University of Pennsylvania Perelman School of Medicine

University of Pennsylvania Perelman School of Medicine
Division of Gastroenterology, PCAM - South Pavilion
7th Floor, 3400 Civic Center Blvd
Philadelphia, Pennsylvania 19104
(215) 662-4301 (V)
Website


2 Positions Available

Program Type: Both ERCP & EUS

Authorized Administrative Official: Alishah Powell (email)

Program Director: Michael L. Kochman, MD, FASGE (email)

Duration: 1 Year

Inclusive Dates of the Program: 7/1/2025 to 6/30/2026

Program Website: www.med.upenn.edu/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 9 >1400 >900
EUS 6 >1200 >950
Lower GI EMR 6 >200 >200
Esophagogastroduodenal EMR 6 >200 >150
Esophagogastroduodenal ablation (e.g., RFA) 5 >60 >50
Small bowel enteroscopy 7 >100 >45
ESD 6 >90 >50
Bariatric endoscopy 1 >20 >20
POEM 1 >45 >30
Other (specify)
Zenkers diverticulotomy 		2 >35 >35

Unsupervised Trainee Activities

Procedure		 Value
General GI procedures (per year) 325
Inpatient service (weeks/year) 3
Ambulatory clinics (per year) 0
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


PROGRAM DESCRIPTION

The Division of Gastroenterology (GI) at the Hospital of the University of Pennsylvania offers a comprehensive 1 year Advanced Endoscopy Fellowship. This program is intended for those who have successfully completed a GI fellowship. The advanced endoscopy fellow receives advanced endoscopic training in both the cognitive and procedural aspects of advanced endoscopic procedures with the goal of being trained as an academic interventionalist. The trainee will participate in clinical care, be expected to partake in active research projects and initiate their own projects, and participate in the training of regular GI fellows with gradated attending responsibility. During the training period the advanced fellow will become proficient in ERCP, EUS, PDT, endoprosthetic placement, complex stricture remediation and enteral feeding access.


Endoscopy Procedural Responsibilities:

1. Attendance as attending on-service, longitudinal clinics and endoscopy as per schedule

2. Coordination and maintenance of distribution of therapeutic procedures, including, but not limited to:
• ERCP
• EUS
• Ablation/AMR
• Endoprosthetic placement
• Fistula management
• Complex stricture remediation, if primary GI team requests
• Enteral Feeding Access, other than G-tube

3. Participation in pre-procedure therapeutic evaluation at the request of the inpatient teams (GI/Liver). Therapeutic consults should be seen by the primary GI team and when a procedure/scheduling or guidance is needed the 4th year should be called who will then see the patient to make sure all is in order and perform the duties below, including:
a. teaching of housestaff
b. therapeutic note indicating that the patient has been seen and evaluated with pertinent history, recommendations, and plan. If a GI procedure is to follow then the note will also include documentation of the potential risks and alternatives
c. communication of preparation and scheduling information
d. communication of procedural results and post-procedural recommendations to primary GI team and requesting service
e. post-procedure follow-up,for example post-ERCP check to r/o complication

4. Patients that the therapeutic attending admits/accepts in transfer with therapeutic problems or post-procedure are to have a note from the 4th year fellow and seen each day by the fellow in addition to the primary GI team.

5. If the therapeutic fellow is off-site they will not be able to follow-up or see HUP inpatients, the PCAM fellow will cover as per the cover memo.

6. Participation in clinical and pre-clinical research activities of the therapeutic attendings

7. Design and execution of trials of the fellow’s design

8. It is expected that the fellow will maintain a high-degree of academic involvement and demonstrate this by scholarly activity.


Outpatient Clinic

All fellows have continuity clinic throughout the fellowship under the auspices of faculty members. There are weekly conferences devoted to outpatient diagnostic and management issues. Additionally, fellows participate in specialized clinics to complement their research interests and projects.


CONFERENCE SCHEDULE

Clinical training is also supplemented by interrelated didactic conferences:

• Clinical Journal Club
Description: The purpose of this conference is to examine critically current literature. Fellows discuss an article or group of articles with active participation by faculty.

• Clinical Case Conference
Description (CME credit for attendance): The medical history of patients with important gastrointestinal and liver disorders is presented by first year GI Fellows. Senior Fellows without knowledge of the case analyze the history, laboratory tests, and procedures and discuss the differential diagnosis and management. There is active participation by faculty. Both adult and pediatric GI Fellows participate.

• Interdisciplinary Case Conference
Description (CME credit for attendance): This conference is directed at advanced trainees and faculty for the discussion of complex gastrointestinal and liver disease. Cases often represent challenging consultations from within or outside the Medical Center. Multiple departments participate including Surgery, Radiology, Radiation Therapy, and Pathology

• Grand Rounds
Description (CME credit for attendance): State-of-the-art lectures on important topics in gastroenterology and hepatology are delivered by visiting Professors and University of Pennsylvania faculty who represent national and international authorities in their areas of expertise. Linked speakers are also giving seminars in the Center for Molecular Studies in Digestive and Liver Disease Series.

GOALS AND OBJECTIVES

Utilize EUS and ERCP to diagnose and manage patients with a variety of GI disorders

Identify the unique features of dedicated echoendoscopes, catheter probes, and EUS and ERCP accessories

Identify normal and abnormal EUS and ERCP anatomy

Establish the T, N, and M stage for luminal tumors and pancreatic cancer

Differentiate the various types of cystic pancreatic tumor

Identify the utility of EUS for evaluating patients with chronic pancreatitis including autoimmune pancreatitis

Differentiate the various subepithelial mass lesions

Assess the N stage for lung cancer

Integrate EUS into the care of patients with inflammatory bowel disease

Demonstrate proper technique for EUS guided biopsy (FNA, Trucut)

Demonstrate proper technique for selective biliary and pancreatic cannulation, endoscopic sphincterotomy, pre-cut sphincterotomy, and needle-knife sphincterotomy

Recognize the technical aspects and role of interventional EUS and ERCP procedures including, but not limited to, stone retrieval, cyst drainage, stent insertion and retrieval, removal of migrated stents, rendezvous procedures, pseudocyst drainage, celiac plexus block and neurolysis, duodenal and other luminal stenting, and endoscopic
Ampullectomy

Begin the process of overseeing and teaching these skills and techniques to other GI fellows

Integrate proper reimbursement and billing into their practice


CURRICULUM

• 2-4 weeks attending (VA/PMC)
• Monday – Advanced endoscopy outpatient/inpatient – HUP
• Tuesday – Animal lab/inpatient advanced endoscopy
• Wednesday – Advanced endoscopy outpatient/inpatient
• Thursday – Advanced endoscopy outpatient/inpatient
• Friday – office/endoscopy


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