Mission

We strive to train future gastroenterologists that excel in clinical and endoscopic skills, academic leaders that are abreast of cutting-edge techniques and therapeutics in the world of Gastroenterology, and skilled military leaders and officers.

Vision

Fellows of the SAUSHEC Gastroenterology Fellowship Program are empowered to excel in all facets of the practice of Gastroenterology. After graduation, each of our graduates will be able to enter practice and become a local subject matter expert at their future military treatment facility. Furthermore, they are trained in military relevant leadership techniques that will empower them to rise as leaders in their future careers.

Aims

• Produce competent gastroenterologists who will be leaders in medicine and the military
• Teach fellows on the importance of life-long learning
• Produce compassionate fellows who serve in the local and global community
• Promote scholarly pursuits for the purpose of advancing the field of gastroenterology

Didactics at BAMC occur weekly on Wednesday mornings from 7 - 9 a.m. with a series of lectures provided by both fellows and attending physicians. Monthly, there is a board review session that follows from 9 - 10 a.m. based on a chapter of the Digestive Disease Self Evaluation Program curriculum from the American Gastroenterology Association.

Additionally, there are weekly case conferences and grand rounds with the University of Texas Health fellowship program every Thursday from 2 – 4 p.m. Fellows are required to present both case presentations and a grand rounds lecture annually.

Additionally, there are multidisciplinary conferences with the General Surgery residency monthly and Pathology conferences monthly as well. As part of the curriculum of rotations, fellows may be required to be present at multidisciplinary tumor board meetings weekly on Thursday mornings at 7 a.m.

Fellows are able to set up and/or apply for elective rotations if they are passionate about a subspecialty area in Gastroenterology. Previous fellows have completed elective rotations in advanced endoscopy at Baylor. Furthermore, fellows have been accepted to visiting fellowships at Mount Sinai, Mayo Clinic, Washington University, and University of North Carolina through the Crohn’s and Colitis Foundation and rotations at Northwestern University through the American Neurogastroenterology and Motility Society.

The fellows will cover a weekend of coverage as well as one night per week during their inpatient blocks. Fellows on outpatient blocks will cover nights during the week and a weekend per month. Overall, the Post Graduate Year (PGY)-4 fellows cover 6 weekends per year, PGY-5 will have 3-4, and PGY-6 will cover 2-3.

Gastroenterologists are trained in two critical medical specialties: internal medicine and gastroenterology. The importance and versatility of the specialty were highlighted in 2020-2021. A third of the career field was deployed primarily in support of COVID-19 operations at home and abroad. For example, one Air Force gastroenterologist played a key role in setting up vaccinations at Bagram Airfield and two Air force gastroenterologists were deployed to El Paso to work as intensivists during the COVID-19 surge.

In addition, the field of gastroenterology uniquely prepares physicians for the battlefield. Gastroenterologists specialize in treating emergent, massive blood loss. Our fellows regularly manage the resuscitation of patients with hypovolemic shock. The need for minimally invasive procedures has woven the fields of gastroenterology and surgery together. Our faculty often collaborate with surgeons for biliary, pancreatic, and intestinal injury. Third, the most common cause of death in war had been disease, non-battle injury. The field of gastroenterology focuses on infectious diarrhea and viral hepatitis, which are the diseases that inflict significant injury to soldiers as well as civilians in war and humanitarian crisis.

We have recently added a lecture series on military relevant topics that a gastroenterologist may face. These include Military Evaluation Boards, grit/resiliency leadership training, and military career path planning.

All fellows will be provided a subscription to the American Gastroenterology Association Digestive Disease Self Evaluation Program curriculum. Furthermore, first year fellows will be provided funding to attend the American Society of Gastrointestinal Endoscopy First Year Fellow course as well as the local First Year Fellow Course called FOCUS-GI.

We have several offsite events to learn endoscopic skills using specifically designated equipment. First Year Fellows also attend a course using simulation and other modalities.

We continue to grow our diversity, equality, and inclusion curriculum. The program encourages fellows to attend grand rounds talks on diversity, equity and inclusion topics at the institution. Fellows have also been involved in recruitment events at universities and community outreach program through the American College of Gastroenterology. We have included leadership didactics emphasizing leadership as a skill and enabling fellows to self-evaluate their leadership abilities.

