thing to consider in your final year of gi...

Thi t C id i YThi t C id i YThings to Consider in Your Things to Consider in Your Final Years of GI TrainingFinal Years of GI TrainingFinal Years of GI TrainingFinal Years of GI Training

Amy S. Oxentenko, MD, FACP, FACGAmy S. Oxentenko, MD, FACP, FACGAmy S. Oxentenko, MD, FACP, FACGAmy S. Oxentenko, MD, FACP, FACGAssociate Professor of MedicineAssociate Professor of Medicine

Vice Chair of Education; Fellowship Program DirectorVice Chair of Education; Fellowship Program Directorp gp gGastroenterology and HepatologyGastroenterology and Hepatology

Mayo Clinic, RochesterMayo Clinic, Rochester

OutlineOutline

•• Advanced FellowshipsAdvanced Fellowships–– The rationaleThe rationaleThe rationaleThe rationale–– The optionsThe options

•• GI BoardsGI BoardsTimelineTimeline–– TimelineTimeline

–– What to studyWhat to studyH t t dH t t d–– How to studyHow to study

DisclosuresDisclosures

•• Advanced FellowshipsAdvanced Fellowships–– Program Director: Mayo Advanced ProgramsProgram Director: Mayo Advanced ProgramsProgram Director: Mayo Advanced ProgramsProgram Director: Mayo Advanced Programs

•• GI BoardsGI Boards•• GI BoardsGI Boards–– CoCo--Director: Mayo GI Board Review CourseDirector: Mayo GI Board Review Course

CoCo Editor: Mayo GI Board Review BookEditor: Mayo GI Board Review Book–– CoCo--Editor: Mayo GI Board Review BookEditor: Mayo GI Board Review Book

Advanced FellowshipsAdvanced FellowshipsAdvanced FellowshipsAdvanced Fellowships

Your Training: Next StepsYour Training: Next StepsYour Training: Next StepsYour Training: Next Steps

More More TrainingTraining

ClinicalClinical

Ahhh!!!Ahhh!!!Training Training vs Job?vs Job?

Interviews/MatchInterviews/MatchMovingMoving

CallCallResearchResearch

AdvancedAdvanced

Resident 1Resident 1stst yr Fellow 2yr Fellow 2ndnd yr fellow 3yr fellow 3rdrd yr fellowyr fellow

ggIM BoardsIM Boards

AdvancedAdvancedTraining ProcessTraining Process

Resident 1Resident 1 yr Fellow 2yr Fellow 2 yr fellow 3yr fellow 3 yr fellowyr fellow

Initial Career Choice byInitial Career Choice byAdvanced FellowshipAdvanced FellowshipAdvanced FellowshipAdvanced Fellowship

19931993--20112011

80%90%

100%

50%60%70%80%

20%30%40%50% Private Practice

Academics

0%10%20%

Ad d N Ad dAdvanced Fellowship

No AdvancedFellowship

(n=55) (n=100) Mayo data onlyMayo data only

Choice of Practice Based on Choice of Practice Based on Type of Advanced FellowshipType of Advanced FellowshipType of Advanced FellowshipType of Advanced Fellowship

19931993--20112011

80%90%

100%

50%60%70%80%

20%30%40%50% Private Practice

Academics

0%10%20%

Ad d E d Oth Ad dAdvanced EndoFellowship

Other AdvancedFellowship

(n=20) (n=35) Mayo data onlyMayo data only

Advanced EndoscopyAdvanced Endoscopy

•• ASGE match processASGE match process•• Does not use the ERAS systemDoes not use the ERAS systemDoes not use the ERAS systemDoes not use the ERAS system•• Process continually refined Process continually refined

P dd d/ bt t d lP dd d/ bt t d l•• Programs added/subtracted yearlyPrograms added/subtracted yearly•• Match data (2012)…..unofficial:Match data (2012)…..unofficial:

–– 53 fellows matched to programs53 fellows matched to programs–– 37 fellows did not match to programs37 fellows did not match to programs

Find the Various ProgramsFind the Various Programs

Look by stateLook by state ERCP, EUS, BothERCP, EUS, Bothhttp://www.asge.org/apps/aef/aef_main.aspxhttp://www.asge.org/apps/aef/aef_main.aspx

Advanced Endoscopy Fellowship: Advanced Endoscopy Fellowship: Important Dates for 2014 SlotsImportant Dates for 2014 SlotsImportant Dates for 2014 SlotsImportant Dates for 2014 Slots

Program may have individual application deadlines!!!Program may have individual application deadlines!!!

