The clinical training of gastroenterology-hepatology fellows takes place in the multidisciplinary environment of the James A. Clifton Center for Digestive Diseases at The University of Iowa, and at the adjacent Iowa City Veterans Affairs Medical Center. Medical students, residents, fellows, and faculty participate in patient care in both hospitals on a rotating basis. Outpatient clinics inpatient consultation services, state-of-the-art endoscopy units with active programs in endoscopic retrograde cholangio-pancreatography (ERCP), endoscopic ultrasonography exist and liver transplantation provide the framework for clinical training in gastroenterology and hepatology. Fellows become experienced in diagnostic and therapeutic endoscopic procedures as part of their clinical training. Additional clinical programs are tailored to the needs of fellows wishing to pursue specialized training in areas such as hepatology, transplantation, therapeutic ERCP or endoscopic ultrasonography. Ample opportunity exists to interact with colleagues in pediatric gastroenterology, pathology, surgery and radiology.

The clinical responsibilities of the division are divided into several key services. The team on each clinical service is composed of a faculty member who may be accompanied by a fellow, a physician assistant, residents, and senior medical students.

The University of Iowa Hospitals and Clinics

The Procedure Service at the University Hospitals. A faculty member supervises all of the endoscopic diagnostic and therapeutic procedures performed on patients from the inpatient and outpatient services at the University Hospitals. This work is carried out in the procedure unit of the James A. Clifton Center for Digestive Diseases. Fellows perform procedures on their patients with the assistance of a faculty member.

The University Hospitals Gastroenterology-Hepatology Inpatient Consultation Service. This consult team consists of one faculty member, a fellow, one physician assistant and sometimes a resident or medical student. The team evaluates about five inpatients a day. The fellow on this service helps formulate and carry out the plans for evaluating and treating patients with gastrointestinal illnesses. He or she performs the endoscopic procedures needed to meet these objectives.

The VA Service . One faculty member, one fellow, one resident, and occasionally one medical student provide all of the gastroenterology-hepatology consultation services at the Iowa City VA Medical Center. The fellow participates in the evaluation and management of each patient and performs all of the endoscopic procedures done at the VA Medical Center under the supervision of the faculty.

 The Liver Service. One faculty member, a physician assistant   and one fellow staff a liver service at the University of Iowa Hospitals. This team sees all of the inpatient and some outpatient liver consultations. There is also a service to support the liver transplant program.

The Outpatient Clinics at the University Hospitals. Outpatient clinics are held each weekday at the University of Iowa Hospitals. The clinic is staffed by members of the medical faculty and GI surgeons each day and offers specialty services for patients with a variety of gastrointestinal, nutritional and liver diseases. Fellows and residents participate in the evaluation of new and return patients. Patients with all types of gastrointestinal, pancreatic, and liver diseases are seen in these clinics.

The ERCP Service. The ERCP service is staffed by two faculty members. Fellows may participate in the evaluation of patients with pancreatic and biliary diseases during the first two years of their training. Experience in therapeutic ERCP techniques is reserved for advanced fellows who dedicate additional time to obtain training in diagnostic and therapeutic ERCP.

The Endoscopic Ultrasonography Service. Two faculty members perform diagnostic and therapeutic procedures involving endoscopic ultrasonography.   Fellows may participate in the evaluation these patients after in the final year of their clinical training.

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