Journey of FIRST YEAR of
GI FELLOWSHIP
Is It the Cecum Yet?
By Shifa Umar, MD, Allegheny Health Network
in the power of PPI and MiraLAX® daily, and, your mantra will become: “patients avoid NSAIDs, you avoid NSAIDs, everyone AVOID NSAIDS!”
THE TRANSITION TO GI FELLOWSHIP FROM RESIDENCY
WELCOME TO THE FIRST YEAR OF FELLOWSHIP! You have finally made
it here. Congratulations, you are on your journey to becoming a Gastroenterologist. For some of you it may have been a lifelong goal, and for others of you it may have been a pursuit you started during your residency. It is exciting and thrilling, and you are going through mixed emotions. You are proud of what you have accomplished, and you are nervous about what lies ahead (“I have never scoped anyone!”) As you transition from a knowledgeable third-year resident (medicine attending) to a firstyear fellow, you will learn that this year may be daunting, but your
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three years of residency training have prepared you to be a good physician, triage patients, gather information and effectively provide care. Remember those skills and have confidence in your training – it will be the foundation of your fellowship training and future role as a consultant. In most fellowship programs, the first-year GI fellows are mostly assigned to the consult service. The most common consult will be “GI bleed.” The golden rule to evaluating a GI bleed is to “always have your finger, nose and jelly ready.” You will learn to know your patients with cirrhosis and obscure GI bleeders better than your family, following hemoglobins will become the bane of your existence, you will believe
The most challenging part of the transition from medicine to GI is holding yourself back from addressing those high blood sugars—while it is important to see the patient as a whole, it is also important to gather information that is more GI-centric (that is why the primary team consulted you.) A wise man once said, “don’t be so focused on the trees that you can’t see the forest.” As you take on your new role as a consultant, introduce yourself clearly to patients, as they see many faces in the hospital. When interacting with house staff, strike a collaborative tone, acknowledge their efforts in taking care of the patients, verbally communicate recommendations, and embrace your role as an educator. In return, they will