Advanced/TransplantAdvanced/TransplantAdvanced/Transplant Advanced/Transplant Hepatology (TH) FellowshipsHepatology (TH) Fellowships•• 2 Types of Programs:2 Types of Programs:

–– AccreditedAccreditedAccreditedAccredited–– NonNon--AccreditedAccredited

•• Accredited Programs (n= 37)Accredited Programs (n= 37)•• Accredited Programs (n= 37)Accredited Programs (n= 37)–– Under the review of the ACGMEUnder the review of the ACGME

Need to have done GI fellowship 1Need to have done GI fellowship 1stst–– Need to have done GI fellowship 1Need to have done GI fellowship 1stst

–– Allows you to take TH boardsAllows you to take TH boards

http://www.aasld.org/education/Pages/TrainingPrograms.aspxhttp://www.aasld.org/education/Pages/TrainingPrograms.aspx

ABIM Approved ABIM Approved pppp33--Year Combined GI/TH PilotYear Combined GI/TH Pilot

Advanced IBD FellowshipsAdvanced IBD Fellowships

•• CedarsCedars--SinaiSinai•• Cleveland ClinicCleveland Clinic

•• Univ ChicagoUniv Chicago•• Univ MarylandUniv Maryland

•• Cornell WeillCornell Weill•• MGHMGH

yy•• Univ N. CarolinaUniv N. Carolina•• Univ PennUniv Penn

•• MayoMayo•• Mount SinaiMount Sinai

•• UPMCUPMC•• VCUVCUMount SinaiMount Sinai

•• RobartsRobarts•• UCSDUCSD

VCUVCU•• Beth IsraelBeth Israel•• Brigham & Women’sBrigham & Women’s•• UCSDUCSD

•• UCSFUCSF•• Brigham & Women sBrigham & Women s

Other Advanced FellowshipsOther Advanced Fellowships

MotilityMotility•• MayoMayo

EsophagealEsophageal•• MayoMayo

GI NeoplasiaGI Neoplasia•• MayoMayoyy

•• DartmouthDartmouth•• MGHMGH

MayoMayo•• UNCUNC•• NorthwesternNorthwestern

MayoMayoPancreasPancreas•• MayoMayo

•• California PacificCalifornia PacificNutritionNutrition

NorthwesternNorthwestern MayoMayoCeliacCeliac•• Beth IsraelBeth IsraelNutritionNutrition

•• Univ ChicagoUniv Chicago•• Cleveland ClinicCleveland Clinic

•• Beth IsraelBeth IsraelObesityObesity•• MGHMGH•• Cleveland ClinicCleveland Clinic •• MGHMGH

GI BoardsGI BoardsGI BoardsGI Boards

Your Third YearYour Third YearYour Third YearYour Third Year

Not too early to start studying!!!Not too early to start studying!!!Not too early to start studying!!!Not too early to start studying!!!

WrapWrap--UpUpPackingPacking

Job/House SearchJob/House SearchBusy rotationsBusy rotations

PackingPacking

MovingMovingN j bN j b

NovNov JanJan MarMar May July SeptMay July Sept NovNov

Finishing researchFinishing research New jobNew job EXAM!!!EXAM!!!

