The clinical training is divided among the three participating hospitals: Stanford University Medical Center, VA Palo Alto Health Care System, and Santa Clara Valley Medical Center. The first-year fellow will spend an equal amount of time at each hospital.
Stanford University Medical Center (SUMC)
The fellows manage the inpatient consult gastroenterology service and are supervised by faculty in all consultationsand related procedures.
Fellows also obtain substantial clinical outpatient training by participating in weekly continuity clinics and other specialty clinics throughout the 3 years of training. On average, 40-50 inpatient consults and 450 outpatient visits total are seen in the gastroenterology and hepatology clinics per month. The endoscopy unit is fully equipped to provide endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, capsule endoscopy, double-balloon enteroscopy, and manometry. Over 5,000 procedures are performed in the Endoscopy Unit annually
The inpatient service commonly includes medicine housestaff and medical students, and the fellow is also responsible for supervising and teaching them while on service. In addition to extensive hands-on learning, several weekly conferences (see Conferences) are organized to provide a comprehensive clinical education. Unique to the clinical program at Stanford is The Liver Transplant Program at Stanford.
Approximately 70-80 liver transplantations are performed at Stanford annually. Second-year, third year, and advanced hepatology fellows have the opportunity to manage the inpatient hepatology service in partnership with the transplant hepatology surgeons. During this time, fellows get substantial exposure to inpatient and outpatient transplant hepatology, as well as see all hepatology inpatient consults.
Stanford University Medical Center
Stanford University Medical Center is a 600-bed tertiary care facility where most patients are referred by internists, surgeons and community physicians. Patients with complex gastrointestinal and liver diseases that present major diagnostic and therapeutic challenges are seen at Stanford.
Palo Alto VA Medical Center
The VA Palo Alto Health Care System is a 900-bed, multi-campus integrated facility of hospitals and clinics, and a tertiary referral center for satellite campuses much of Northern California. It has been consistently rated on of the best VA hospitals in the nation.
VA Palo Alto Health Care System (VAPAHCS)
The fellows manage the inpatient consult gastroenterology and hepatology services and are supervised by in all consultations and related procedures.
Fellows also obtain substantial clinical outpatient training by participating in weekly general gastroenterology and hepatology clinics.
There are approximately 500 inpatient consultations, 4,000 outpatient consultations, and more than 3,000 endoscopic procedures provided annually.
The endoscopy unit provides a full range of diagnostic and therapeutic procedures including endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, endoscopic dilation, capsule endoscopy, and double-balloon enteroscopy.
There are weekly conferences organized and held to provide formal didactic education (see Conferences).
Santa Clara Valley Medical Center
Santa Clara Valley Medical Center is a 574-bed tertiary medical center, owned and operated by the County of Santa Clara. The Medical Center is part of the Santa Clara Valley Health and Hospital System.
It offers a full-range of gastroenterological services, including ERCP, capsule endoscopy, pH/motility studies, and deep enterosocpy.
The GI division sees approximately 14,000 outpatient visits and 1,100 inpatient consults per year.