Hepatology Fellowship Curriculum

Overview

Training in the 2-year Swedish Medical Center Liver Care Network Hepatology Fellowship includes exposure to and expertise in management of patients with a variety of common as well as unusual liver disorders. The training program incorporates training in all aspects of clinical hepatology and liver transplantation and research. Fellows will be trained in performance and interpretation of liver biopsy and transient elastography using Fibroscan. Successful completion of the fellowship will allow the trainee to function independently as a consultative hepatologist, be part of liver transplant program as a hepatologist and be familiar with the research landscape in liver disease.

Clinical Training

The fellowship is designed to incorporate inpatient clinical training on the hepatology consultation service, a referral outpatient hepatology consult service and provide substantial protected time for mentored research. Five hepatology faculty members and a large and diverse patient population are available for clinical training. In addition, our Organ Research Program has a state-of the-art research laboratory and resources available through the Providence St. Josephs Health system (one of the largest health systems in the United States across seven states and 55 hospitals), providing the setting for an outstanding teaching and patient care experience.

Rotations and Structure of the Fellowship

The primary clinical training site during the two-year fellowship period is Swedish Medical Center First Hill. Fellows will round on the inpatient consult hepatology and liver transplant service, perform consultations with an attending physician and participate in outpatient clinics with the program director and other faculty members.

The typical year includes 3- months on inpatient service, 3-4 months in outpatient block and approximately 3-4 months of protected time for research, during which there are minimal clinical responsibilities. Weekend call is approximately once every 3-4 weekends and ensures an opportunity to maintain continuity of care and work up of patients with acute liver failure and other urgent liver patients within a multidisciplinary team. Inpatient service fellows will also evaluate urgent outpatient consultations with the attending on call. The outpatient rotation (3-4 months per year) includes working with the program director and other faculty in complex consultations as well as two weekly continuity clinics where the fellows will have the opportunity to follow their own panel of patients. This will provide the opportunity to develop skills as an independent provider with mentorship and guidance from the program director and other faculty members, including instruction on documentation, billing, coding and compliance.

A unique strength of this fellowship is the availability of a substantial amount of protected time for research which will comprise approximately 30% of the two-year fellowship. A large number of clinical, research opportunities are available both for clinical, basic and translational research. In addition, there will be a broad exposure to clinical trials, including the opportunity to attend investigator meetings which will provide a unique exposure to the current cutting-edge of clinical trials in liver disease and to network with leading hepatologists. 

Didactic Training

Clinical conferences, seminars, small discussion groups, journal clubs and one-on-one instruction are all integral parts of the Hepatology Fellowship.

There is an active schedule of teaching conferences relevant to hepatology and liver transplantation. The goal of these conferences is to help fellows develop the knowledge and skills necessary to function as an effective consultant in hepatology and liver transplantation in a clinical tertiary care setting.

During a series of Hepatology Care Conferences, faculty members provide a didactic review of important topics in hepatology and liver transplantation. Visiting professors give state-of-the-art talks and review cases with fellows.

Other regular conferences provide teaching in the format of case discussions and literature reviews. These include:

  • Liver Tumor Board
  • Weekly one-on-one didactic meeting with program director
  • Monthly Hepatology Lecture Series
  • Liver Biopsy Conference
  • Liver Transplant Selection Conference
  • Inpatient attending rounds
  • CME dinner programs and symposia
There are other conferences at Swedish Medical Center and many other teaching opportunities.

Research and Scholarly Activities

Participation in research is an important component of the Fellowship. Fellows are expected to participate in research projects, which may include review articles, and other scholarly monographs as well as original research The Organ Care Research Department provides facilities, equipment and research nurse assistants to support fellow clinical research projects. In addition, our laboratory has a research scientist and technician. For fellows with bench research, opportunities to perform and gain expertise in procedures as PCR and Western Blotting are available.

Career Development

Each fellow will meet weekly with the program director to review progress, review career goals and future plans and receive feedback with regard to clinical skills and academic productivity. In addition, fellows will have the opportunity and be encouraged to provide feedback about the program, areas for improvement in the clinical, scholarly and logistic aspects of the training program including the evaluation process, areas for teaching improvement from faculty members and staff.