NovNov JanJan MarMar May July SeptMay July Sept NovNov20122012 20132013

Important GI ABIM DatesImportant GI ABIM DatesImportant GI ABIM Dates Important GI ABIM Dates 20132013

ItemItem DatesDatesE amE am No ember 20 2013No ember 20 2013Exam Exam November 20, 2013November 20, 2013Exam Dates Exam Dates (Accommodations)(Accommodations) November 18November 18--22, 201322, 2013

OORegistration OpensRegistration Opens March 1, 2013March 1, 2013Deadline RegistrationDeadline Registration May 1, 2013May 1, 2013Late RegistrationLate Registration May 2, 2013May 2, 2013Deadline Late RegistrationDeadline Late Registration June 1, 2013June 1, 2013Deadline CancellationDeadline Cancellation September 1, 2013September 1, 2013

FirstFirst--Time Pass Rates: GI Time Pass Rates: GI

20072007 20082008 20092009 20102010 20112011

95%95% 94%94% 97%97% 89%89% 94%94%

Categories on the ABIM ExamCategories on the ABIM Exam

Esophagus (10%)G / ( %)Gastric/Duo (15%)Liver (25%)Bil (8%)Bilary (8%)Pancreas (10%)S ll B l (10%)Small Bowel (10%)Colon (15%)G l (7%)General (7%)

The “General” Category:The “General” Category:Topics to RememberTopics to Remember

TopicsTopics # of MCQs# of MCQs•• AdolescenceAdolescence 00--22AdolescenceAdolescence 00 22•• GeriatricsGeriatrics 00--22

E d tiE d ti 00 22•• Endoscopy preparationEndoscopy preparation 00--22•• Multisystem disordersMultisystem disorders 00--22•• NutritionNutrition 00--22•• EthicsEthics 00--22EthicsEthics 00 22•• StatisticsStatistics 00--22

Examples of Category BlueprintsExamples of Category Blueprints

http://www.abim.org/exam/certification/gastroenterology.aspxhttp://www.abim.org/exam/certification/gastroenterology.aspx

Take the Tutorial!!!Take the Tutorial!!!

•• Answer questions Answer questions •• Change answersChange answers•• Change answers Change answers •• Make notes electronically Make notes electronically •• Access table of normal lab values Access table of normal lab values •• Mark questions for reviewMark questions for review•• Mark questions for review Mark questions for review

How Do You Prepare?How Do You Prepare?R l di d i f ll hiR l di d i f ll hi•• Regular reading during fellowshipRegular reading during fellowship–– PatientPatient--centered readingcentered reading–– Scheduled reading of other topicsScheduled reading of other topics

•• Board review sessions at your programBoard review sessions at your program•• Review your GIReview your GI--ITE resultsITE results

–– Focus on content areas of weaknessFocus on content areas of weaknessFocus on content areas of weaknessFocus on content areas of weakness–– Review objectives of questions missedReview objectives of questions missed

•• Practice multiplePractice multiple--choice questionschoice questions•• Practice multiplePractice multiple--choice questionschoice questions

Board Review Courses/BooksBoard Review Courses/Books

•• Helps distill information down to Helps distill information down to highest yield for the examhighest yield for the examg yg y

•• Not allNot all--inclusive of exam contentinclusive of exam content•• Using and/or attendingUsing and/or attending ≠ passing≠ passing•• Using and/or attending Using and/or attending ≠ passing≠ passing•• Something > NothingSomething > Nothing•• Consider cost/time/learning needsConsider cost/time/learning needs

COURSESCOURSES William William SteinbergSteinberg

Mayo Mayo ClinicClinic

Harvard Harvard AdvancesAdvances

Brigham Brigham RecordingRecording

Cleveland Cleveland ClinicClinic

S dS d 19851985 20012001 2004 ?2004 ? 20102010 20122012StartedStarted 19851985 20012001 2004 ?2004 ? 20102010 20122012

Dates 2013Dates 2013 Oct 5Oct 5--88 Sept 5Sept 5--88 June 10June 10--1313 Ends Sept Ends Sept ??????

