Geisinger Medical Center

Geisinger Medical Center
Department of Gastroenterology, Hepatology, & Advanced Endoscopy
100 N. Academy Avenue, 21-11
Danville, Pennsylvania 17822-2111
(570) 271-6856 (V)
Website

2 Positions Available

Program Type: Both ERCP & EUS

Authorized Administrative Official: Lisa Itts (email)

Program Director: Harshit S. Khara, MD, FASGE, FACG (email)
Program Director Phone: 570-271-6651

Duration: 1 Year

Inclusive Dates of the Program: 7/1/2027 to 6/30/2028

Program Website: www.geisinger.edu/gchs/education/residencies-fellowships/fellowships/gastroenterology-fellowship/advanced-endoscopy-fellowship

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

Type of Interview Offered: Both In-Person & Virtual

Supervised Procedures Procedure	Faculty Involved in AEF Training	Total Annual Volume	Average Annual Volume with Hands-on AEF Involvement per Fellow
ERCP	15	1668	538
Diagnostic EUS	15	511	253
Interventional EUS	15	1551	350
Deep enteroscopy	15	192	50
Luminal stenting	15	150	125
ESD	6	218	50
Bariatric endoscopy	1	48	48
POEM	6	126	60
Endoscopic management of GERD and Barrett’s	15	110	101
Other (specify) EndoHepatology	15	350	325

Unsupervised Trainee Activities Procedure	Value
General GI procedures (per year)	450
Inpatient general GI service (weeks/year)	4 weeks/year
Inpatient advanced endoscopy service (weeks/year)	0
Ambulatory clinics (per year)	6 days/year
Committed time for research (days/month)	2

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

Geisinger Advanced Endoscopy Fellowship

Our one-year Advanced Endoscopy Fellowship program at Geisinger Medical Center’s Advanced Center for Endoscopy (ACE) division provides a broad hands-on experience in all aspects of therapeutic interventional endoscopy for TWO advanced endoscopy fellows each year. Our advanced fellows have an amazing opportunity to train with 15 Advanced Endoscopy attendings with wide range of experiences that they bring to our program from various parts of the country, including 6 dedicated third space endoscopy faculty, and EndoBariatrics faculty.

Our AEF program has been in existence since 2007, and the focus has always been on one-on-one teaching, with ample hands-on scope time from day 1. The Geisinger Health System consists of a number of affiliated hospitals, with a catchment area of 31 counties and 2.8 million people. The Advanced Endoscopy Group within Gastroenterology offers the full array of diagnostic and therapeutic advanced endoscopy procedures and annually performs more than 1600 ERCPs and 2000 EUS procedures, in addition to a large number of other complex procedures as described below. We are a regional liver transplant center and manage complex pre- and post-transplant Hepatology patients in collaboration with our transplant team, which has helped us build a robust internationally recognized EndoHepatology program. We utilize a state-of-the-art 25,000 square foot endoscopy center which has 10 procedure rooms, with 3 rooms having fluoroscopic capability for advanced procedures at the main campus in Danville, PA; along with 3 other state-of-the-art Advanced Endoscopy Units across the system at Wilkes Barre, Scranton, and Lewistown, PA. All cases are done with full anesthesia assistance with a dedicated experienced endoscopy lab staff.

Curriculum:

Our Advanced Endoscopy Fellowship offers hands-on certification advanced training in:

