The Gastroenterology float rotation is rarely a first-year rotation. Fellows have the same lines of responsibility as described for any rotation they are covering. While they are at Rady Children's Hospital-San Diego on the Pediatric GI rotation, they work closely with the attending physician in a much more observational role. Occasionally, first-year fellows are assigned this rotation. First-year fellows are expected to be closely supervised by attending physicians in terms of inpatient gastroenterology and hepatology consults, presentations, and endoscopic procedures. Fellows are learning how to conduct inpatient GI consultations efficiently and how to perform basic EGD and colonoscopies. They are starting to learn therapeutic procedures (i.e., not actively bleeding variceal and non-variceal hemostasis and non-complex polypectomy). They usually do not participate in advanced procedures such as ERCP.
This rotation is predominantly for second- and third-year fellows. Fellows are expected to need less supervision by the attending physician. Second- and third-year fellows are expected to provide more complete GI consultations, to run the service with supervision by the attending physician, to be comfortable performing basic EGD and colonoscopies, and to be comfortable performing therapeutic procedures (i.e., actively bleeding variceal and non-variceal hemostasis and complex polypectomy). They may participate in advanced procedures such as ERCP.
On the weeks when fellows are not covering an inpatient rotation, they will rotate through subspecialty clinics such as capsule endoscopy, advanced endoscopy, motility disorders clinic, pediatric general GI clinic, pediatric GI endoscopy, and hereditary colon cancer syndrome.