Hepatology Fellowship

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Cirrhosis

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i have a great interrest in this field area and it came to my knowledge there are some hepatology programs out there that will accept you right out of IM without a prior GI training.

any thoughts or advise?
 
yeah ones that are not certified/not eligible for boards, and you'll won't be able to scope. typically these are programs that can't recruit GI fellows to come and need recent residency grads to do their work. it used to increase people's chance of getting into GI, but that's changing.
 
how is that changing ? i heard that this whole Hepatology fellowship is gonna stop and will be merged in the 3 years of GI training
 
[it used to increase people's chance of getting into GI, but that's changing. ]how is that changing ? i heard that this whole Hepatology fellowship is gonna stop and will be merged in the 3 years of GI training[/QUOTE]
 
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[it used to increase people's chance of getting into GI, but that's changing. =Cirrhosis;13730511]how is that changing ? i heard that this whole Hepatology fellowship is gonna stop and will be merged in the 3 years of GI training[/QUOTE][/QUOTE]
 
now typically the certified hepatology programs require GI before hep. There's only a handful of GI programs that have hep integrated so they are eligible to sit for both boards. Eventually the uncertifield hepatology programs will go away. Honestly liver PDs hate getting people who do hep just so they can get into GI fellowship and do scopes all day, their goal is to raise more hepatologists. In contrast most hepatologists went through GI, were not tempted by the money-making field, and continued another year of hep, a more cognitive/less procedure field (thus less money).
 
darkelven29 said:
now typically the certified hepatology programs require GI before hep. There's only a handful of GI programs that have hep integrated so they are eligible to sit for both boards. Eventually the uncertifield hepatology programs will go away. Honestly liver PDs hate getting people who do hep just so they can get into GI fellowship and do scopes all day, their goal is to raise more hepatologists. In contrast most hepatologists went through GI, were not tempted by the money-making field, and continued another year of hep, a more cognitive/less procedure field (thus less money).
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It's funny that people think liver is more complex than the rest of GI. Hepatology is fairly algorithmic and endoscopy is important in the management of sick liver pts. My easiest clinic visit of the day is a Hep B follow up.

Doing an uncertified hepatology program might help you get GI, I don't really know. Otherwise you'll be the NP that takes care of HCV tx while the rest of us are in endoscopy.
 
HBV and HCV are pretty algorithmic, I agree, there are well delineated guidelines that most people follow (thanks to Anna Lok). For that reason, infectious disease is moving into the treatment arena. What's more difficult and cognitive is doing pre- and post- transplant care for chronic liver disease and acute liver failure. This area plus PBC/PSC/autoimmune have a lot of unanswered questions, but the solutions is usually non-procedural, provided the actual transplantation belongs to surgeons. Some are working on liver dialysis.

The rest of GI is also complex, but the solution is usually endoscopy. IBD is kind of an exception, being a translational hot topic and lots of medications based on immuno/microbio mechanisms. But the rest of GI (polyps/cancer screening, motility/IBS, GERD/esophageal, pancreas/biliary/advanced endoscopy) are much more clinical/less academic and involves lots of endoscopy. And no one wants to study IBS.

Hepatologists don't always perform endoscopy (defer to GI) or liver biopsy (defer to IR) on their patients, depending on how the hospital is run. Overall, hepatologists spend more time in the clinic than general gastro and less time in the endoscopy suite. So they get paid less than other GI sub-subspecialties usually. So maybe you can say hepatologists are a bit bitter and thus don't like to see candidates going into their field for the sake of going into the GI endoscopy suite.
 
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You're missing the point. Its the standard hepatology drum that they are the thinkers in GI and the rest of us are just hollow-gut automatons and I just rolled my eyes to see it beaten again. PBC is pretty algorithmic for most patients and the only part of PSC that isn't is the endoscopic part. Transplant hepatology borders on primary care more than on gastroenterology. I enjoy a smattering of hepatology in my practice but I wouldn't dream of doing a year of training dedicated to it. If its what you like, more power to you.

For the OP, this used to be a well-worn backdoor into GI but to sit for transplant boards you would have to do a second hepatology fellowship. The only one I would consider now is the NIDDK fellowship with an eye towards a purely academic job.
 
Its pretty funny why do people always think that if someone is applying to Hepatology they only want to use it as a route to GI. i genuinely love Hepatology for the field itself. and even if i go through the GI training i would still do the extra year of Hepatology.
and its true, thanks to People like Dr. Anna Lok how made this field an interresting one to me and personally seeing the way she practice makes you fall in love more with this field.
 
Cirrhosis said:
Its pretty funny why do people always think that if someone is applying to Hepatology they only want to use it as a route to GI. i genuinely love Hepatology for the field itself. and even if i go through the GI training i would still do the extra year of Hepatology.
and its true, thanks to People like Dr. Anna Lok how made this field an interresting one to me and personally seeing the way she practice makes you fall in love more with this field.
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Cuz most of the people who do nutrition, motility, unaccredited hepatology, a research fellowship etc, do want to do GI. Being a hepatologist who doesn't scope is a PITA. Even the most liver-focused doc needs to complete a GI fellowship so you can manage your own patients. We would never hire a hepatologist who wasn't a BC/BE GI.

If you want to sit for transplant boards, you need to do hepatology after GI (for exactly this reason). Because of that, the perception of people who do hepatology first will always be that they couldn't get GI up front. Why else do an extra year?
 
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