Frequently Asked Questions

What kind of applicant is the program looking for?

We are seeking the future leaders of tomorrow. This may sound trite, but many of the leaders in Gastroenterology and Hepatology graduated from the UCLA Training Program in Digestive Diseases, including internationally-recognized investigators at most of the major medical centers throughout the United States and beyond. Along these lines, we are seeking applicants who demonstrate and articulate a sense of personal vision, a compelling story, energy, enthusiasm, and a strong committment to the scientific process. In evaluating our applicants, we consider several factors, including: (1) the personal statement, where we specifically seek information about your detailed personal vision for the future; (2) letters of support, where we seek evidence of outstanding residents rated at or near the top 5-10% in the judgment of the reviewers; (3) research experience, where we seek evidence of a commitment to the research process (no minimum amount of publications - merely a concerted and consistent dedication to the scientific process); and (4) USMLE scores, where we seek (but do not necessarily overemphasize) evidence of outstanding achievement. We typically receive over 300 applications from around the Nation, and interview between 25 and 50 applicants for our 6-7 slots per year. Thus, the process is competitive. But we encourage any and all applications, since we do not value any single factor above others - we remain balanced in our approach, and simply seek the best we can find from around the Nation to be the future clinical and research leaders in our field.

How large is the program?

We accept up to 7 fellows per year. Thus, there are up to 21 fellows in the program at any given time.

How are the various hospitals used to augment the curriculum?

The UCLA Training Program in Digestive Diseases is the largest in the Nation. We currently have 6 hospitals in our harmonized program, and Fellows have equal opportunities to rotate through all of the sites. This provides a tremdous opportunity for exposure to a broad range of healthcare settings. The Ronald Reagan UCLA Medical Center is a major, University-Based, tertiary care medical center. This provides Fellows with the opportunity to learn about rare and exotic disorders, transplant medicine, and, in essence, the full range of digestive diseases. The West Los Angeles VA Medical Center is a large, tertiary-care VA medical center within a half mile of the UCLA campus. The VA Medical Center provides Fellows with experience in the full range of GI disorders, with an emphasis on GI hemorrhage, pancreaticobiliary disorders, and GI and Hepatic malignancies. Cedars-Sinai Medical Center provides trainees with exposure to a large, urban, tertiary-care community hospital. Fellows have unprecedented exposure to IBD patients, motility pathology, and liver pathology, along with the full range of other digestive disorders. Both Olive View-UCLA Medical Center and Harbor-UCLA Medical Center provide trainees with exposure to busy county hospitals known for outstanding teaching. Finally, the Santa Monica-UCLA Medical Center, which is part of the integrated UCLA Healthcare System, provides exposure to a community-based secondary-care hospital.

With so many hospitals, how can they be harmonized into one program?

We are careful to ensure harmonization of our goals, objectives, policies, and procedures throughout the entire network of hospitals. This is accomplished through several methods. First, each of the core hospitals has a representative that sits on the Program-wide Curriculum Action Committee, or CAC. The CAC oversees all policies and procedures for the Program, and makes ongoing decisions regarding curriculum, goals and objectives, and program activities. This allows for a flexible and nimble body to have authority over the entire program. Second, the Fellows are represented by a Fellows' Advisory Committee, which consists of one member from each year of Fellowship training. The committee meets with the CAC every 1-2 months. This allows real-time feedback to the CAC from the field, and provides mutual opportunities for ongoing program enhancements and fine-tuning. Third, the faculty meets in annual retreats to review the curriculum, teaching methods, and overall goals and objectives of the program. Fourth, all teaching evaluations are harmonized through the online "Verinform System," a computerized login that provides a unified source of evaluations. The system also provides Fellows and Faculty with a core set of reading, full set of rotation-specific goals and objective, and the full set of updated policies and procedures. Finally, the Fellows meet together regularly, including the weekly core curriculum lectures, weekly pathology conferences, and weekly patient case conferences.

Do all Fellows have equal opportunity to train at all hospitals?

