Gastroenterology Fellowship at Massachusetts General Hospital

Welcome

Welcome to the Gastroenterology Fellowship at Massachusetts General Hospital!

We prepare our trainees to provide expert clinical and endoscopic care to patients with a wide variety of gastrointestinal, pancreaticobiliary and liver disease. We aim to develop leaders in innovation and investigation in the field of gastroenterology. Every year we attract a diverse group of ambitious, thoughtful, compassionate and engaging fellows!

Our fellowship provides broad exposure to common GI problems and complicated tertiary management in the inpatient and outpatient settings. Fellows work directly with attending physicians in continuity and subspecialty clinics, as well as on multidisciplinary consultative services alongside our skilled surgeons, radiologists, and pathologists. Fellows play a key role in educating our medical students and residents.

We focus on career development for our trainees, so they can enjoy rewarding careers in academic medicine. We are privileged to share the rich academic and scientific resources of Mass General, Harvard and MIT. Our fellows have a strong track record of success in basic science, translational and clinical research and many are now leaders in academic centers throughout the country.   

We welcome six new first year fellows each year. We hope that you will join us!  

Karin Andersson, MD, MPH
Program Director

Key Program Dates

• July: Apply through ERAS. Application deadline 3^rd Wednesday in July
• August: NRMP opens
• September–October: Interviews
• November–December: Match Day
• July 1: Fellowship Begins

Requirements

Applicants must be enrolled in or have completed an American Council of Graduate Medical Education-accredited internal medicine residency.

Applicants must document successful completion of USMLE Step 3 by the time of appointment (beginning of fellowship). In rare circumstances, LMCC/MCCQUE and COMLEX examinations may be substituted.

Applicants interested in entering the American Board of Internal Medicine (ABIM) Research Pathway (“short track”) must have the support of their current internal medicine residency program director. The applicant must notify the ABIM of their intention to pursue such training by the spring of their PGY-2 year of residency. All ABIM Research Pathway applicants must satisfactorily complete 24 months of accredited categorical ACGME internal medicine training, which includes a minimum of 20 months of direct patient care responsibility.

Curriculum

An overview of our training program by year:

Year One

• Podolsky General GI Service and Inflammatory Bowel Disease inpatient service (6 months)
• Liver and Transplant Hepatology inpatient service (4 months)
• Schapiro Interventional Endoscopy Service with inpatient endoscopy (2 months)
• Ambulatory clinic (1/2 day per week)
• Endoscopy (longitudinal)

Year Two

• Clinical rotations (2 months)
• Ambulatory clinic (1/2 day per week)
• Endoscopy (longitudinal)
• Mentored research / research didactic training

Year Three

• Clinical rotations (1 month)
• Ambulatory clinic (1/2 day per week)
• Endoscopy (longitudinal)
• Mentored research / research didactic training

Year Four (optional)

• Ambulatory clinic (1/2 day per week)
• Endoscopy (longitudinal: 1.5 months)
• Mentored research / research didactic training

Clinical

Overview

Our clinical curriculum encompasses a minimum of 18 months of rigorous work in all aspects of digestive diseases. Our training program also affords opportunities for fellows to develop as clinical teachers for their colleagues, medical residents and Harvard medical students. Fellows are offered broad exposure to specific clinical areas, including:

• GI Bleeding and Endoscopic Evaluation
• Esophageal and Swallowing Disorders
• Inflammatory Bowel Disease
• Liver Disease
• Transplant Hepatology
• Pancreaticobiliary Disease
• Interventional Endoscopy
• Motility and Neurogastroenterology
• Gastrointestinal Oncology, Surgery and Radiology

