Week and day in the life of a GI fellow

[lp92]

hi there!

can GI fellows share what their day to day and weekly breakdown of their lives are like?


some of the things I’d love to know more about are what’s the inpatient/outpatient split, what types of procedures and complaints make up your practice by proportion, and do you ever do procedures in the OR or is it all non sterile?

I’m also a female so if any female GI docs can share how they’ve been able to maintain a work life

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[hemosuccus]

Are you asking about what the fellowship schedule is like or actual job? Because the rest of your questions will likely differ program strength and program to program to both, which actual job very variable.

As to Gen GI fellowship, your consult experience as a resident will be pretty similar to what you'll see the fellows do, come in 6-8 depending in volume hospital, take consults, leave 4-6 when work is done. What you don't see is that fellows also do pathology followup of biopsies done in endoscopy. Endo is similar hours, on endo weeks and try to fit in what you can during consults. Gen fellows will do EGD, push enteroscopy, and colonoscopy, it can be done in OR but usually in an endo suite, usually this is not a 'sterile' procedure, only the PEG field comes into mind. Call is call, you win some, you lose often.

The only thing I'll say, not to get into semantics, but my mentors tell me to think about it as work-life harmony rather than balance. Balance is a myth. Rant over.

 

[lp92]

Are you asking about what the fellowship schedule is like or actual job? Because the rest of your questions will likely differ program strength and program to program to both, which actual job very variable.

As to Gen GI fellowship, your consult experience as a resident will be pretty similar to what you'll see the fellows do, come in 6-8 depending in volume hospital, take consults, leave 4-6 when work is done. What you don't see is that fellows also do pathology followup of biopsies done in endoscopy. Endo is similar hours, on endo weeks and try to fit in what you can during consults. Gen fellows will do EGD, push enteroscopy, and colonoscopy, it can be done in OR but usually in an endo suite, usually this is not a 'sterile' procedure, only the PEG field comes into mind. Call is call, you win some, you lose often.

The only thing I'll say, not to get into semantics, but my mentors tell me to think about it as work-life harmony rather than balance. Balance is a myth. Rant over.

Thanks for the insight. I am asking about fellowship specifically for now. What is a typically call schedule? I’m assuming you are in some sort of pool system? Do you take call from home? What makes up most of your call complaints, what is your clinic/inpatient split?

 

[Scope guy]

not sure what level of training you are in to understand specifics.
Call is program specific. larger programs with 3 or more fellows per year with 1 or 2 sites only will have less call than smaller fellow class. Call can be busy. some program have heavy call in 1st year fellowship and just 1 or 2 week call in final year, some split evenly all 3 years. there are so many variations that no matter what I say, there will be exceptions.

clinic usually 1 day a week. ambulatory vs inptient would be 80:20 split in most places but most of inpatient work will be in 1st year

 

[cabergoline2]

What is the typical number of outpatients you guys see in a single clinic patient?

My program we see 8-10 patients in a 3 hour session..

How many programs entertain inpatient consults on outpatient issues like GERD,IBS or chronic constipation ?

Just wondered how things worked in other programs

 

[ChessMaster3000]

What is the typical number of outpatients you guys see in a single clinic patient?

My program we see 8-10 patients in a 3 hour session..

How many programs entertain inpatient consults on outpatient issues like GERD,IBS or chronic constipation ?

Just wondered how things worked in other programs

our program is one of those 'see every consult' type of program. i think many programs are like this. however, generally the residents do not abuse it. i only recall seeing one GERD consult, and maybe a handful of chronic constipation. it is not a big deal

as for clinic, i tend to see 7-8 in a 4 hour session

 

[1Cor1557]

hi there!

can GI fellows share what their day to day and weekly breakdown of their lives are like?


some of the things I’d love to know more about are what’s the inpatient/outpatient split, what types of procedures and complaints make up your practice by proportion, and do you ever do procedures in the OR or is it all non sterile?

I’m also a female so if any female GI docs can share how they’ve been able to maintain a work life

It's all very program specific, some programs you will get smoked your first year other programs spread it out, some are more reasonable work-life balance, it's the importance of doing your homework and interviewing broadly to figure out what you're getting yourself into

 

[1Cor1557]

What is the typical number of outpatients you guys see in a single clinic patient?

My program we see 8-10 patients in a 3 hour session..

How many programs entertain inpatient consults on outpatient issues like GERD,IBS or chronic constipation ?

Just wondered how things worked in other programs

Pretty similar slots, and the emphasis is on slots because in a academic center for training in an urban setting that is the only hospital that treats the uninsured or takes charity cases you could have eight appointments and only three show

 

[lp92]

It's all very program specific, some programs you will get smoked your first year other programs spread it out, some are more reasonable work-life balance, it's the importance of doing your homework and interviewing broadly to figure out what you're getting yourself into

Would you say the training of fellowship more rigorous than during residency?

 

[lp92]

our program is one of those 'see every consult' type of program. i think many programs are like this. however, generally the residents do not abuse it. i only recall seeing one GERD consult, and maybe a handful of chronic constipation. it is not a big deal

as for clinic, i tend to see 7-8 in a 4 hour session

In the outpatient setting, what are the "bread and butter" patient complaints you see? And what proportion out of the 7-8 patients have that complaint?

 

[ChessMaster3000]

In the outpatient setting, what are the "bread and butter" patient complaints you see? And what proportion out of the 7-8 patients have that complaint?

Just making it up here, for the 8 patients, this would be a possible rundown. obviously highly variable

1. GERD
2. abdominal pain
3. abdominal pain
4. constipation
5. diarrhea
6. blood in stool
7. set up colonoscopy screening
8. abnormal abdominal imaging showing terminal ileitis (possible crohn's disease)

 

[1Cor1557]

Would you say the training of fellowship more rigorous than during residency?

Really Depends what med residency and gi fellowship you did or will do....if you wanna do it go for it don't let it scare you off just interview broadly

 

[1Cor1557]

Just making it up here, for the 8 patients, this would be a possible rundown. obviously highly variable

1. GERD
2. abdominal pain
3. abdominal pain
4. constipation
5. diarrhea
6. blood in stool
7. set up colonoscopy screening
8. abnormal abdominal imaging showing terminal ileitis (possible crohn's disease)

There's actually really good published data on the top ten icd codes pcp's refer to GI and for the most part that is the list, also includes dysphagia and abnormal LFTs, but that's about it

 

[lp92]

Just making it up here, for the 8 patients, this would be a possible rundown. obviously highly variable

1. GERD
2. abdominal pain
3. abdominal pain
4. constipation
5. diarrhea
6. blood in stool
7. set up colonoscopy screening
8. abnormal abdominal imaging showing terminal ileitis (possible crohn's disease)

Thank you!

There's actually really good published data on the top ten icd codes pcp's refer to GI and for the most part that is the list, also includes dysphagia and abnormal LFTs, but that's about it

Awesome will check it out

 

[hemosuccus]

What is the typical number of outpatients you guys see in a single clinic patient?

My program we see 8-10 patients in a 3 hour session..

How many programs entertain inpatient consults on outpatient issues like GERD,IBS or chronic constipation ?

Just wondered how things worked in other programs

15-20 min for followup, 40 min for new from 8 to 12. Not everyone shows of course. See every consult. I'd fight this initially but its more trouble then its worth, just see them and sign off quickly.

What you see in clinic will be dictated by your program/ clinic location. I'd say abdominal pain and abnormal liver tests (usually NAFLD) are my two most common, then diarrhea/ constipation. The top ICD codes comment is probably most helpful for OP