Fellowship Course in Surgical Gastroenterology

1 year

MS (General Surgery) or DNB ( General Surgery )

2

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.

The Surgical Gastroenterology fellowship is designed to:

• Provide comprehensive training and acquisition of skills in management of Gastrointestinal & Pancreas & Hepato-biliary diseases.
• Help in integration of Surgical gastrointestinal , Liver and Pancreas diseases, Diagnosis – preoperative management, operative surgery and post operative management.
• Training in research for Gastrointestinal diseases.
• Inculcate appreciation of humanistic (cost conscious, caring) and ethical (accountability, integrity) aspects of medicine.
• Develop ability to work as part of a multidisciplinary team.

• Understanding Gastrointestinal diseases and various Surgical procedures for it.
• 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.
• Surgical training in assisting surgeries at Operation Room.
• Maintaining surgical audit and analysis of patient’s outcome.
• Regular follow up of patients after surgeries at ward, ICU and post operative OPD consultations.
• Understand the surgical instruments and equipments used in Surgical gastroenterology.
• Integration of academic, Pathology report, Radiology report, Endoscopic findings and patient’s examination knowledge for patient’s better surgical outcome.

• Acquire technical skills in performing the following procedures, interpreting findings, recognizing and treating complications:
  1. Management of gastrointestinal trauma. Recognizing the injury, investigations for gastrointestinal injury, initial management and operative management.
  2. Management of Upper Gastrointestinal bleeding as well lower gastrointestinal bleeding
  3. Management of Acute Pancreatitis and it’s complications
  4. Management of Esophagus cancer and Multimodality treatment for Esophagus cancer, surgery for esophageal injury, surgery of corrosive injury of esophagus etc.
  5. Surgery of Gastric tumor, Surgery of Gastric perforation.
  6. Surgery of Intestinal obstruction, Surgery of intestinal stricture and intestinal perforations.
  7. Surgery of Intestinal cancer.
  8. Surgery of Liver diseases like, Liver cancer, Hydatid cyst of the liver, Cystic lesion of the liver etc.
  9. 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.
  10. Surgery of the pancreas diseases like, pancreas cancer, chronic pancreatitis, pancreatic trauma etc
  11. Surgery of the spleen like, trauma of the spleen, splenic abscess etc.
  12. Surgery of the large intestine diseases, like ulcerative colitis, cancer of the colon, Diverticular disease of the colon, stricture of the colon etc.
  13. Surgery of the rectum diseases like surgery of rectal cancer, surgery of rectal prolapse, surgery of rectal stricture etc.
  14. Surgery of perianal diseases like Haemorrhoids, fistula in ano, fissure in ano etc.
  15. Surgery of retroperitoneal diseases.

 

• 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

 

• Night call on rotation for observing / assisting /performing emergency surgeries.
• See consultations for surgical procedures and follow up patients after the procedures.
• Supervising and teaching at wards Medical officers, and staff nurses.
• Regular discussion with radiologists, pathologists.
• Regular presentation of journal articles and seminars in the departmental Weekly academic meetings.
• Integrate Gastrointestinal knowledge with patient care.
• Research presentation at state / National / International conferences.
• 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.

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:

• Written exam
• Practical test: Skill assessment in performing endoscopies,
• 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.
• Evaluation of research project.

d. To successfully Complete the Fellowship:

• The candidate should pass the exit exam with at least 50%marks.
• The research project should be complete and approved by external Faculty.
• The log book containing documented competence in endoscopic procedures should be approved by the external faculty.

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.)

• Theory : 100 marks. Passing marks 50%. All theory examinations will be held on a single day for all courses of similar lengths.
• 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.

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.

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.