Hepatology Fellowship Program

Fellowship Training in Hepatology

Program Director: Nikolaos T. Pyrsopoulos, MD, PhD, MBA, FACP, AGAF

The Rutgers New Jersey Medical School Hepatology Fellowship is one year program and during this period the trainee physicians will acquire skills and proficiency in clinical assessment, diagnostic approach and comprehensive management of patients with diverse liver diseases including liver transplant. The training emphasizes development of clinical expertise as a consultant, teaching proficiency as an academician, and skill of clinical researcher.

Clinical Training:

The trainees will gain knowledge and experience in diagnosing and managing patients with different liver diseases like viral, alcoholic, metabolic, drug induced, immune mediated liver diseases, end-stage liver disease, jaundice, patients with hepatocellular carcinoma, and acute fulminant hepatic failure, liver disease in pregnancy and other liver diseases but not limited to a few listed above.  They will acquire particular knowledge of liver diseases prevalent in the community and participate in the teaching community about prevention and care of the liver diseases.

The trainees will gain expertise in evaluating prospective transplant candidates. They will learn about multidisciplinary approach in the care of patients with end-stage liver disease and transplant including psychosocial and ethical issues. Candidates will learn immediate and long term management of patients after liver transplant. They will acquire understanding of the surgical procedures performed both in donors and recipients of liver transplant. They will gain experience in the use of immunosuppressive agent, drug interactions as well as evaluation and management of graft dysfunction.  The trainees will maintain continuity of care both in the in-patient and out-patient setting.  This will give them opportunity to learn about immediate and long term infectious, metabolic, cardiovascular, renal and other complications after liver transplant.

The trainees will develop understanding and participate in the decision making and care of patients undergoing various interventional radiology procedures. They will gain knowledge and understanding of the indications, contraindications and outcomes of procedures like TIPS, hepatic artery chemo-embolization, radio frequency ablations, biliary stent placements etc. Trainees will interact with attendings in the review and discussions on patient care options.  Trainees will interact with attendings in the review and discussions on patient care options.  Trainees will read and get nvolved in the implementation of evolving newer treatment modalities for chronic viral hepatitis and liver cancer etc.

They will gain further skills in endobiliary diagnostic and therapeutic procedures. The candidates will develop proficiency in the indications, techniques and interpretations of liver biopsy. Interpretation of liver histology including graft rejection will be an integral part of the training.  The training encompasses patient care learning in areas of ambulatory patient management, consult services and in-patient hepatology unit patient care.

Trainees will gain expertise in all the elements of general hepatology as detailed in the guidelines and recommendations of the AASLD, and Internal medicine Task force on graduate training in hepatology. (Rosen et al. Liver Transplantation 8: 85-87, 2002) Hepatology training guidelines of the American Association for the Study of Liver Diseases; Berk, PD, Hepatology 16: 1084-1086, 1992).    

Teaching:

The trainees will participate in teaching medical students, resident house staff and participate in peer teaching activities and that of the department of Medicine

Research:

Trainees will participate in ongoing research projects in the hepatology and liver transplant surgery services. In addition, candidates will be encouraged to have a well defined research project in the area of their interest in the field of hepatology. Candidate will work under the mentorship of a faculty to complete the project during training period. List of topics of ongoing research is available with the faculty.

Facilities and Resources:

Being a tertiary referral center with state of the art liver transplant program of national standing (data given below),  we have large volume of patients with various liver diseases.  We have to make continued effort to grow the volume of patient referrals from the network of patients in the community.

We are also the first and largest liver transplant program in the state of New Jersey and have done over 1200 liver transplants.  Hepatology and liver transplant are closely integrated services with hepatologists, and transplant surgeons working as a team for patient care responsibilities. The trainees will have full, open and interactive participation in all of the general Hepatology and transplant related activities including committed ward rounds with transplant surgeons and assigned clinic responsibilities. They will participate by presenting cases and conducting discussions in teaching and patient care conferences noted below.

Conferences and Clinics:

• In-patient and consult service: Trainees will be responsible for and manage patients admitted to the Hepatology in-patient unit at the University Hospital under supervision of hepatology attending.

• Liver Transplant Continuity Clinic: These clinics provide continuity of care from pre-transplant valuation to immediate and long term post-transplant care of patients.

• General Hepatology Clinic: Provide care to patients with a wide variety of liver diseases at a tertiary level.

• Combined Hepatology-Surgery in-patient Rounds: This provides unique learning experience for trainees and an efficient system for interdisciplinary rounds that improves patient care and outcome.

• Hepatobiliary-transplant Radiology Rounds: This round is not only a great learning session but is also an effective forum for discussion and decision making for complex patient care issues.

• Hepatology-hepatobiliary Histology Conference: At this conference liver biopsies and other surgical specimens are reviewed by hepatopatholgist with trainees and faculty being in attendance.  Provides learning experience for histology of diverse liver diseases, graft rejection, hepatocellular and biliary carcinoma etc.

• Multi-disciplinary Transplant conference: Potential candidates for liver transplant are presented by different members of the transplant selection committee followed by discussion and decision for future management and follow-up plan.

• Hepatology Didactic and key Topic Discussions: These conferences are held once a week with the objective of keeping fellows updated on recent developments in Hepatology.

• Hepatology  Journal Club: Once a week

• Morbidity and Mortality Conference:  Once a Month

• Transplant Surgery Journal Club: Alternate Tuesday

 

Click here for information on applying to the Hepatology Fellowship Program