Fellowship Program in Surgical Gastroenterology & Advance Endoscopy
1. Name of the course : Fellowship Course in surgical gastroenterology
2. Duration of the Course: 1 year
3. Eligibility criteria for admission: MS (General Surgery) or DNB ( General Surgery )
4. Number of Seats: 2
5. Selection Process: A total of 2 candidates per year will be selected for each course. Selection will be based on performance at interview 30%, University level academic merits (20%) publications if any (20%) and recommendations from teacher PG teacher (30%) or by university rules and regulations.
6. Program Objectives:
The Surgical Gastroenterology fellowship is designed to:
a. Provide comprehensive training and acquisition of skills in management of Gastrointestinal & Pancreas & Hepato-biliary diseases.
b. Help in integration of Surgical gastrointestinal , Liver and Pancreas diseases, Diagnosis - preoperative management, operative surgery and post operative management.
c. Training in research for Gastrointestinal diseases.
d. Inculcate appreciation of humanistic (cost conscious, caring) and ethical (accountability, integrity) aspects of medicine.
e. Develop ability to work as part of a multidisciplinary team.
7. Complete Curriculum of the course
a. Understanding Gastrointestinal diseases and various Surgical procedures for it.
b. Comprehensive training of various diagnostic approach to gastrointestinal and HPB Surgery, starting from History taking, Examination of patients, laboratory report analysis, Radiological report review as well endoscopic report examination.
c. Surgical training in assisting surgeries at Operation Room.
d. Maintaining surgical audit and analysis of patient's outcome.
e. Regular follow up of patients after surgeries at ward, ICU and post operative OPD consultations.
f. Understand the surgical instruments and equipments used in Surgical gastroenterology.
g. Integration of academic, Pathology report, Radiology report, Endoscopic findings and patient's examination knowledge for patient's better surgical outcome.
8. Course Contents:
A. Acquire technical skills in performing the following procedures, interpreting findings, recognizing and treating complications:
a. Management of gastrointestinal trauma. Recognizing the injury, investigations for gastrointestinal injury, initial management and operative management.
b. Management of Upper Gastrointestinal bleeding as well lower gastrointestinal bleeding
c. management of Acute Pancreatitis and it's complications
d. Management of Esophagus cancer and Multimodality treatment for Esophagus cancer, surgery for esophageal injury, surgery of corrosive injury of esophagus etc.
e. Surgery of Gastric tumor, Surgery of Gastric perforation.
f. Surgery of Intestinal obstruction, Surgery of intestinal stricture and intestinal perforations.
g. Surgery of Intestinal cancer.
h. Surgery of Liver diseases like, Liver cancer, Hydatid cyst of the liver, Cystic lesion of the liver etc.
i. Surgery for the diseases of gallbladder and bile ducts like, gallbladder stones, gallbladder cancer, benign bile duct stricture, cancer of the bile ducts, choledocal cyst etc.
j. Surgery of the pancreas diseases like, pancreas cancer, chronic pancreatitis, pancreatic trauma etc
k. Surgery of the spleen like, trauma of the spleen, splenic abscess etc.
l. Surgery of the large intestine diseases, like ulcerative colitis, cancer of the colon, Diverticular disease of the colon, stricture of the colon etc.
m. Surgery of the rectum diseases like surgery of rectal cancer, surgery of rectal prolapse, surgery of rectal stricture etc.
n. Surgery of perianal diseases like Haemorrhoids, fistula in ano, fissure in ano etc.
o. Surgery of retroperitoneal diseases.
