively in improving the health systems to optimize patient care.

Please Note: All data in this program description is entered on a voluntary basis