The Scripps Clinic and Scripps Green Hospital Gastroenterology and Hepatology Fellowship Program started in 1959 and is the oldest in San Diego. It is a three-year ACGME-accredited training program, designed to provide clinical expertise in gastroenterology and hepatology. The curriculum is structured to provide the full spectrum of educational experiences. After completing the program, fellows are fully prepared for board certification in both gastroenterology and transplant hepatology.
During clinical rotations, fellows work closely with dedicated teaching faculty to provide training in all aspects of GI and hepatology. Most inpatient and outpatient rotations are at Scripps Green Hospital, but fellows spend at least one month per year at Scripps La Jolla and Scripps Mercy, providing exposure to diverse patient populations and disease pathology. The lecture series features expert teaching in GI and liver histopathology, radiology, in addition to the full spectrum of GI and hepatology. Fellows maintain a weekly continuity clinic with their own panel of patients supported by a dedicated teaching faculty. Research and scholarly opportunities are provided by research mentors, protected research time, and access to the Scripps Research Institute (TSRI).
Sample of clinical rotations:
- Advanced endoscopy
- Inflammatory bowel disease (IBD)
- Inpatient GI
- Inpatient hepatology
- Outpatient GI/research
- Outpatient hepatology/transplant
- Surgery, radiology, nutrition and pathology
- Electives (available in the second and third years)
The Scripps liver transplantation program is thriving with one of the highest volumes and best outcomes in California. The program recently hired three additional transplant hepatologists (total of five) that will be involved in trainee education, and is in the process of applying for the Transplant Hepatology Track to allow fellows to be board eligible for both GI and transplant hepatology at the end of three years. Our hepatitis study group is one of the largest referral centers for chronic viral hepatitis treatment in the United States. We collaborate with The Scripps Research Institute and many other centers around the country. Our members present and publish research regularly and lecture nationally and internationally.
Scripps Clinic has a nationally recognized expertise in the treatment of GI and liver malignancies and is now affiliated with MD Anderson Cancer Center as of October 2017. The Scripps Clinic Esophageal Center is a site of excellence with a unique focus on Barrett’s and early esophageal cancer providing ablative services by radiofrequency ablation and cryoablation. We have created a large multi-disciplinary pancreaticobiliary cancer team that participates in the national PanCan network. This team of gastroenterologists, oncologists, and surgeons provides state-of-the-art endoscopic and oncologic treatment of pancreatic and biliary cancers. We have access to multiple leading-edge protocols and are having great success in treating our patients. We have expanded our treatment of liver cancers providing resection, transplant and advanced radiation treatment to our patients. Our colorectal service provides state-of-the-art care from endoscopic diagnosis and treatment to surgical resection using minimally invasive techniques and endoscopic submucosal dissection (ESD).
Fellows have many opportunities to participate in ongoing research projects. All trainees must develop their own research project and are expected to publish in a peer-reviewed journal. Fellows are encouraged to participate in local, regional and national professional organizations. Many trainees have presented abstracts that have been honored at the national level. The Division is active in clinical research in viral hepatitis diagnosis and treatment, cirrhosis and cholestatic diseases liver (PBC, PSC), colon cancer detection, organ transplantation, circulating tumor cells in pancreatic cancer, hepatocellar carcinoma, therapeutic procedures in Barrett’s esophagus, including radiofrequency ablation, cryoablation and endoscopic mucosal resection, and inflammatory bowel disease, including Crohn’s disease and ulcerative colitis.
The Division of Gastroenterology and Hepatology is exceptionally productive and fellows have access to a wealth of endoscopic training. Our fellows perform an average of at least 400 procedures during their first year and over 1,000 procedures before graduation. During an average year, the Division performs approximately:
- 6,000 colonoscopies (33% polypectomies)
- 2,000 esophagogastroduodenoscopies (EGDs)
- 300 endoscopic ultrasounds
- 250 ERCPs
- 100 liver biopsies
The advanced endoscopy group performs more than 600 procedures each year, including:
- Anorectal motility testing
- Endoscopic ultrasonography (EUS) with fine-needle aspiration
- Esophageal motility testing
- Single-balloon enteroscopy
- Choledochoscopy (Spyglass)
- Capsule endoscopy
- Radiofrequency ablation
- Cryotherapy ablation
- EUS guided fiducial placement
- Enteral stenting techniques
- Per-oral endoscopic myotomy (POEM)
- Endoscopic submucosal dissection (ESD)
Fellows have the opportunity to gain experience in these procedures as early as their second year.