Division of Gastroenterology & Hepatology
Leadership
Program Information
Advanced Endoscopy Fellowship
Thomas Jefferson University Hospital (TJUH) and the Division of Gastroenterology & Hepatology sponsor a one-year position for training (Advanced Endoscopy Fellowship) in advanced endoscopic procedures. The program offers training in Endoscopic Retrograde Cholangiopancreatogram (ERCP), Endoscopic Ultrasonography (EUS), and other advanced procedures.
The one-year training program was started in 2001 and has trained over 24 advanced endoscopy fellows since then. Prospective candidates apply to our program through American Society of Gastrointestinal Endoscopy (ASGE) match program. Applicants need to have finished internal medicine residency and either enrolled in or completed a gastroenterology fellowship program. Applications coming through the ASGE match have a packet that includes curriculum vitae (CV), letters of recommendation (LORs) and personal statement. These applications are reviewed by our faculty, a few of the applicants are selected for interview and eventually ranked to participate in the ASGE match program. One of these applicants gets matched to our training program. The purpose of the training program is to develop knowledge and endoscopic skills in these candidates to become an academic advanced endoscopist. The advanced endoscopy fellowship (AEF) is considered a non-standard training (NST) program by Accreditation Council for Graduate Medical Education (ACGME).
There are six advanced endoscopic faculty at TJUH that are involved in teaching and training the advanced fellow. One of the six faculty serves as the program director. All six faculty are involved in direct supervision of the trainee. The faculty perform advanced endoscopic procedures at TJUH and trainee has the opportunity to work with every advanced faculty member. The trainees perform on average over 1,000 EUS and ERCP procedures per year with additional exposure to luminal stents, third space endoscopy, endobariatrics, advanced polyp resection, Barrett’s ablation and deep enteroscopy.
The one-year Fellowship in Advanced Endoscopy is designed to develop the knowledge and skills to become an academic advanced endoscopist. These include technical, non-technical and cognitive skills. Core-training skills modified from ASGE curriculum:
| Technical Skills | Non-Technical Skills | Cognitive Skills |
| Pass endoscope to the target locations and accurate guidewire or stent placement | Communicate effectively with patient and other consulting services | Understand the procedure-specific indications, contraindications and potential adverse events |
| Interrogate luminal and extraluminal structures | Evaluate patient’s cardiovascular fitness for endoscopy in consultation with anesthesia | Diagnose and distinguish luminal and extraluminal malignancies and stage appropriately with either sampling or resection as indicated |
| Manipulate image processing (external or internal) as applicable | Obtain informed consent explaining procedure-specific risks and benefits | Know the differences between various endoscopes and choose the appropriate one based on indication |
| Perform safe and effective tissue sampling/resection or cannulation to achieve the desired outcome | Review radiographic imaging studies prior to the planned procedure | Understand the principles of image processing and manipulation (both external and internal) |
| Be familiar with advanced techniques and when to pursue them | Communicate effectively with endoscopy intra-procedural staff | Know accessories for sampling, resection, cannulation and stents |
| Perform fixation of stents or closure of defects as appropriate | Generate a detailed accurate procedure report | Understand external tissue processing techniques and pathology interpretations |
| Careful inspection in the end for effectiveness of the intended intervention and maximize prevention of adverse events | Select the appropriate treatment modality and adjust electrosurgical generator settings | Know signs and symptoms of adverse events |
Participation in the advanced endoscopy program includes:
- Patient preparation for advanced endoscopic procedures.
- The performance of advanced procedures.
- Report dictation, image and video archiving and management.
- Research data entry.
- Attendance and presentation, as needed, at conferences.
- Designing, writing, and conducting clinical research.
The fellowship emphasizes endoscopic research, and each fellow is expected to be actively involved in multiple research projects and produce at least one publication by the end of the fellowship year. The division hosts an Endoscopic Research Group that meets monthly to discuss current and proposed research protocols. Educational conferences include:
- Endoscopy Conference – Held twice a month and is dedicated to various aspects of endoscopy, and includes an advanced endoscopy (ERCP and EUS) case conference.
- Monthly Morbidity and Mortality Conference – Reviewal of untoward outcomes usually pertaining to endoscopic procedures.
- Clinical Case Conference – Held every month and is a classic case presentation and brief literature review.
- Multidisciplinary Conference – Held once a month; frequently focuses on advanced endoscopic techniques and includes a dynamic educational interaction between surgeons, gastroenterologists, radiologists, interventional radiologists, oncologists, and pathologists.
- Pathophysiology Conference – A monthly conference that allows fellows to present an in-depth lecture on a specific topic.
- Colorectal Conference – Held once a month, during which multidisciplinary approaches to difficult colorectal problems are discussed.
- GI Grand Rounds/Research – A monthly conference where visiting lecturers are invited to give state-of-the-art lectures.
- GI Pathology Conference – A monthly meeting that allows fellows to study and appreciate the histologic correlates of the gastroenterological disorders routinely encountered.
- Motility Conference – Held monthly and reviews interesting motility cases from the prior week.
- Liver Pathology Conference – Meets weekly to review the week's liver biopsies and is attended by liver pathologists, the medical liver transplant service, and the surgical liver transplant service.
- Nutrition Conference – Held every other month.
- Enterprise Advanced Endoscopy Conference – once a month case based discussions with advanced endoscopists across the entire Jefferson enterprise which includes at present 17 hospitals and soon to be over 20 hospitals.
- GI Tumor Board – once a week case based discussions focused on multidisciplinary management of GI malignancies.
Fellows are always under direct supervision of advanced faculty. Feedback is given in real-time as it pertains to a technical skill during an advanced procedure. More formal evaluations are done quarterly with the program director. Research progress meetings are held weekly to maintain appropriate timelines. A procedure log is maintained through an endoscopic database to track procedural volumes.
Faculty
- Thomas Kowalski, MD
- Rishi Pawa, MD
- Anand Kumar, MD, Program Director
- Alexander Schlachterman, MD
- Faisal Kamal, MD
- Yasi Xiao, MD
Fellows 2025-2026
- M'Hamed Turki, MD
- Talal Alenezi, MD