Facilities

All fellowship training occurs on the main Mass General campus located in the heart of Boston. Mass General is the third-oldest general hospital in the United States and the oldest and largest hospital in New England. Mass General is consistently recognized as a top hospital in the nation by U.S. News & World Report. The main hospital has more than 1000 beds with more than 47,000 admissions annually. Clinical activities in gastroenterology take place primarily in our new 18,700 square foot ambulatory clinic on the main campus, in our 17,000-square-foot endoscopy suite, and in an additional 13,000-square-foot endoscopy and clinic facility in Charles River Plaza, an adjacent outpatient building. Each year more than 30,000 endoscopic procedures are performed in our endoscopy units, ranging from diagnostic upper and lower studies (esophagogastroduodenoscopy and colonoscopy) to highly advanced diagnostic interventional and therapeutic modalities (endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, optical coherence tomography, photodynamic therapy, video capsule endoscopy of the small intestine), reflecting the role of the Mass General GI Division in the care of patients in the local community and as a major regional, national and international referral center for problems requiring consultation and endoscopic expertise.

Inpatient Experience

In their first year, fellows gain clinical experience as consultants in gastroenterology on the inpatient Podolsky Service (general GI). Their work is directly supervised by a GI teaching attending physician. Because Mass General is a leading tertiary care hospital in New England as well as a primary care facility for the Boston area, fellows gain in-depth exposure to both common and uncommon problems in gastroenterology. Within this service, one fellow focuses on the care of patients with inflammatory bowel disease. This work is directly supervised by a faculty member with a focus in IBD.

First-year fellows also rotate through a dedicated inpatient hepatology service, with specialized care for patients with and chronic liver disease. This service is staffed by leading hepatology attendings and offers fellows an opportunity to gain substantial experience in hepatology and liver transplantation.

Fellows also rotate through the interventional endoscopy service providing care to patients with complex pancreaticobiliary disease and those who require specialized advanced procedures. Fellows on this service have additional endoscopy time for both inpatient and outpatient procedures. Fellows work directly with our expert interventional endoscopists on this service.

Outpatient Experience

In their first year, fellows have a half-day ambulatory continuity clinic every week, rotating between general GI and liver disease-focused sessions. Fellows provide initial consultations as well as long-term longitudinal care for their own panel of patients with GI and liver problems. The GI Clinic is staffed by our seasoned general gastroenterology attendings while the Liver Clinic is staffed by attending hepatologists. Beyond the first year, fellows continue to have a half-day of ambulatory continuity clinic every week running longitudinally during their mentored research time. Specific clinic sessions focused on the care of patients with liver disease or inflammatory bowel disease are also offered by request. Each clinic session is staffed with a 1:1 or 1:2 ratio of attending to fellows to maximize teaching and supervision.

GI Endoscopy

Fellows receive instruction and experience in the techniques of esophagogastroduodenoscopy (control of bleeding, banding, dilation, percutaneous endoscopic gastrostomy), sigmoidoscopy and colonoscopy (polypectomy and control of bleeding). In the first year, fellows primarily provide endoscopy for the inpatients they evaluate in consultation. Beyond the first year, fellows also have a half-day endoscopy session each week, running longitudinally during their mentored research time. During this session, the fellow can expect to perform upper and lower endoscopies for outpatients and some inpatients.

GI Specialty Electives

In the second year of fellowship, fellows complete two months of clinical rotations in specialty areas in gastroenterology. These include electives in geriatric GI, women’s health, high risk cancer genetics, inflammatory bowel disease, cholestatic liver disease, motility, obesity medicine, interventional GI, GI oncology, GI radiology, GI pathology, video capsule endoscopy and nutrition. In the third year of fellowships, each fellow will complete a one-month elective block which is specially designed to meet their clinical interests.

Longitudinal Didactic Activities

Formal attending and teaching rounds take place daily. In addition, a series of didactic lectures are offered throughout the week. A partial listing of formal conferences includes:

GI Fellow Core Curriculum:

• Introduction to Clinical GI (twice-weekly in July and August)
• GI Grand Rounds (weekly)
• Clinical and Research Journal Club (weekly)
• Kelsey Rounds – multidisciplinary case conference (weekly)
• Tuesday Core Curriculum lectures and case conferences on topics including GI pathophysiology, nutrition, pancreaticobiliary, general GI, IBD and liver/transplant (weekly)
• IBD Clinical Forum (weekly)
• GI Motility Conference Series (~monthly)
• Pathology Slide Rounds (weekly)
• Monthly Master Clinician rounds – endoscopy tips and clinical case reviews
• Boston Interhospital GI Grand Rounds (bimonthly)