Yes. Fellows are equally eligible to travel to all hospitals. All Fellows experience the same training program, and have equal time spent throughout the 3 core hospitals. The concept of a “base hospital” is obsolete.

What are the core clinical training requirements of the program?

All fellows, independent of whether in the Clinical or the Research Track, do a minimum of 20 months of clinical training, and a one-half day-per-week continuity clinic throughout the Fellowship Program. During the first year, each fellow spends 4 3-month blocks on the inpatient services of the 3 core hospitals. In addition, all fellows must complete 5 months of Hepatololgy. This is split evenly between Ronald Reagan UCLA Medical Center and Cedars (i.e. 2.5 months of Hepatology at each hospital). All fellows must also complete 1-month of pancreaticobiliary training, either at Ronald Reagan UCLA Medical Center or Cedars. Additional clinical time is variably spent at Harbor (1 month), Olive View (1 month), and electives (e.g. IBD, motility, pancreaticobiliary, endoscopy, obesity). All fellows receive directed training in nutrition and GI radiology during a 2-week blocks at Ronald Reagan UCLA Medical Center.

How do the continuity clinics work?

All Fellows must attend half-day weekly continuity clinics throughout their training period. During the first year, Fellows are assigned to either the VA clinic or Cedars Fellows’ clinic. Thereafter the continuity clinics occur in 6-month blocks across the 3 core hospitals.

Is research required for everyone?

Yes. All Fellows, regardless of being in the clinical track or research track, must do research. At a minimum, all Fellows are required to perform 6 months of research while in the Program. Those on the research track spend more time in research, as detailed below.

What is the “clinical track”?

Fellows in the clinical track will spend 36 months in our program. Despite its name, the track is designed to nurture clinical investigators and still has a research component. All Fellows in the clinical track must complete 6 months of block time for research. So, even though Fellows in this track are not supported by STAR or the Training Grant, they are still expected to complete research, including an abstract submitted to a professional meeting and a subsequent manuscript. These fellows are focused on clinical GI, but with an emphasis on critical thinking, the scientific process, and clinical research. As with the research track, Fellows in the clinical track must complete the basic core training requirements, outlined above.

Additional clinical training is usually tailored as an adjunct to the research program, or to the individual Fellow’s career plans following completion of the fellowship. The determination of how much extra clinical time [beyond the 20 month minimum] and in what venue is determined in discussions with the Fellow’s 6 month block research mentor and the Curriculum Action Committee. There is no hands-on training in advanced procedures, e.g. EUS, ERCP during the 3-year program with one exception. Those who are accepted into a fourth year of Advanced Procedures Fellowship, anywhere in the U.S. or Canada will be permitted, if they wish, to do up to 3 months of hands-on advanced procedures training before they commence the fourth year Fellowship.

What is the “research track”?

This is available in either clinical investigation or in basic/translational research. In most instances the clinical investigation pathway usually requires a minimum of 4 years to complete the clinical and research training. Those in the clinical investigation pathway enroll in a Masters Program with the School of Public Health or in the STAR Clinical Investigation Masters Program at Ronald Reagan UCLA Medical Center. The graduates of the clinical investigation pathway in the UCLA Fellowship program emerge with unique expertise in outcomes research, evidence-based medicine, and health services research. Basic or translational research usually requires a 5-year program to complete the clinical and research training. Of course, all members of the research track must complete the basic core curriculum, outlined above.

Members of the research track can be supported by one of two mechanisms: the UCLA Department of Medicine STAR (Specialty Training & Advanced Research) Program, and the NIH Training Grant. Although these are different funding mechanisms, both work together and have the same goal of developing future investigators that are independently funded. In order to be brought onto the Training Grant, applicants must identify a research mentor and develop a specific research plan during their first year of Fellowship. Their plan will be reviewed by the Training Grant committee, and, if acceptable, the Fellow will be brought onto the Training Grant during year 2. This will provide protected research time to ensure completion of the research over a 4-year period, on average. STAR candidates have the additional requirement of interviewing with the STAR research committee, headed by Joy Frank. Those accepted onto STAR can enroll in the STAR Master’s Program in Clinical Investigation. Basic research STAR Fellows can advance to a PhD. Postoctoral Fellows may also be accepted.

