Curriculum

Global goals to be attained by the completion of the Bariatric fellowship

• Be able to independently evaluate, diagnose and plan operative strategy for complex bariatric patients.
• Perform complex laparoscopic procedures independently and instruct residents within appropriate cases.
• Develop an understanding of how to manage and perform clinical and basic science research.
• Become comfortable with currently available simulation and education tools, and understand how to incorporate this into new programs.

Clinical responsibilities

• Discuss with residents the case assignment for the upcoming week.
• Attend all service clinics except when in the OR performing a case with an attending.
• The fellow is in charge of rounds on the bariatric service and will delegate rounding duties to the residents.
• The fellow will see all patients when the residents on the bariatric service are PGY-1 and PGY-2.
• It is up to the fellow’s discretion whether a mid-level resident is responsible enough to round on patients without the fellow on the bariatric service.
• See patients in pre-op for cases on which you will be scrubbed on.
• Attend all surgeon courses.
• Attend a bariatric seminar and be prepared to participate in local seminars.
• Round on all bariatric surgery patients on weekends.
• Be on call as attending with senior attending as back-up.
• Help give lectures for the skills lab and surgeon courses.
• Be available for the resident labs and attending courses.
• Forward all consults, H&P, admission, clinic progress notes, OP notes, discharge summaries to the attending.

Call routing procedures

• All in house patient calls go to the resident, including ER calls.
• All outpatient bariatric phone calls go to the fellow.
• All physician calls go to the attending.
• If the resident cannot resolve the patient problem, he/she should call the fellow and from there, the fellow can call the attending if necessary.

Conferences

• Grand Rounds attendance is mandatory.
• M&M conference attendance is mandatory.
  • M&M conference is held every Wednesday morning at 7:00am except for instances when Grand Rounds is also presented. On those days M&M will be at 6:00am.
  • All cases are to be presented in a PowerPoint format with pertinent films. Your presentation should be knowledgeable in regards to the patient’s hospital course.
  • Fellows should present the complication unless an appropriate level resident performed the case.
  • Complications should be put on the list within 1-2 weeks of the complication unless the patient has a prolonged hospital course.
  • Please arrive to the designated meeting space PRIOR to the start of the conference to load your presentation on the computer.
  • Please ensure deletion of the presentation from the computer desktop after the M&M conference.
• Research Meeting (q 3 months) is mandatory.
• MBS Committee Meeting (monthly) is mandatory for the fellow.
• Journal Club (monthly) is mandatory for the fellow.
  • Topics will be chosen ahead of time and it will be the fellow’s responsibility to choose the appropriate article.

Research expectations

• Complete IRB, ACUC, HIPAA training as appropriate prior to beginning any research projects.
• Fellows are expected to work on at least 1 project during their fellowship year.
• New projects may be initiated with the approval of the supervising attending.
• Manuscripts for any project that is to be presented at a national/international conference either in poster or presentation form must be completed and submitted to the other authors prior to the conference.
• All posters/presentations/abstracts need to be presented to the attending prior to submission.

Bariatric fellow curriculum

• Practice suturing and knot tying in the dry lab.
• One on one sessions will be arranged with attending’s during the first month and then as needed.
• Complete FLS preparation and testing within the first month of fellowship.
• Read about operative approach ahead of time and arrive prepared. Roux-en-Y gastric bypass has been standardized in this program and detailed operative technique will be provided in written form.
• Informal discussion will be had at 3 months with the fellowship director regarding the fellows progress, his/her concerns and identify any areas that can benefit from improvement.
• Formal 6 month evaluation will be given.
• Attend labs as an opportunity to practice skills and teach residents.