Additional Optional Conferences:

• Subspecialty conferences
• Multidisciplinary Liver-Biliary-Pancreas Rounds (weekly)
• Transplantation Rounds (weekly)
• NEJM Clinical Pathological Conference and Medical Grand Rounds
• Annual Postgraduate Course in Gastroenterology at Harvard

Evaluations

After each rotation, each faculty member evaluates each fellow according to the six ACGME core competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and system-based practice. Faculty members meet with fellows individually for verbal feedback and evaluation. For endoscopy, technical competence is evaluated through specifically designed evaluation forms, a simulator laboratory, and through a semiannual skills assessment program. Twice yearly, an aggregate evaluation of a fellow’s clinical progress is conducted through a clinical competency faculty committee.

Work Hours

We adhere fully to ACGME common program requirements for resident and fellow work hours. We conduct ongoing monitoring of work hours to ensure compliance.

Moonlighting

Fellows are not permitted to moonlight in their first year of fellowship. After the first year, moonlighting is permitted with approval of the Program Director if it does not interfere with the ability of the fellow to achieve the goals and objectives of the educational program. Moonlighting must also adhere to the ACGME common program requirements for fellow work hours.

Research

Overview

Fellows generally begin their mentored research after their clinical rotations in the second year.  Over the course of their research time, fellows continue to have one half-day of continuity clinic and one half-day per week of endoscopy and dedicate the remainder of their time to basic science, translational or clinical research. There is no routine call during research time. Some fellows elect to do additional endoscopy or clinical sessions to expand their clinical experience, but this is not required. We strive to protect the research experience.

Our research curriculum involves hands-on mentored research training that offers fellows a range of scientific approaches relevant to digestive disease-related research. All fellows are required to conduct at least 18 months of in-depth mentored research and scholarship in the clinical, translational or basic sciences relevant to gastroenterology. Research training may extend beyond 18 months to develop the necessary scientific foundation for successful, independent investigation.

Fellows have an opportunity to gain expertise in several disciplines as a foundation for digestive disease-related research, including but not limited to:

• Epidemiology and Biostatistics
• Outcomes Research/Decision Analysis
• Clinical and Intervention Trials
• Computational Biology
• Molecular and Cell Biology
• Systems Biology
• Immunology
• Developmental Biology
• Genetics
• Engineering

Facilities

Mass General has an annual research budget exceeding $550 million, the largest hospital-based research program in the United States. The Mass General research program spans more than 20 clinical departments and centers across the hospital. Beyond the main hospital, there is dedicated research space at a 400,000-square-foot facility at the Charlestown Navy Yard and a 260,000-square-foot facility at the Simches Research Building adjacent to the main hospital. The GI Division has nearly 2,000 square feet of space committed for research. Moreover, additional space is available through the expansion of research programs of the broader faculty of the training program, most notably in the context of new multidisciplinary research centers in Genetics, Integrative and Computational Biology, Systems Biology and Stem Cell/Regenerative medicine, the Clinical and Translational Epidemiology Unit (CTEU), and the Center for the Study of Inflammatory Bowel Disease (CSIBD). The CTEU, directed by our former Program Director Dr. Andrew Chan, is a research unit within the Mongan Institute in the Department of Medicine that is dedicated to the advancement of epidemiologic investigation for the translation of discoveries into clinical interventions in chronic disease. The CSIBD is an NIDDK Digestive Disease Center directed by Dr. Ramnik Xavier that promotes studies of basic mechanisms contributing to the pathogenesis of inflammatory bowel diseases. The Center has fostered research through a highly productive base of established and new investigators focused on molecular biology, immunology and epithelial cell biology.

Mentors

The GI Division has more than 50 faculty who may serve as potential mentors in clinical or basic research. Many faculty are leading investigators in a range of GI research areas.Learn more about our team.

