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).
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.
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).
Interdisciplinary Team: The resident works well in a team, shares work, and interacts with allied healthcare providers and other consultants effectively.
Efficiency: The resident prioritizes tasks and manages time effectively.
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.
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.
Scope of Practice: The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.
We use the following In-Training Evaluation Report (ITER):
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
Dr. Mahmod Mohamed
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).
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.
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).
Interdisciplinary Team: The resident works well in a team, shares work, and interacts with allied healthcare providers and other consultants effectively.
Efficiency: The resident prioritizes tasks and manages time effectively.
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.
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.
Scope of Practice: The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.
We use the following In-Training Evaluation Report (ITER):
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
Dr. Mahmod Mohamed