# Days# Days 55 3 53 5 4 54 5 NANA 44# Days# Days 55 3.53.5 4.54.5 NANA 44

LocationLocation Arlington, Arlington, VAVA

Chicago, Chicago, ILIL

Boston, Boston, MAMA

AnywhereAnywhere San Diego, San Diego, CACA

Cost (2012)Cost (2012)FellowsFellows

$999$999 $725$725** $990$990 $895$895(video)(video)

$799$799

C (2012)C (2012) $1399$1399 $995$995 $1475$1475 NANA $1199$1199Cost (2012)Cost (2012)Staff MDsStaff MDs

$1399$1399 $995$995 $1475$1475 NANA $1199$1199

IncludedIncluded BreakfastBreakfast BreakfastBreakfast ?????? Can buy:Can buy: BreakfastBreakfastIncludedIncluded BreakfastBreakfastSnacksSnacksPaperPaper

BreakfastBreakfastLunchLunchSnacksSnacks

?????? Can buy: Can buy: Audio onlyAudio onlyVideo onlyVideo onlyB thB th

BreakfastBreakfastLunch x2Lunch x2SnacksSnacks

CDCD USBUSBBR BookBR Book

BothBoth OnlineOnline

*scholarship program*scholarship program

Other CoursesOther Courses

•• ACG PostACG Post--Graduate CourseGraduate Course–– Friday: Pharmacology, Pathology, ImagingFriday: Pharmacology, Pathology, ImagingFriday: Pharmacology, Pathology, ImagingFriday: Pharmacology, Pathology, Imaging

•• AGA PostAGA Post Graduate CourseGraduate Course•• AGA PostAGA Post--Graduate CourseGraduate Course

Societal Board Review Societal Board Review Materials:Materials:

SAT (ACG)SAT (ACG)•• SAT (ACG)SAT (ACG)–– SelfSelf--Assessment TestAssessment Test

•• DDSEP (AGA)DDSEP (AGA)( )( )–– Digestive Diseases SelfDigestive Diseases Self--Education ProgramEducation Program

•• GESAP (ASGE)GESAP (ASGE)GI E d S lfGI E d S lf A t PA t P–– GI Endoscopy SelfGI Endoscopy Self--Assessment ProgramAssessment Program

Other Board Review ResourcesOther Board Review Resources•• Mayo GI & Hepatology Board Review BookMayo GI & Hepatology Board Review Book

–– Stephen HauserStephen Hauser


–– Stephen HauserStephen Hauser•• Acing the GI Board ExamAcing the GI Board Exam

–– Brennan SpiegelBrennan Spiegel



–– Brennan SpiegelBrennan Spiegel•• GI/Liver Secrets PlusGI/Liver Secrets Plus

–– Peter McNallyPeter McNally




–– Peter McNallyPeter McNally•• GI & Hepatology Board Review: GI & Hepatology Board Review:

P l f Wi dP l f Wi dPearls of WisdomPearls of Wisdom–– John DiBaiseJohn DiBaise




–– Peter McNallyPeter McNally•• GI & Hepatology Board Review: GI & Hepatology Board Review:

P l f Wi dP l f Wi dPearls of WisdomPearls of Wisdom–– John DiBaiseJohn DiBaise

H i ’ Y d Sl iH i ’ Y d Sl i•• Harrison’s, Yamada, Sleisenger Harrison’s, Yamada, Sleisenger Study GuidesStudy Guides

And the 2 lucky winners of And the 2 lucky winners of free GI board reviewfree GI board reviewfree GI board review free GI board review

materials……materials……

SummarySummarySummarySummary•• It is never too earlyIt is never too earlyyy

–– To consider advanced fellowshipsTo consider advanced fellowships–– To study for boardsTo study for boardsyy

•• Don’t proceed blindlyDon’t proceed blindlyDo your research on advanced programsDo your research on advanced programs–– Do your research on advanced programsDo your research on advanced programs

–– Understand what you will be tested onUnderstand what you will be tested onPick hat is best for oPick hat is best for o•• Pick what is best for youPick what is best for you–– Not all programs will meet your needsNot all programs will meet your needs–– Pick study method(s) and know them wellPick study method(s) and know them well

Thank you!Thank you!Thank you!Thank you!

[email protected]@mayo.edu

thing to consider in your final year of gi...

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