Our research experience integrates basic and clinical research programs beyond gastroenterology, including faculty from several basic science departments (Biology, Molecular Biology, Genetics, Cell Biology, Systems Biology, Regenerative Medicine, Stem Cell Biology, Computational and Integrative Biology) as well as other laboratories in the Renal, Infectious Disease, Cardiac, Endocrinology and Pediatric GI Units of Mass General. Trainees interested in clinical, epidemiological and translational research have access to amazing programs at the Harvard Chan School of Public Health, the Broad Institute and the Harvard Catalyst program. This research base provides our trainees with diverse opportunities to apply cutting edge research methodology to digestive disease research. Our training program is uniquely able to provide trainees the strongest possible foundation on which to sustain a career of independent investigation.

Basic and Translational Science Training

Research training is enhanced by the active participation of fellows in a rich program of didactic courses, seminars and journal clubs as well as a wealth of optional seminar and training experiences available at Mass General, Harvard Medical School, Harvard Chan School of Public Health, Harvard University and MIT. The following are integral to the program for all fellows:

• Research Journal Club–Rigorous examination of basic and translational science articles and methodology led by senior research faculty
• Research Seminars–Seminars offered throughout the year in Mass General GI Division
• Work-in-Progress Seminars–Review, evaluate and critique the fellows’ research projects in a format that facilitates collaboration with other investigators
• GI Unit Research Retreat–Annual showcase of the GI Unit’s broad research activities comprising both poster and oral presentations. This provides helpful critiques and fosters collaboration
• Mass General Office of Research Career Development Series–Periodic seminars and workshops on grant writing, manuscript preparation, promotion criteria, and work-life balance

In addition to these series, numerous additional longitudinal seminars are sponsored by the various laboratory groups of Mass General and more broadly in the Boston biomedical community. Preceptors provide guidance in identifying the most worthwhile for a trainee; in a recent typical week 42 announced laboratory seminars were conducted at Mass General alone!

Clinical Research Training

Recognizing that fellows pursuing clinical investigation need a different foundation, we offer the following incredible programs to support the development of a clinical research career:

• Summer Program in Clinical Effectiveness–Summer course work at the Harvard Chan School of Public Health (HSPH) through its internationally regarded Program in Clinical Effectiveness. This is a nine-week didactic, hands-on curriculum in epidemiology, biostatistics, study design, decision analysis, and research ethics
• CATALYST program/Mass General Clinical Research Program–A wide array of didactic resources provided by Mass General Clinical Research Program and the Harvard CTSC (also referred to as the Harvard CATALYST Program). This includes seminars in clinical trial design, biostatistics, and bioethics. They also provide an intensive one-week course for translational investigators on genomics, proteomics, cohort assembly, repository and tissue banking, and bioinformatics
• GI Division/CTEU Clinical Research Interest Group–GI research fellows may attend conferences held jointly with fellows and faculty in the CTEU.  All faculty and fellows who engage in clinical research meet to discuss works in progress and present research findings

Apply

Thank you for your expressed interest in the Massachusetts General Hospital Gastroenterology Fellowship Program. We hope you find the information on this page helpful in learning about our program and in navigating the application process.

All applications to our program (and supporting documents) must be submitted via ERAS (Electronic Residency Application System). Note: written applications will not be accepted. Our Selection Committee will review your completed application and you will be notified of your interview status.

Requirements for All Applicants:

• Completed ERAS Fellowship Application
• 3 letters of recommendation 
• Medical School Transcript
• Personal Statement
• Curriculum Vitae
• Photograph

Additional Requirements for Graduates of International Medical Schools (Except Canadian):

• 6-12 months of US-based hands on clinical experience
• Three letters of recommendation from American Medical School faculty who are acquainted with your clinical skills, either because they have worked with you prior to your arrival in the United States or because they have worked with you in an internship, externship, clerkship, 5th pathway or equivalent experience.
• Evidence of having passed the USMLE Step 1 and Step 2 exams
• ECFMG Certification
• Massachusetts medical license or Applicant Evaluation Status letter issued by the Medical Board of Massachusetts
• Appropriate VISA, if applicable (J-1 visas are acceptable; H-1B visa applicants considered on rare occasions)