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Away rotations for subspecialty training
THE FELLOWS’ CORNER
Away rotations for subspecialty training Often our own fellowship programs may not be able to provide us with the depth of training and experience in certain subspecialties of gastroenterology that we desire. For example, your program may be very strong in training you in liver disease but unable to provide you with a wellrounded and adequate experience in motility. This may be a problem if you have a strong interest in practicing GI motility in the future. Doing an away rotation, however, may give you the experience you need to take your subspecialty training to the next level. This month, Dr Alissa Quin, senior fellow at the Naval Medical Center in San Diego, California, discusses her views on the benefits of doing a rotation outside your own institution. Jonathan M. Buscaglia, MD Fellows’ Corner Editor Therapeutic Endoscopy Fellow Johns Hopkins University School of Medicine Johns Hopkins Hospital Baltimore, Maryland, USA The luxury of an additional year of subspecialty training is not always an option for fellows. Family, financial, and military commitments are but a few of the limiting factors in extending our training. For fellows with a program that emphasizes personal and professional development, there may be freedom to customize training to individual interests while meeting the requirements of the Accreditation Council for Graduate Medical Education. With creativity and planning, we can enhance our careers by scheduling outside rotations at centers of excellence in our areas of interest. Alternative options for training are not always readily apparent. For example, in the area of inflammatory bowel disease (IBD), one resource available is the new Crohn’s and Colitis Foundation Fellowship Training Program. This program annually sponsors a month of training in 1 of 6 IBD centers of excellence for 12 fellows. This is a resource that is not readily apparent to most fellows when contemplating more specialized training in IBD. Furthermore, opportunities to do more advanced training may be discovered during medical conferences and meetings such as Digestive Disease Week or the American Society for Gastrointestinal
Endoscopy First Year Fellows’ Endoscopy Course. Here, fellows can establish mentoring relationships with leaders in their field of interest and thus open windows of opportunity for more specialized training. Many of these mentors may be willing to accept a fellow for a limited training period. To do this, however, it is important to define a specific area of interest as early as possible. Once you define your area of concentration, finding a university or hospital is the next step in the long process of organizing a productive away rotation. Issues such as medical licensure (if rotating out of state), malpractice insurance, medical insurance coverage, competencies, health
Key points d
d
d
Subspecialty training is not restricted to an additional postgraduate year of training Optimal experiences require significant advanced planning and research Training outside your fellowship program builds a foundation for future work
Copyright ª 2007 by the American Society for Gastrointestinal Endoscopy 0016-5107/$32.00 doi:10.1016/j.gie.2006.09.017
screening, Health Insurance Portability and Accountability Act (HIPAA) training, and institutional expectations are frequently communicated in a memorandum of understanding between both programs. Letters of good standing from a program director, letters of recommendation, and documentation of education are often required. A minimum of 90 days is required to complete this process. The timing of the rotation should be optimized as well. For example, summer rotations may be diluted by faculty vacations and the influx of new trainees. This often results in postponed academic conferences, such as grand rounds and subspecialty lecture series. Therefore, explore the weekly schedule at the institution to create a combined inpatient, outpatient, and consultative experience. Logistical issues of concern also include funding (often none), housing (friends or family?), transportation, hospital, and computer access. Once the rotation begins, several details can enhance the experience. Become familiar with and consider participating in clinical and basic science research at the host institution. If allowed, participating in the call schedule and
www.giejournal.org
Volume 65, No. 2 : 2007 GASTROINTESTINAL ENDOSCOPY 285
Away rotations for subspecialty training
Quin
carrying your own clinic may establish more individual development. Involving yourself in the daily activities of the host program allows you to become an asset to the other fellows. Yet, it is important to remember your role as a guest. Relationships developed during an away rotation may lead to future collaboration, employment opportunities, research, and friendships. Ideally, subspecialty training can be obtained through an additional year of training. In the area of IBD, for example, these programs are offered at the Mayo Clinic, Johns Hopkins University, University of Chicago, and Cedars-Sinai Hospital, just to name a few. If this is not an option, be creative and proactive to guide your career in the direction you want it to go. Doing an away rotation at another institution is a perfect opportunity to gain subspecialty
experience while establishing new professional and personal relationships. If you are not sure whether another institution offers such a rotation .it never hurts to ask!
