Gastroenterology Residency Programme

The programme is design ed to develop academically oriented gastroenterologists who would serve as specialists in the area. The training is recognised by the College of Physicians and Surgeons, Pakistan .

Objective

At the completion of training, the trainee will be able to diagnose and treat commonly encountered gastrointestinal disorders in a cost-effective manner. S/he will be experienced in history taking, physical examination and judicious use of laboratory investigations and their interpretation. S/he will have knowledge of applied basic sciences (pathophysiology, pharmacology, molecular biology, etc), pertinent to gastroenterology as well as clinical gastroenterology, hepatology and enteral and parenteral nutrition. The resident will be on-call in rotation with other residents to attend to hospitalised patients, GI emergencies, endoscopies and outpatients. After completing the training, s/he is expected to be able to function as an independent consultant in gastroenterology in Pakistan . S/he will have adequate experience in applied basic sciences, clinical gastroenterology and research. S/he will be able to teach gastroenterology to medical students, residents, subspecialty trainees and practicing physicians in the community.

Duration of training

The duration of the training is three years.

Eligibility

• MBBS or equivalent degree approved by PM&DC
• One year of house job or internship, of which six months should be in Medicine and allied and six months in Surgery and allied disciplines
• FCPS Part I in Medicine and allied
• FCPS Part II or equivalent diploma (e.g. MRCP or Diplomate ABIM) OR two years approved training in Internal Medicine and must have cleared Intermediate Module (IM) at the time of interview.
• Candidates with FCPS Part II/ MRCP/ DABIM will be preferred.
• The selection process is based purely on merit

Scope and content

Skills and clinical training

The trainee will be able to perform gastrointestinal endoscopic procedures such as proctosigmodoscopy with biopsy, colonoscopy and esophagogastroduodenoscopy with biopsy.

In addition, the trainee will be proficient in diagnostic and therapeutic upper and lower GI endoscopies, including dilatations and polypectomies, etc. S/he will be competent to perform diagnostic ERCP. The GI section is equipped with state-of-the-art 24 hours pH monitoring, esophageal / rectal manometry and endoscopic ultrasonography.

The trainee will be provided adequate experience in therapeutic pancreatobiliary endoscopic procedures. He/she will be able to perform simple and uncomplicated procedures, but the proficiency in performing these procedures increases with experience and it is expected that the trainee will perform these procedures keeping his/her limitations in mind after completion of the third year of training. The resident will be able to supervise the residents and junior trainees.

Skills

Year 1	Year 2	Year 3
a. EGD diagnostic with biopsy, Sigmoidoscopy with biopsy.	a. EGD therapeutic: Bands, sclerotherapy for varices and Ulcers, heater probe.	a. EGD therapeutic dilatation and stenting
b. Liver biopsy	b. Colonoscopy diagnostic with biopsy pH monitoring, Manometry	b. Colonscopy therapeutic polypectomy sclerotherapy ERCP Diagnostic

Didactics

The resident will prepare, present and discuss cases in teaching conferences such as medical grand rounds, gastroenterology conferences and mortality and morbidity conferences. He will be taught at the bedside and also in the form of formal lectures and seminars.

In addition to daily teaching rounds and clinics, medical grand rounds are held once a week and these include GI topics in which GI trainees participate actively. Regular teaching sessions are held in Internal Medicine on Wednesdays; these also include GI topics. GI residents are encouraged to participate in them. These teaching sessions alternate with M&M conference and clinical practice guidelines.

The trainee is expected to present in weekly GI Audit and Radiology Rounds (on Fridays), GI case presentation and review of literature, weekly journal club, and Histopathology Conference and also to attend the Professor's Lecture.

GI trainees undergo mandatory rotation in Radiology and Histopathology during the second year of GI residency.

Research

The resident will develop skills such as literature search, including computer-assisted literature search. At the completion of the training, he will have adequate clinical and/or basic research experience under the supervision of a faculty member. With this background, the resident will be able to carry out clinical research independently after the completion of his/her training.

Gastroenterology section has been quite active in clinical and basic research. This can be judged by the number and quality of research papers presented at national and international meetings and published in referred medical journals by the faculty members and trainees of Gastroenterology section of AKU and AKUH.

Year 1	Year 2	Year 3
a. Retrospective analysis/audit: ONE	a. Retrospective analysis/audit: ONE	a. Retrospective analysis/audit: ONE
b. Prospective study design ing and collection of data. Apply for URC grant	b. Prospective study collection of data and analysis on the basis of prospective study.	b. Presentation of results and writing a paper
	c. Review article	c. Review article

Evaluation

The trainees will be in almost daily contact with one or more faculty members; the faculty member will have opportunity to discuss with the residents their progress in the Programme on a day-to-day basis. The faculty members will give regular feedback to the residents and to the programme director/coordinator.

The programme director or coordinator will discuss the performance with each trainee every six months. When necessary, the programme director/coordinator will discuss the performance of the trainee with him/her more frequently than the above schedule.

The GI section has nine full-time faculty members. This permits close monitoring of the residents and close interaction with the faculty members. Consistent inability on part of the trainee to meet the required standard would lead to discontinuation from the training programme.

Educational responsibilities

The GI resident will supervise and teach medical students and residents on clinic and hospitalised patients and consultations. He/she will mediate (along with faculty members when necessary), in cases where confusion or conflict exists in patient care. He/she will help medical students or house staff coordinate with other departments (Radiology, Surgery, Pat hology, Anaesthesia and Blood Bank, etc) when interventional (GI) procedures are being performed. He/she will also help the students and house staff in the coordination of multidisciplinary teaching exercises.

Scholarly/Research Component of Residency-Presentations at national, international meetings, publications, etc are encouraged.

Attitude and behaviour (e.g. affective skills)

Due attention will be given to the development of positive understanding, sympathetic and appropriate attitude and behaviour. Counselling will be provided where necessary.

External rotations

This activity will be encouraged if another institution has something worthwhile to add to the training of AKU residents.

Positions available

Six trainees in Gastroenterology (two-three residents in each year in a three-year programme).

Administrative set-up

There are eight full-time faculty members in the Gastroenterology Section. In addition to clinical and teaching responsibilities, these faculty members have administrative responsibilities.

In addition to full-time faculty members, there are ten honorary faculty members, including one paediatric gastroenterologist in this section.

Full-time faculty:

Professors

Dr S.M. Wasim Jafri
MBBS Karachi ; FRCP London, Edinburgh & Glasgow; FACP; FACG

Dr Saeed Sadiq Hamid
MBBS Punjab; FRCP London and Ireland; FACP; FACG

Dr Hasnain Ail Shah
MBBS Punjab: MD, FRCP (Edinburgh); FACG

Associate Professor

Dr Shahab Abid
MBBS (Dow); FCPS Pakistan ; FRCP (Edinburgh); FACG
Programme Director

Assistant Professors

Dr Javed Yakoob
MBBS Karachi ; PhD

Dr Khalid Mumtaz
MBBS Karachi ; FCPS (Med); FCPS (GI)

Dr Rustam Khan
MBBS Karachi; FCPS (Med); FCPS (GI)

Dr Mohammad Salih
MBBS Peshawar ; FCPS (Med); FCPS (GI)
Programme Coordinator

Program Coordinators

Dr Mohammad Salih
MBBS Peshawar; FCPS (Med); FCPS (GI)

Dr Amna Subhan
MBBS Karachi; FCPS (Med); FCPS (GI)