>>IMPORTANT<< If you intend to apply for the research track, you are heavily encouraged to apply both through ERAS, as everyone does, and also through the UCLA STAR Program. There is a separate application for STAR. Applicants who arrive on interview day expressing a strong interest in the research track will be expected to have already applied, in advance, to STAR as well. Those expressing a strong interest in a research career who have not applied, in advance, to STAR, will be at a disadvantage.

How do I decide whether to do the “research track” or “clinical track?”

Each applicant needs to decide for him/herself, based on personal vision and objectives. There is no strategic advantage to selecting one track over the other. Instead, each applicant should consider what he/she wants, and then decide what fits best. Those interested in the research track are encouraged to apply to the STAR program along with the customary ERAS application. Applicants who have not applied through STAR will be at a disadvantage on interview day if they claim a strong interest in a research track, but have not otherwise demonstrated interest in advance by applying to STAR. On a similar note, there is no strict “quota” for the number of position we accept in each track. Instead, we consider each applicant on his/her own merits, and make decisions about acceptance on that basis. We look for the best, regardless of specific career track.

What conferences do the Fellows have in common?

Although each hospital has its own weekly conferences, the Fellows all meet once weekly for 2 hours of didactic training. The weekly curriculum is monitored by the Curriculum Action Committee to ensure adequate breadth and depth so that all Fellows are exposed to the same content. Fellows located at UCLA and VA meet weekly for the Journal Club at UCLA and for the weekly clinical case conference at UCLA. Fellows located at Cedars, Olive View, and Harbor, have a separate Journal club during their time in those hospitals.

What electives are available?

All Fellows have the opportunity to take electives after the F1 year. These include the following:

• Motility Elective: This is a 2-4 week elective offered at Cedars-Sinai. The objective of this elective is to provide all trainees with a clear understanding of the indications and potential pitfalls in the performance of motility studies and the limitations of interpretation of esophageal manometry, esophageal pH studies, esophageal motility with provocative agents, radionuclide gastric emptying studies, small bowel motility, colonic transit measurements, anal sphincter manometry, and anal sphincter biofeedback training. This level of training is done primarily on an intellectual level to produce an understanding of the value and limitations in interpreting the findings of the tests.

• Advanced Nutrition Elective: This is a 4-week elective offered at Ronald Reagan UCLA Medical Center. This is in addition to the mandatory basic 2-week training in nutrition. This elective provides an in-depth understanding and clinical experience in nutritional assessment and management, with a focus on complex cases.

• Pancreaticobiliary Elective: This is a 4-week elective offered at Ronald Reagan UCLA Medical Center, Cedars, and Harbor-UCLA. A major goal of the training is to develop highly skilled consultants who can provide state-of-the-art care to patients with complex biliary and pancreatic disease. This training includes learning the advantages and disadvantages of available options involving the diagnosis and therapy of biliary diseases and of potential complications and their management.

• IBD Elective: This is a 2-month elective offered at Cedars. The objective is to become exposed to a wide range of inpatient and outpatient presentations of IBD, and to gain expertise in diagnostic and managements of this complex population under the guidance of world-experts in IBD.

• Gastrointestinal Endoscopy: This is a 4-week elective offered at Ronald Reagan UCLA Medical Center, Cedars, Harbor-UCLA, and the VA. The objective of this rotation is to provide trainees with critical, supervised instruction in gastrointestinal endoscopy to ensure quality care for patients with digestive diseases. Endoscopic procedures are not isolated technical activities but are integral aspects of clinical problem solving. Endoscopic decision-making, technical proficiency, and patient management are equally important, and the interdependence of these skills is emphasized repeatedly during the training period.