GI

Rotation Director: Mikelle Bassett, MD

Email: bassett@ohsu.edu

Office: CDRC 4228

Pager: 10475

Overview:

Residents spend time with inpatient and/or outpatient services based on future educational goals after discussion with the rotation director.

Rotation goals and objectives:

• Teach residents about the clinical presentation, differential diagnosis, management, and pathogenesis of core gastrointestinal, liver, and nutritional problems in children and infants.

• The resident will be able to evaluate growth and nutritional status of inpatients and clinic patients, the differential diagnosis of deviations from optimum growth and nutrition, and interventions to correct them.

Prior to the start of the rotation:

• Please email Dr Bassett before the first day of your rotation to schedule a meeting on the first day

• Review inpatient and outpatient opportunities below, and then be prepared to talk about preferences with Dr Bassett

First day of the rotation:

• Meet with Dr Bassett about determining outpatient vs inpatient delineation.

Resident Expectations:

• Active and contributing member to inpatient/outpatient team. This could include pre-rounding and/or pre-clinic review of patient charts, asking pertinent questions during rounds, and taking thorough histories regardless of setting

• Completing all daily clinic and consult notes on same day

• Timely arrival and appropriate departure times

• Continuity clinic ½ day per week

General Schedule:

• Overall residents should expect to work 2 weeks in outpatient and 1 week in inpatient. If there is a vacation during the block, expect 2 weeks of outpatient unless there are extenuating circumstances

A. Inpatient experience opportunities:

• See new consults and follow old consults for continuity. Must arrive in time to preround on all active consults (usually 0730-0800)

• Attend daily GI rounds for exposure to primary GI service (Coast workroom at 0900)

• Attend procedures for inpatients (occur in GI endoscopy suite 7 and 8 near ECHO lab). Note, some of these occur prior to rounds

• Teaching/discussion with inpatient attending on 1-2 topics/week

• 1-2 days with inpatient GI dietitian

• May leave in afternoon after all, especially new, consults have been seen, assessed, and discussed

B. Outpatient experience opportunities

• See NEW patients in GI clinic. Residents are encouraged to look at scheduled patients that day and select ahead of time which patients you would like to see.

• If GI provider has an interesting return patient they will include you for educational reasons, but you are not expected to write the clinic note for return patients.

• Our NP’s (Janice Tendler and Suzanne Kavett) see the vast majority of our constipation patients. If you are planning on going into outpatient primary care, please consider spending some time shadowing them.

• Arrange time with dietitians for new consults (e.g. FTT, obesity, celiac)

• Observe procedures (especially for a patient you saw in clinic)

Specific outpatient clinics

• Monday PM: Digestive-Aero Clinic (DAC) on 1st and 3rd Monday afternoons with pulmonary, ENT, and Dr Eroglu.

• Tuesday AM: Combined GI/CF clinic with Dr Garcia.

• Tuesday 1pm: outpatient TPN rounds

• Wednesday PM: Liver clinic with Dr Eroglu

Arrive: Clinic starts at 0900

Depart: At conclusion of clinic in afternoon.

C. Conference

• You should ALWAYS attend grand rounds, morning report, noon conference and Friday Forum

If you are going to be absent for all or part of a day:

Please email Mikelle Bassett, attending of record (if on service), chief on call, and Michael Grubbs if you are unable to make it to work. Please also contact chief on call after 0700 and, if on inpatient, attending by pager after 0800 to inform them of you absence. A verbal exchange must happen with the chief on call.

Resident Resources, Helpful Tips, and Further Readings:

1) Rotation specific readings, handouts, etc is available on BOX

2) ABP Content for Gastroenterology

A. Clinical presentation (eg, abdominal pain, nausea/vomiting, diarrhea, constipation)

B. Diseases, disorders, and conditions

• Esophagus

• Stomach

• Proximal bowel

• Liver

• Pancreas

• Distal bowel

• Rectal-anal

• Celiac disease

• Cystic fibrosis