Harborview Medical Center

Gastroenterology

Faculty Contact
Chris Surawicz, MD
Professor of Medicine
Section Head, Gastroenterology

Address:
Box 359733
325 9th Avenue
Seattle, WA 98104
Phone: (206) 341-4634
Email: surawicz@uw.edu

Overall Educational Purpose:
To learn to recognize and treat major and common GI problems including upper and lower GI bleeding, acute and chronic diarrhea, GI tract cancer and cancer screening, chronic liver disease including Hepatitis B, C, and alcohol, biliary tract disease, and inflammatory bowel disease.

To determine proper use of endoscopy as a diagnostic and therapeutic tool, as well as x-rays and other diagnostic tests.

Team Structure
1. GI Attending
2. GI Fellow (occasionally a 3rd year Surgery resident)
3. R2 or R3
4. Medical Student (sometimes)

Principal Teaching Methods
Case discussion and review
The fellow and faculty review each case and diagnosis with resident. Bedside rounds recommended.

Rounds
Daily

Didactics
Conference Friday morning (7:30-10:00 am)

Educational Content
Mix of Diseases
Alcoholic liver disease
UGI & LGI bleeding
Liver disease, other liver toxicity
Peptic ulcer disease
Gallstones

Patient Characteristics
Very varied, multicultural, many ethnic and socio-economic groups.

Types of Clinical Encounters
Inpatient and outpatient consults

Procedures
Resident may learn flexible sigmoidoscopy, but in limited numbers.

Services
Full spectrum of endoscopic procedures and advanced therapeutics. Endoscopy is done daily. There is a Hepatology clinic each morning to which residents are welcome to attend.

Rotation Specific Schedule

Monday

Tuesday

Wednesday
12:15-1:00 Pre Clinic Teaching Conference – 2nd Wednesday monthly (lunch provided)
1:00-5:00 GI Clinic (3W-Clinic)

Thursday
8:00-9:00 Grand Rounds (T-629)
9:15-10:15 Resident Teaching Conference (T-739)

Friday
7:30-10:00 Teaching Conference (K-069 Health Sciences)

Call and Weekend Responsibilities
None

Principle Educational Materials Used
Recommended Readings
GI texts and journals in conference room

Pathologic Materials
Same

Methods Used in Evaluating Resident and Program Performance
At the end of the rotation, the resident is evaluated in writing and their performance reviewed with them verbally by every attending and fellow he or she has interacted with for a significant amount of time. The evaluator rates the resident on a nine-point scale in each component of clinical competence (i.e. patient care, medical knowledge, practice based learning improvement, interpersonal and communication skills, professionalism, system based learning, educational attitudes, leadership, overall clinical competence).

The resident is given the opportunity to evaluate in writing the quality of the curriculum and the extent to which the educational goals and objectives of the rotation have been met. The resident also evaluates the teaching competence of each attending and fellow with whom s/he has interacted for a significant amount of time.

Explicit Lines of Responsibility for Care of Patients on this Service
Primary responsibility for care is attending and fellow together.

Each outpatient seen in GI clinic is the responsibility of the attending staff physician. That faculty physician sees, examines, and discusses all new patients with the resident or fellow. Outpatients on return visits are seen by the senior resident or fellow with a subsequent discussion with the attending, who also sees the patient. We will try to give continuity of care as much as possible.

The attending faculty member is responsible for every inpatient seen by the resident. That faculty person will interview, examine and discuss with the resident every new patient. Ongoing care will be provided by the resident with discussion with the attending. All major changes in status will have documented involvement by the attending faculty member.