Surgery Resident Rotation

The UCSF East Bay Surgery Rotation is designed to provide surgical residents with an experience in the evaluation and care of patients with GI disorders . . . from a gastroenterologist's perspective. Although the primary focus of this rotation is to develop a foundational education in GI endoscopy, surgery residents will also gain experience in both the clinic and inpatient setting. 

Surgery residents from UCSF East Bay Surgery Residency program will rotate on the GI rotation for a 4 week block. During this time they will learn and perform the component elements (i.e. Pre-Op H&Ps, procedure performance, technical support) related to GI endoscopy under the supervision of the GI Attending and the Endoscopy Staff. They will act as the liaison between the GI service and the surgical service on surgical patients being followed by the GI consult service, and they will attend related educational conferences. 

If you have been APPROVED and SCHEDULED to rotate on the Surgery Resident Rotation, please fill out the "GI Trainee Intake Form" using this link: https://goo.gl/forms/qLFqVfTz27npPVux1

• Attending Faculty: Our five full-time faculty (Drs. Benny Liu, Christina Chou, Jennifer Lai, Aaron Lee, and Ayesha Zahiruddin) and eleven of our part-time faculty staff this rotation. Their general role is to provide daily teaching, clinical oversight, and mentorship to the trainees on this rotation. Our full-time faculty staff Endoscopy Room 2 every Monday to Friday. 

• UCSF East Bay Surgery Resident: UCSF East Bay Surgery Residents rotate for approximately 8 months per year. Their general role is to learn the fundamentals of gastrointestinal endoscopy and to facilitate the flow of the outpatient endoscopy unit. 

• Endoscopy Staff: Our nurses, GI techs, and registration staff are the core engine behind the Highland Endoscopy Unit. On this rotation, the Surgery Resident will interface with them on a minute to minute basis.

• Daily endoscopy

• Videos on the Education Resources page

1) Describe the operation and features of the diagnostic and therapeutic upper endoscopes, colonoscopes and pediatric scopes.

2) Surgery resident is able to connect the endoscope to the processor to ensure its safe and proper use.

3) Describe the risks benefits and alternatives of upper endoscopy and colonoscopy.

4) Describe the proper indications for upper endoscopy and colonoscopy

5) Describe the mechanism of action and risks of commonly administered sedatives (and their reversal agents) for endoscopic procedures.

6) Describe the referral process for ambulatory GI endoscopy at Highland Hospital.

 Upper Endoscopy

7) Accurately assess the patient’s ASA class and monitor the patient’s level of consciousness throughout the procedure to maintain a safe and effective level of sedation.

8) Safely and routinely intubate the esophagus

9) Perform a controlled and thorough evaluation of the body and antrum of the stomach

10) Perform a complete evaluation of the cardia, fundus and incisura of the stomach under retroflexion

11) Intubate the duodenum routinely

12) Completely evaluate the duodenum to the 2nd and 3rd portions

13) Describe the indications for biopsy on upper endoscopy

14) Complete targeted biopsies on upper endoscopy

15) Describe endoscopic findings to patients and prescribe proper follow up

 Colonoscopy

16) Accurately assess the patient’s ASA class and monitor the patient’s level of consciousness throughout the procedure to maintain a safe and effective level of sedation.

17) Perform a complete digital rectal exam and safely insert the colonoscope into the rectum

18) Skillfully remove liquid contents from the colon in order to ensure proper mucosal visualization

19) Intubate the sigmoid colon routinely

20) Intubate the descending colon routinely

21) Intubate the transverse colon

22) Intubate the ascending colon

23) Intubate the cecum

24) Examine the rectum under retroflexion

25) Know the indications for colon biopsies

26) Recognize the endoscopic features of hyperplastic and adenomatous polyps

27) Describe the safe and effective technique of snare polypectomy- including proper equipment choice and management of the endoscopic team required for independent practice

28) Describe the rate of post polypectomy bleeding and its management

29) Describe colonoscopic findings to patients and prescribe proper follow up

• Get to know the trainees on the the GI Consult Rotation, the endoscopy staff, and the faculty.

• Provide primary responsibility for pre-op orders, pre-endoscopic H&Ps, consents, and post-op orders  during the day.

• Our Division strives to help the surgical resident fulfill their residency requirement of 50 colonoscopies and 35 EGDs. However, because of the learning curve and the need to maintain endoscopic flow, the likelihood of completing all the required procedures during this one month rotation is unlikely.

• Expect no more than 4 'hands-on' endoscopic procedures in a day (we have to keep the procedural flow going).

• Give a 15-minute GI/Liver Conference talk on the GI/Surgery topic of your choice during your rotation.