Gastroenterology

During this rotation, residents should develop an approach to the following conditions:

• Abdominal exam, physical exam & clinical signs of cirrhosis (including jaundice and extra-hepatic signs of liver disease)

• Dysphagia, GERD & Barrett's

• Dysmotility disorders of esophagus (including non-cardiac chest pain)

• NSAIDs and the GI tract

• Abnormal liver function tests

• Acute liver failure

• Cirrhosis-alcohol, PBC, PSC, autoimmune, genetic liver disease

• Management of complications of cirrhosis: Portal hypertension, varices, ascites, and hepatic encephalopathy

• Ischemic bowel disease

• Non-variceal upper & lower GI bleeding and chronic iron deficiency

• Gallstones, pancreatitis, pancreatic cancer

• Viral hepatitis, diagnosis and treatment (use of antiviral therapies)

• Weight loss, anorexia, nausea and vomiting, including malabsorption

• Irritable bowel syndrome, constipation/diarrhea

• IBD (Crohn’s disease, ulcerative colitis and microscopic colitis), including steroid and immunosuppressive use in gastroenterology

• Gallstones, pancreatitis, pancreatic cancer

• Acute and chronic abdominal pain

• Diverticulosis

• Liver masses

• Nutritional assessment and management, including TPN

• Management of upper GI bleed

• Management of lower GI bleed

Updated August 2025.

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level (See Program Information - Overall Goals and Objectives). 

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential diagnosis.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and verbally presents cases for new admissions, progress notes, handover of care, and discharge summaries (succinctly organized, prioritized, summarized).

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with allied healthcare providers and other consultants effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident advocates for patients by obtaining/expediting investigations, consults, or access to other resources during inpatient care or during transition to the outpatient setting.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment

We use the following In-Training Evaluation Report (ITER):

• GI Wards

Entrustable Professional Activities (EPAs)

This rotation may be done during Transition to Discipline or Foundations. If done during Transition to Discipline (July and August of R1) this is an ideal learning environment for the following EPAs:

• TD1: Performing histories and physical exams, documenting and presenting findings, across clinical settings for initial and subsequent care

• TD2: Identifying and assessing unstable patients, providing initial management, and obtaining help

• TD3: Performing the basic procedures of internal medicine

If done during Foundations (September and onward during R1) this is an ideal learning environment for the following EPAs:

• FD1: Assessing, diagnosing, and initiating management for patients with common acute medical presentations in acute care settings

• FD2: Managing patients admitted to acute care settings with common medical problems and advancing their care plans

• FD3: Consulting specialists and other health professionals, synthesizing recommendations, and integrating these into the care plan

• FD4: Formulating, communicating, and implementing discharge plans for patients with common medical conditions from acute care settings

• FD5: Assessing and providing targeted treatment for unstable patients and consulting as needed

• FD6: Discussing and establishing patients’ goals of care

• FD7: Identifying personal learning needs while caring for patients and addressing those needs 

In addition to the above, residents can also be observed performing a paracentesis with assessment and logging part of:

• CD5: Performing the procedures of Internal Medicine

Rotation Supervisor

Dr. Mahmod Mohamed

mahmod1@ualberta.ca

Medical Education Program Coordinator

medndgi@ualberta.ca

During this rotation, residents should develop an approach to the following:

• Approach to overt GI bleed 

• Approach to dysphagia, including esophageal motility disorders and eosinophilic esophagitis

• Approach to functional GI disorders, including dyspepsia and irritable bowel syndrome

• Peptic ulcer disease, H pylori, NSAIDs and GI tract 

• Approach to diarrhea

• Care of IBD patients: diagnosis, induction and maintenance therapy

• Gallstones and complications, including cholecystitis, choledocholithiasis, cholangitis and pancreatitis 

• Acute and chronic pancreatitis, including complications

• Approach to abnormal liver function tests 

• Alcohol and drug induced liver disease, including alcoholic hepatitis

• Viral hepatitis: diagnosis and treatment, including complications

• Approach to acute liver failure 

• Approach to obscure GI bleed

• GERD (including extraesophageal manifestations of GERD), Barrett’s esophagus, infectious and pill induced esophagitis

• Liver transplant assessment and follow up care 

• Complications of chronic liver disease, including portal hypertension, SBP, hepatorenal syndrome and HCC 

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level (See Program Information - Overall Goals and Objectives). 

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential diagnosis.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and verbally presents cases for new admissions, progress notes, handover of care, and discharge summaries (succinctly organized, prioritized, summarized).

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with allied healthcare providers and other consultants effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident advocates for patients by obtaining/expediting investigations, consults, or access to other resources during inpatient care or during transition to the outpatient setting.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Assessment 

We use the following In-Training Evaluation Report (ITER):

• GI Consults 

Entrustable Professional Activities (EPAs)

This rotation is done during Core of the Discipline and is an ideal learning environment for the following EPAs:

• CD1: Assessing, diagnosing and managing patients with complex or atypical acute medical presentations

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

• CD5: Performing the procedures of Internal Medicine

  • Paracentesis

• CD7: Discussing serious and/or complex aspects of care with patients, families, and caregivers

  • Breaking Bad News

• CD8: Caring for patients who have experienced a patient safety incident (adverse event)

• CD10: Implementing health promotion strategies in patients with or at risk for disease

  • E.g. Colon cancer screening, Barrett's screening, Alcohol use

Rotation Supervisor

Dr. Mahmod Mohamed

mahmod1@ualberta.ca

Medical Education Program Coordinator

medndgi@ualberta.ca