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    Transplant Hepatology Fellowship Curriculum

    Mission

    Our Mission is to provide outstanding clinical and research training that will prepare the fellow to become an independent consultant in Hepatology, qualify for UNOS certification as a Transplant Hepatologist and fulfill criteria for the ABIM Certificate of Added Qualification (CAQ) in Transplant Hepatology.
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    Curriculum

    1. Outpatient clinic (4 months): assess pre OLT and general hepatology Clinic patients. Fellow expected to take a complete H/P and formulate an assessment and plan. Needs to be capable to assess the need for further studies. Assess need for additional consultants.

    2. Transplant Continuity Clinic (4 months twice weekly, 5 month weekly): The use of immunosuppressants in the setting of liver or combined liver/kidney transplantation is discussed for each patient. Identification of surgical complications. Diagnosis and management of recurrent disease in Transplanted Liver. Prevention and management of extrahepatic complications of OLT.

    3. Inpatient rotation (ICU/Surgical) (2 months): Management of acute complications of liver diseases as well as acute liver failure ALF. Management of post operative liver surgery patients including OLT, hepatic resection, biliary reconstruction etc. The Fellow will provide Hepatology consultation to other ICU/CCU patients. One weekly continuity clinic.

    4. Inpatient rotation (Hepatology patients) (3 months): management of patients with acute and chronic liver disease not necessitating ICU care. The Fellow is responsible of scheduling and performing endoscopic procedures on his/her patients, One weekly continuity clinic.

    5. Research rotation (2 months): The Fellow will choose 2 projects at the beginning of the year, to be completed during the academic year. At least 1 is expected to result in publication in a peer-reviewed journal. Alternatively, laboratory rotation is available if approved by the Fellowship committee.

    6. Literature review: The fellow will rotate with the GI Fellows in presenting GI/Liver case conference on Thursday noon, as well as Journal Club liver articles, and GI/Liver research meetings. The patient will attend all Transplantation Grand Rounds and will present at least once during the year.
    7. Conferences: selection committee, transplant grand rounds, GI grand rounds, transplant journal club, clinical case conference, radiology conference, pathology conference, M&M conference, research conference.

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    Specific goals

    1. Outpatient Clinic:

      • Diagnose chronic liver disease and manage its complications prior to OLT

      • Identify suitable patients, both medically and psychosocially, to evaluate for OLT

      • Indications and implementation of treatment for Hepatitis B and C.

      • Identify of subjects suitable for inclusion in clinical trials

    2. Transplant Clinic:

      • Demonstrate understanding of transplant immunology including immunosuppressant drugs administration and their adverse events.

      • Identification of surgical complications.

      • Diagnosis and management of recurrent disease in Transplanted Liver.

      • Prevention and management of extrahepatic complications of OLT.

    3. Inpatient ICU/Surgical:

      • Identify and manage all the causes of acute liver failure

      • Manage ICU patients with acute complications of liver disease

      • show proficiency in endoscopic procedures pertaining to patients with liver disease.

      • Understand the principles of surgical techniques for liver procurement and transplantation

      • Demonstrate ability to recognize medical futility in care of ICU patients

    4. Inpatient medical:

      • Show expertise in managing of patients with acute and chronic liver disease not necessitating ICU care.

      • Ability to establish indication and performing endoscopic procedures on his/her patients.

      • Show aptitude to discuss management of complex patients with the multidisciplinary team

      • Demonstrate competence in the indication and the performance of percutaneous liver biopsies, including allografts.

      • Show proficiency in evaluating pathological liver specimen.

    5. Research rotation:

      • Identify gaps in medical knowledge

      • Assess the feasibility of a project

      • Identify data and statistical methods

      • Write a structured scientific manuscript

      • Become author or co-author in at least 1 publication in a peer-reviewed journal.

      • Optionally, become acquainted with laboratory methods and procedures.

    6. Literature review: The fellow will become adept at reading the literature in a critical manner. The Protocol meetings will teach the Fellow how to apply published data to patient care management.

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