B. Clinical Procedure Surgical procedures, candidates are expected to perform or assist:
1. Esophagus - Heller's Operation - Fundoplication - THE + GPU - TTE + GPU - Colonic pull up
2. Stomach and Duodenum - TV + G.I./Pyloroplasty - Billroth I & II gastrectomy - Radical gastrectomy
3. Small Intestine - Resection and anastomosis - Ileostomy closure - Feeding jejunostomy
4. Large Intestine - Rt hemicolectomy - Lt hemicolectomy - APR - Ant.Resection - Restorative Proctocoledctomy - Ileal J Pouch and anastomosis
5. Pancreas - Pancreatic Necrosectomy - Cyto-gastrostomy/jejunostomy - Lateral pancreatico-jejunostomy - Whipple's procedure
6. Billary surgery - Open cholecstectomy - Radical cholecystectomy - CBD Exploration/CDD - Hepatico-jejunostomy R-en-y - Segment III HJ
7. Portal Hypertension - Splenectomy+ Devasscularisation - Proximal Ilenorenal shunt - Portocaval/Mesocaval shunt
8. Liver Surgery- Major hepatic resection - Wedge resections - Hydatid cyst excision
9. Others - Diagnostic Laparoscopy - Perianal Procedures
C. Night call on rotation for observing / assisting /performing emergency surgeries.
D. See consultations for surgical procedures and follow up patients after the procedures.
E. Supervising and teaching at wards Medical officers, and staff nurses.
F. Regular discussion with radiologists, pathologists.
G. Regular presentation of journal articles and seminars in the departmental Weekly academic meetings.
H. Integrate Gastrointestinal knowledge with patient care.
I. Research presentation at state / National / International conferences.
J. Clinical research in Surgical gastroenterology and evidence based practice. Regular Meeting will be held between fellows and faculty members to design and conduct research. The fellows are required to complete a minimum of one research project in Surgical gastroenterology during the one year training under the supervision of faculty members. The project proposal should be submitted within a month of joining the fellowship to the project proposal should joining the fellowship to institute review board for obtaining ethical clearance and funding if required.
9. Evaluation Process
a. The performance of the fellow will be monitored carefully during the course of training.
b. Formal evaluation by the faculty members on a regular basis. This includes the performance of procedure of findings and planning/ performance of appropriate therapy. These will be recorded in the log book maintained by the candidate. Procedure Number done Documentation of competence by the faculty member
c. At the end of the course there will be:
i. Written exam
ii. Practical test: Skill assessment in performing endoscopies,
iii. Orals: Radiology / instruments, clinical reasoning and selection of surgical procedures in different case scenarios. The candidate should secure a minimum of 50%marks each in written and practical tests and 50% in orals to pass the examination.
iv. Evaluation of research project.
d. To successfully Complete the Fellowship:
i. The candidate should pass the exit exam with at least 50%marks.
ii. The research project should be complete and approved by external Faculty.
iii. The log book containing documented competence in endoscopic procedures should be approved by the external faculty.
10. Faculty: 2 senior faculties- 20 years experience 2 senior faculties - 10 years experience.
11. Pattern of Exam Each year an examination coordination committee (ECC) consisting of three teachers running Fellowship / certificate courses will be nominated by the director of the Institute. Both theory and practical Examinations will be concluded within 15 days of the end of the course. Examination will be conducted in individual institutions. Each examination will have one internal and one external (approved by the ECC.)
a. Theory : 100 marks. Passing marks 50%. All theory examinations will be held on a single day for all courses of similar lengths.
b. Practicals : Each candidate will examined by both examiners simultaneously for between 60 and 90 mins. This will cover a viva - voce and practical. Passing marks 50%. Candidates have to pass individually in both theory and practical.
12. Announcement of results : Results will be announced on the Website and Notice board within one week of the conclusion of the examination. The result will be only "Fellowship granted / Denied and marks will not be displayed. Repeats will be at the end of on earlier then 3 -6 months depending on the length of the course.
13. Award of Fellowship : Certificates will be awarded by the Gujarat University after the results will be sent to the GU. The University (with signature of the Registrar) will award the certificate.
Note - The decision of the Examination Co- ordination Committee will be binding on all matters pertaining to the examinations.
Fellowship Program for Specialist in Critical Care Medicine
1. Eligibility: Allopathic doctors holding valid MBBS, DNB or MD degree in India or equivalent (with valid MCI registration) and atleast 2 years of hospital experience after internship (of which atleast 1 yr is in critical care units) are eligible to register for this Fellowship program. From 2017, MD candidates with 2 years ICU Experience can apply for exemption from Part 1 examination (in specific form). Those MD Candidates exempted from Part 1 Examination can directly register for Part-2 course A letter from the Institute/ teacher to this effect must be submitted along with every application.