• Diagnostic & Therapeutic Endoscopic ultrasound (EUS) including placement of AXIOS stent for WON, EUS-guided gallbladder drainage (EUS-GB), EUS-guided gastro-enterostomy (EUS-GE), EUS-guided fiducial placement (EUS-FNF), and EUS-guided hemostasis.
• Endoscopic Retrograde Cholangiopancreatography (ERCP), ampullectomy, SpyGlass cholangioscopy, intraductal ablation, complex hilar biliary stenting and significant volume of pancreatic endotherapy; EUS-guided ERCP in altered anatomy, EUS-guided biliary drainage (EUS-BD/EUS-HG), and EUS-Directed transgastric ERCP (EDGE) procedures
• EndoHepatology with EUS-guided liver biopsy (EUS-LB), Shearwave, FibroScan, and EUS-guided portal pressure measurement (EUS-PPG)
• Barrett’s esophagus diagnosis and therapy, including endoscopic mucosal resection (EMR), Endoscopic Submucosal Resection (ESD), Radiofrequency ablation (RFA), conventional and Hybrid-APC, and Cryoablation (both spray and balloon cryotherapy)
• Complex colon and duodenal polypectomy, with use of various assistive devices, Endoscopic Full Thickness Resection (EFTR), EMR, and ESD
• Luminal stenting of esophagus, duodenum, and colon
• Interventional IBD and management of difficult strictures of the GI tract (including incisional therapy, Purastat, and stenting)
• Device-assisted enteroscopy including single balloon enteroscopy (SBE) & Pathfinder-assisted enteroscopy
• Endoscopic management of GERD with Bravo, EndoFlip, Stretta and Transoral Incisionless Fundoplication (TIF) procedures
• Third Space Endoscopy including endoscopic treatment of Zenker’s diverticulum (Z-POEM), Achalasia management with E-POEM and pneumatic dilation, and Gastroparesis management with G-POEM, including extensive Overstitch endosuturing and OTSC training
• EndoBariatrics with Endoscopic Sleeve Gastroplasty (ESG) for weight and metabolic management
• Advanced Hemostasis including Hemorrhoidal therapy with banding and HET treatments.
The advanced fellow will not only be involved in advanced endoscopic training with attending staff at the main hospital in Danville but will also have the opportunity to train with our other interventional faculty at various Geisinger hospitals in Wilkes Barre (Geisinger Wyoming Valley Medical Center), Scranton (Geisinger Community Medical Center), and Lewistown (Geisinger Lewistown Hospital).

A large percentage of the ERCPs are in patients with “native papillae” rather than just being re-do procedures. The EUS service has grown impressively in the past 10 years, with approximately 1300 cases done annually in Danville alone. On-site cytopathology services (ROSE) are readily available for all our FNAs, with Tele-cytopathology review on all cases. Trainees will get experience with both radial and linear echoendoscopes, as well as EUS miniprobe.

We have a hands-on training lab for the fellows, and various simulation labs are arranged throughout the year for the advanced fellows, such as Axios, Endosuture and tissue closure, OTSC, Stenting, ESD, POEM, FTRD etc for the teaching of advanced procedures. The department has a conference room with video conferencing capability, video library, and necessary clinic and office space.

There is ample opportunity and resources for clinical research and internal grants are available to support this. Geisinger has used an electronic medical record system for more than three decades and invests a lot into support of this infrastructure. This, in combination with a stable patient demographic, creates great potential for longitudinal clinical research. We frequently collaborate with our department of epidemiology to assist with studies.

We have a close relationship with excellent, minimally invasive surgeons, surgical oncologists, medical oncologists, radiation oncologists, pathologists and cytopathologists, including weekly tumor board conferences and other didactics. Advanced Endoscopy fellows participate in departmental conferences including the weekly Core Curriculum conference, weekly multidisciplinary Tumor Board meetings, and the monthly Foregut, GI pathology, GI radiology, Journal Club, and Research conferences. Fellows participate in and present at the monthly multicenter Pancreaticobiliary national conference (PB Live) representing Geisinger as one of the teaching centers. Teaching opportunities are available for fellows in the endoscopy suite and residents and fellows during conferences and in the inpatient consult service. Fellows are supported to attend the ASGE Advanced Endoscopy course, Boston Scientific Passport Program, ACG Annual meeting, Digestive Disease Week, Pennsylvania Society of Gastroenterology conferences, and various other meetings throughout the year.

We have an excellent placement track record for all our graduating fellows to practice environments of their choice including academic/university-based centers, large health systems, community hospitals, as well as private practice groups based on their geographical and family preferences. We also have a large in-house retention rate with ongoing openings for advanced endoscopy faculty at our various practice centers!

For additional information, please visit our Geisinger Advanced Endoscopy webpage: https://www.geisinger.edu/gchs/education/residencies-fellowships/fellowships/gastroenterology-fellowship/advanced-endoscopy-fellowship


Program Director:
Harshit S. Khara, MD, FACG, FASGE
Phone: (570) 271-6856
[email protected]

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