Graduates of the fellowship program are required to have a manuscript that is publishable in a peer reviewed journal. This can include original research, quality improvement projects, or case reports with reviews of literature.

Many of our faculty are passionate about long term clinical research projects. Fellows are encouraged to collaborate with attendings for research opportunities. We have been very successful in sending a majority of all fellows to annual meetings of the American College of Gastroenterology as well as the Digestive Disease Week.

The division has a long history of clinical research and has over 10 phase II-III clinical trials. We have over 10 full time research staff that are funded through the department’s research. This research enables patients to receive the latest medical therapy and allows trainees to learn research fundamentals.

Each fellow must also complete a quality improvement project at the program level and work with a faculty mentor. A recent QI project example is a report card for adenoma detection that is given to each fellow and attending to ensure that they are meeting recommended guidelines for adenoma detection. At the institutional level, the fellows may participate in root cause analysis cases. The program director and associate program director ensure each fellow has a quality improvement project with a faculty mentor.

We have a strong tradition of fellows presenting their research at national and international conferences. Furthermore, many of our fellows have been selected by professional societies for extramural rotations.

• Brooke Army Medical Center (BAMC)
• Wilford Hall Ambulatory Surgical Center (WHASC)
• University of Texas Health – San Antonio (UTHSA)
• Methodist Specialty and Transplant Hospital

Residents and medical students who are interested in gastroenterology are encouraged to rotate with the program. If the trainee is at BAMC, he or she can contact their residency program leadership to schedule a rotation. If the trainee is at another hospital, he or she can contact the Gastroenterology department at dha.jbsa.brooke-amc.list.saushec-gastro@health.mil to schedule a rotation.

During the rotation, the rotator will spend roughly half of their rotation working with the inpatient consult team. During the other half of their rotation, they will be working in the Inflammatory Bowel Disease clinic, the Hepatology Clinic, or the Advanced Endoscopy Clinic.

Interested applicants should contact the program to schedule an in-person or virtual interview. The benefit of in-person interviews allows the applicant to spend a full day with the fellowship, participate in our educational program, meet with staff and fellows, and participate in a formal interview. For applicants who interview virtually, separate from the formal virtual interview we arrange a virtual meet-and-greet with current fellows as a forum for asking additional questions about our learning environment and culture of the program.

If you would like to schedule an interview with our program, please contact dha.jbsa.brooke-amc.list.saushec-allergy@health.mil.

Program graduates take the American Board of Internal Medicine Gastroenterology. This exam is offered annually. To become fully board certified, applicants are eligible to take board certification exam three months following graduation. To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABIM.

The fellows are actively involved in the didactic curriculum of the department. They present on multiple topics throughout the year in our lecture series. Additionally, the fellows will present at Grand Rounds and Case Conferences with the University of Texas Gastroenterology Fellowship program.

Furthermore, they are encouraged to participate as teachers and leaders in the didactic education for the internal medicine residency. They are also encouraged to perform bedside teaching with rotating medical students and residents.

Our fellows have been invited to be teachers at local and regional conferences. For the past four years, our fellows have been invited to be facilitators at the FOCUS-GI First Year Fellow course as well as lecturers at the FOCUS-GI Advanced Practice Provider Immersion Course.

Our Gastroenterology faculty have additional subspecialty training in:

• Advanced Therapeutic and Third Space Endoscopy
• Transplant Hepatology
• Inflammatory Bowel Diseases

Faculty and fellows work very closely in both a formal and informal mentorship program. The formal mentors for each fellow will meet with him or her bi-annually to discuss progression through fellowship as well as career and research aspirations. Furthermore, faculty are encouraged to act as informal mentors for all fellows in their area of expertise.

Our department has numerous social outings to encourage a strong esprit de corps. Some of these include: Top Golf trips, Fellows Welcome Party, Holiday Parties, and fellows lunches before University of Texas Grand Rounds. Additionally, we have added lectures on the importance of resiliency and grit in our routine didactic lectures for fellows.