286 GASTROINTESTINAL ENDOSCOPY Volume 65, No. 2 : 2007
www.giejournal.org
DISCLOSURE None of the authors of this month’s issue of the Fellows’ Corner have any disclosures to state. Alissa M. Quin, MD Clinical Fellow Department of Gastroenterology Naval Medical Center San Diego San Diego, California, USA
Away rotations for subspecialty training Often our own fellowship programs may not be able to provide us with the depth of training and experience in certain subspecialties of gastroenterology that we desire. For example, your program may be very strong in training you in liver disease but unable to provide you with a wellrounded and adequate experience in motility. This may be a problem if you have a strong interest in practicing GI motility in the future. Doing an away rotation, however, may give you the experience you need to take your subspecialty training to the next level. This month, Dr Alissa Quin, senior fellow at the Naval Medical Center in San Diego, California, discusses her views on the benefits of doing a rotation outside your own institution. Jonathan M. Buscaglia, MD Fellows’ Corner Editor Therapeutic Endoscopy Fellow Johns Hopkins University School of Medicine Johns Hopkins Hospital Baltimore, Maryland, USA The luxury of an additional year of subspecialty training is not always an option for fellows. Family, financial, and military commitments are but a few of the limiting factors in extending our training. For fellows with a program that emphasizes personal and professional development, there may be freedom to customize training to individual interests while meeting the requirements of the Accreditation Council for Graduate Medical Education. With creativity and planning, we can enhance our careers by scheduling outside rotations at centers of excellence in our areas of interest. Alternative options for training are not always readily apparent. For example, in the area of inflammatory bowel disease (IBD), one resource available is the new Crohn’s and Colitis Foundation Fellowship Training Program. This program annually sponsors a month of training in 1 of 6 IBD centers of excellence for 12 fellows. This is a resource that is not readily apparent to most fellows when contemplating more specialized training in IBD. Furthermore, opportunities to do more advanced training may be discovered during medical conferences and meetings such as Digestive Disease Week or the American Society for Gastrointestinal
Endoscopy First Year Fellows’ Endoscopy Course. Here, fellows can establish mentoring relationships with leaders in their field of interest and thus open windows of opportunity for more specialized training. Many of these mentors may be willing to accept a fellow for a limited training period. To do this, however, it is important to define a specific area of interest as early as possible. Once you define your area of concentration, finding a university or hospital is the next step in the long process of organizing a productive away rotation. Issues such as medical licensure (if rotating out of state), malpractice insurance, medical insurance coverage, competencies, health
Key points d
d
d
Subspecialty training is not restricted to an additional postgraduate year of training Optimal experiences require significant advanced planning and research Training outside your fellowship program builds a foundation for future work
Copyright ª 2007 by the American Society for Gastrointestinal Endoscopy 0016-5107/$32.00 doi:10.1016/j.gie.2006.09.017
screening, Health Insurance Portability and Accountability Act (HIPAA) training, and institutional expectations are frequently communicated in a memorandum of understanding between both programs. Letters of good standing from a program director, letters of recommendation, and documentation of education are often required. A minimum of 90 days is required to complete this process. The timing of the rotation should be optimized as well. For example, summer rotations may be diluted by faculty vacations and the influx of new trainees. This often results in postponed academic conferences, such as grand rounds and subspecialty lecture series. Therefore, explore the weekly schedule at the institution to create a combined inpatient, outpatient, and consultative experience. Logistical issues of concern also include funding (often none), housing (friends or family?), transportation, hospital, and computer access. Once the rotation begins, several details can enhance the experience. Become familiar with and consider participating in clinical and basic science research at the host institution. If allowed, participating in the call schedule and
www.giejournal.org
Volume 65, No. 2 : 2007 GASTROINTESTINAL ENDOSCOPY 285
Away rotations for subspecialty training
Quin
carrying your own clinic may establish more individual development. Involving yourself in the daily activities of the host program allows you to become an asset to the other fellows. Yet, it is important to remember your role as a guest. Relationships developed during an away rotation may lead to future collaboration, employment opportunities, research, and friendships. Ideally, subspecialty training can be obtained through an additional year of training. In the area of IBD, for example, these programs are offered at the Mayo Clinic, Johns Hopkins University, University of Chicago, and Cedars-Sinai Hospital, just to name a few. If this is not an option, be creative and proactive to guide your career in the direction you want it to go. Doing an away rotation at another institution is a perfect opportunity to gain subspecialty
experience while establishing new professional and personal relationships. If you are not sure whether another institution offers such a rotation .it never hurts to ask!
286 GASTROINTESTINAL ENDOSCOPY Volume 65, No. 2 : 2007
www.giejournal.org
DISCLOSURE None of the authors of this month’s issue of the Fellows’ Corner have any disclosures to state. Alissa M. Quin, MD Clinical Fellow Department of Gastroenterology Naval Medical Center San Diego San Diego, California, USA