1. The resident will learn the diagnostic and therapeutic approach to the patient with illness of the gastrointestinal system.
2. The resident will develop awareness of the importance of patient and physician partnership towards optimal gastrointestinal health.
3. The resident will understand the working relationship between a gastrointestinal specialist and primary care specialist.

The resident will develop skills, knowledge and attitude to:

1. Perform a physical exam and take an appropriate history from a patient with a complaint referable to the gastrointestinal system.
2. Establish a differential diagnosis.
3. Develop a diagnostic and therapeutic plan including the appropriateness of imagine, endoscopy, laboratory or other ancillary testing in confirmation of a diagnosis.
4. Be readily aware of the indications, potential complications and limitations of endoscopy techniques: anoscopy, flexible sigmoidoscopy, colonoscopy, upper endoscopy.
5. Understand the need for the following techniques: ERCP, enteroscopy, esophageal manometry, endoscopic ultrasound, liver biopsy, PEG tube placement, pn monitoring
6. Approach the patient with abdominal pain, weight loss, anemia and intestinal bleeding in a logical and effective manner.

• Nutrition – Assessment, parenteral and enteral feeding
• Gastrointestinal Emergencies - Acute gastrointestinal bleed
• Esophageal Disease, Gastroesophageal Reflux, Hiatal Hernia, Dysphagia, Stricture, Non-cardiac (functional) chest pain
• Stomach and Doudenal Disease
  • Gastritis/Peptic Ulcer Disease/H. Pylori
  • Celiac Disease
  • Postgastrectomy Disorders
• Small and Large Bowel Disease
  • Diarrhea
  • Neoplasm
  • Diverticular Disease
  • Infections
  • Constipation
  • Irritable Bowel Syndrome
  • Inflammatory Bowel Disease
• Anorectal Disease
  • Hemorrhoids
  • Fissures/Fistulae
  • Sexually Transmitted Enteric Disorders
• Liver and Billiary Tract
  • Hepatitis
  • Cirrhosis
  • Jaundice
  • Billiary obstruction
  • Neoplasm - primary and metastatic
• Gallbladder Disease
• Pancreatic Disease
  • Pancreatitis
  • Neoplasm
  • Pancreatic Insufficiency
• Psychosocial Disorders affecting the GI Tract
  • Anorexia Nervosa/Bulimia
  • Obesity

• Residents provide care to a mixed panel of patient in accordance with RRC guidelines. Many of these patients will have conditions of the gastrointestinal system.

• Dermatologic Procedures – Punch, Shave, Excision, Radiosurgery, Cryosurgery, I&D, KOH
• Topical Therapy – Treatment Triangle, Steroid Potency
• Appropriate consultation and referral for skin conditions

• Residents will appropriately treat and evaluate patients presenting with complaints of the gastrointestinal system

• Residents will appropriately treat and evaluate patients presenting with complaints of the gastrointestinal system. Screening evaluation/management of patients with eating disorders.

• Several questions from the internal medicine subset on the In-Training Exam will be related to GI. The resident should do questions on www.familypractice.com.

• This 2 - 4 week elective experience includes inpatient, outpatient and endoscopy experience with a gastroenterologist. The topic list is large; therefore some topics need greater depth of knowledge than others. The emphasis should be on what the family doctor needs to know to be able to provide effective patient care and appropriate referral. The extent of endoscopy experience should be discussed with supervising gastroenterologist and be consistent with demonstrated skills and future practice plans.

Family Practice contact person - Dr. Miller