Requirements & Timeline
- Inpatient Hepatology & Liver Transplant Service – 6 months
- Outpatient Service – 6 months
- 1/2 Day Outpatient General Hepatology Continuity Clinics – 12 months
- 1/2 Day Outpatient Liver Transplant Continuity Clinics
- 1/2 Day Endoscopic procedures with emphasis on Liver Biopsies and Paracentesis
- Liver biopsies: The trainee must understand the indications, contraindications, complications, and interpretation of allograft biopsies and must perform a minimum of 20 percutaneous ultrasound guided biopsies.
- Inpatient/Outpatient: See each section for details.
- Documentation of Training: Trainee will document patient encounters, surgical (including procurements) observations, and liver biopsies. Log provided in Fellow Evaluation Section
- Inpatient/Transplant: All transplant patients admitted to the Liver Service or medical services, including those in the intensive care units, will be followed by the fellow and the service hepatologist. They will function as the primary consultants for the assigned medical housestaff. On average, 75 patients are admitted to the service each month, along with about 10 new liver transplants per month. The fellow is involved with all aspects of inpatient transplant management. Daily rounds occur with the Transplant Surgeons and staff. In addition, each fellow is expected to participate in three cadaveric liver procurements and three liver transplants. This is a unique opportunity to learn anatomy and gain an understanding of the “surgical” issues that arise in the peri-transplant period. All associated procedures are performed by the fellow, including liver biopsies and paracentesis.
- Outpatient: This rotation involves extensive training in the evaluation of liver disease patients and procedures in the outpatient setting. The fellow will participate in one half-day general liver clinic (UF Health Shands), one half-day liver failure clinic, and two half-day liver transplant clinics per week. In addition the fellow will participate in two half-day endoscopy clinics and will concentrate on liver biopsies. We currently perform about 1,000 liver biopsies per year and train fellows to use ultrasound guidance techniques. The trainee follows at least 20 new liver transplant recipients for a minimum of 3 months from the time of transplantation. The trainee is involved in the follow up of 30 or more liver transplant recipients who survived more than 1 year after liver transplantation to gain familiarity and expertise with the management of common long term problems (e.g., cardiovascular disease, nephrotoxicity, etc.). The trainee will participate in transplant recipient medical care, including acute cellular rejection, recurrent disease, infectious diseases, and biliary tract complications. During the outpatient rotation the trainee will have the opportunity to interact with the liver transplant coordinators and serve as a primary member of the transplantation team and participate in making decisions about immunosuppression.