Adult Gastroenterology Training Program

General Objectives of the Training Program

General Objective

The primary objective of the Gastroenterology Training Program is to produce a competent gastroenterologist with the requisite knowledge, skills and attitudes for providing ethical and effective patient-centred care for a wide variety of gastrointestinal conditions. These include disorders of the gastrointestinal tract, pancreas, biliary tree and liver.

The resident will acquire in-depth knowledge of aspects of biochemistry, genetics, immunology, pathology, pathophysiology, diagnosis and treatment of gastrointestinal diseases and will learn the conditions unique to pediatric and obstetric patients. He/she will learn about the psychosocial care of patients with gastrointestinal diseases, with an understanding of and sensitivity to issues involving disabilities, gender, sexual orientation, race and culture.  The resident will develop skills required for the performance of diagnostic and therapeutic procedures and interpretation of laboratory tests relevant to the practice of Gastroenterology.

The graduating resident is expected to be able to accurately convey relevant information and explanations to patients and their families, colleagues, and other professionals; to effectively collaborate within the healthcare team; to exhibit managerial skills pertinent to the operation of outpatient Gastroenterology clinic and endoscopy unit; to demonstrate a commitment to self-directed learning; to critically evaluate scientific information and facilitate the education of colleagues, students, residents, and other healthcare workers; and to practice in an ethical and professional manner.

It is expected that trainees will meet the requirements for Subspecialty Certification in Gastroenterology by the Royal College of Physicians and Surgeons of Canada. The Gastroenterology Training Program endorses the CanMEDS competency framework of the Royal College of Physicians and Surgeons of Canada. This framework identifies seven physician roles that must be addressed by all Canadian postgraduate training programs. Throughout their training and upon its completion, residents are expected to fulfil all of these roles. Goals and objectives specific to the McMaster University training program are listed below to supplement but not replace those of the Royal College. Trainees are encouraged to review details of the CanMEDS objectives on the Royal College website (www.rcpsc.medical.org). 

Specific Objectives

Medical Expert

In his/her role as Medical Expert, the resident is expected to demonstrate:

  • Effective consultation skills with integration of all of the CanMEDS Roles to provide optimal, ethical and patient-centred medical care
  • Sound knowledge base of the structure and function of the gastrointestinal tract in health and in disease, a strong familiarity with the clinical expression of gastrointestinal disease in our society, and a firm grasp of the underlying pathophysiology
  • Sound knowledge of the pharmacology of drugs that modify gastrointestinal function
  • Familiarity with the histopathology of the gastrointestinal tract in health and disease
  • Familiarity with the radiological appearance of the gastrointestinal tract in health and disease (including barium contrast, ultrasound, CT, MRI, radioisotope scan, ERCP, EUS, capsule endoscopy) with working knowledge of each technique
  • Ability to perform a complete and appropriate assessment of  a patient with sound judgement in all clinical domains of Gastroenterology, from the care of elective outpatients to the management of critically ill patients in the emergency room or intensive care unit
  • Demonstrate effective, appropriate and timely application of preventive and therapeutic interventions relevant to Gastroenterology
  • Effective, appropriate and timely use of procedural skills, both diagnostic and therapeutic, in upper and lower gastrointestinal endoscopy and abdominal paracentesis, with a sound understanding of their indications, contraindications, and complications
  • Meaningful awareness of the interrelationship between behaviour and GI disease with the results that (i) appropriate use is made of support services and other health care professionals (addiction treatment groups, social and psychiatric counselling etc.) and (ii) that the physician adopts an appropriately sympathetic and positive attitude to patients with functional disorders of the GI tract 

Communicator

In his/her role as Communicator, the resident is expected to:

  • Establish a trusting and professional rapport with the patients and families, and health care professionals
  • Provide clear and relevant information and explanations to patients and families, colleagues and other health care professionals
  • Encourage full participation of the patients and families, and health care professionals in shared decision making and management
  • Demonstrate effective consultation skills in presenting well documented assessments and recommendations in both written and verbal forms

Collaborator

In his/her role as Collaborator, the resident is expected to:

  • Work effectively and appropriately in an interdisciplinary team to optimize patient care
  • Take on an appropriate share of team assignments and assist others as required
  • Demonstrate leadership in a health care team, as appropriate
  • Maintain a straightforward and respectful approach with all health care professionals and peers

Manager

In his/her role as Manager, the resident is expected to:

  • Work collaboratively with others in the health care team to enhance patient safety and improve patient care quality
  • Display organizational skills with effective time management
  • Use information technology effectively to optimize patient care and continue self-learning
  • Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population based care as appropriate

Health Advocate

In his/her role as Health Advocate, the resident is expected to:

  • Identify situations where advocacy, health promotion and disease prevention are required in response to the health needs of an individual patient and the communities that they serve
  • Identify the determinants of health of the populations that they serve
  • Understand the role of a gastroenterologist as a health advocate in influencing public health and policy

Scholar

In his/her role as Scholar, the resident is expected to:

  • Attend and contribute to rounds and other learning events
  • Accept and act on constructive feedback
  • Critically appraise sources of medical information and take an evidence-based approach
  • Implement strategies for maintenance of professional competence
  • Use opportunities to teach and supervise juniors effectively
  • Contribute to the development, dissemination, and translation of new knowledge and practices through research and scholarly inquiry

Professional

In his/her role as Professional, the resident is expected to:

  • Report facts accurately, including own errors
  • Perform duties and assignments in a timely and ethical manner
  • Maintain appropriate boundaries in work and learning situations
  • Respect diversity of race, age, gender, disability, intelligence and socio-economic status
  • Recognize limitations and seek advice and consultation when needed
  • Exercise initiative within the limits of knowledge and training
These objectives are expanded to specific first and second year general objectives.