2. Duration of the Course: Total duration of the course is 24 months.
a. The term for part-1 (Primary) starts from 1st January at hospitals recognized by the College for this training. Candidates selected by the institutes must register for the examination with the "College of Critical Care Medicine" at unit-F, Gemini Park, V. N. Purav Marg, Mankhurd, Mumbai-400088, Maharashtra from 1st Jaunary upto latest by 31st March for the Part 1 Examination. Candidates cannot be enrolled after 1st April without special approval from the College (with late fee of Rs 8000) on a case by case basis but not later than 30 April. The Part 1 Examination is held at one location anywhere in India usually in the months of Dec/Jan (theory) and Jan/Feb (practical) in the following year. (see Calendar of College of Critical Care Medicine for details).
b. After successful completion of Part-1 candidates can register for part-2 (Fellowship). They will need to continue to work in ICU during their part 2 training in their hospital. (see Calendar of College of Critical Care Medicine for details).
c. The term for part-2 (Fellowship) starts immediately after completion of the Part 1 Examination. Candidates who have passed part 1 can register for the Part 2 examination with the "College of Critical Care Medicine" at unit-F, Gemini Park, V. N. Purav Marg, Mankhurd, Mumbai-400088, Maharashtra from date of passing upto 30th April. Candidates cannot be enrolled after 30th April without special approval from the College (with late fee Rs. 8000). The Part 2 Examination is held at one location anywhere in India usually in the months of Oct-Dec in the same year. (see Calendar of College of Critical Care Medicine for details).
3. The training program will be a residency program and the trainee should be responsible for patient care and procedures. A minimum 80% attendance at the locally organized teaching programs is mandatory for the candidates. A record of such teaching programs must be maintained (in form of register). All recognized teachers must significantly contribute to their teaching program
4. A Half yearly report (6 monthly) of lectures taken must be sent to the college as an email to email@example.com or firstname.lastname@example.org . This should include topics, speakers, and students attendance. Failure to submit academic reports atleast 2 times a year can result in disqualification of the centre.
a. Selection and Registration of the Trainee-Fellow: The candidates will be selected by individual institute provided they fulfill the eligibility requirements mentioned in (1) above. The name of all such selected candidates must be immediately forwarded to the Chairman, College of Critical Care Medicine in prescribed registration form downloadable from www.icueducation.com (in the download section); through the institute along with the candidates application/fees/photos etc mentioned in the application form latest by dates specified in (2) above. (see Calendar of College of Critical Care Medicine for details).
b. Examination registration form must be submitted by post to the College along with the photos and examination fee as determined by the College of Critical Care Medicine by DD/ multicity cheque. See the latest Examination application form for details of payment (downloadable from www.icueducation.com in the download section). This fee is non-refundable even if candidate does not appear for the examination for whatever reason.
c. Membership form and fee for membership: This is one time payment only during registration for part 1 examination. Membership is preferably completed online at www.icueducation.com
5. Candidates selected will need to work in the ICU. They will receive a monthly stipend at least on par with other doctors of that designation in the department. It is recommended that candidates training for the Fellowship be given a token academic bonus at discretion of the institute. They should be spared from duties to attend academic programs in critical care as best possible without compromising patient care (in rotation).
6. All trainees must submit a log book as prescribed by the College as documentation of work done during their tenure in the ICU. This must strictly be in the prescribed format. Templates, examples and instructions are available at www.icueducation.com and can be downloaded from this site's download section.
7. Rule for candidates who fail to pass the examinations: Candidates who fail in Part 1 examination will not have to wait one full year to reappear for the exam. (see Calendar of College of Critical Care Medicine for details).
8. The examination will be a common examination which will consist of :
a. Theory Papers: 2 papers of 2 hours each and conducted approximately 1 month before the practical examination
b. Practical examination: 4-6 viva and 1-2 bedside ICU cases and 6-8 OSCE stations (Objective Structured Clinical Examinations) as detailed in other document. Part 2 candidates will be evaluated for "communication with relatives" and ICU procedures and drugs/equipments among other components of the examination.