Subspecialty Program Information - Gastroenterology

INTRODUCTION

Welcome to the Section of Gastroenterology at the University of Manitoba.  The Gastroenterology Program is a two-year program approved and accredited by the Royal College of Physicians and Surgeons of Canada.  Our primary objective is to provide excellence in the domains of patient care, research and teaching.  We have a young, collegial and well diversified section.  Intensive training in clinical Gastroenterology will enable our trainees to acquire the necessary skills to become expert GI clinicians.  Trainees will also be strongly encouraged to pursue their academic / research interests (see below).

The section of Gastroenterology includes 6 University affiliated gastroenterologists, 1 full time health economist, and 10 community practicing gastroenterologists.  Fellows will also receive training from members of the section of Hepatology.  We provide clinical service and teaching to the two major teaching hospitals in Winnipeg (Health Sciences Center [HSC] and St. Boniface General Hospital [SBGH]).  HSC is a quaternary hospital that serves as a major referral site for Winnipeg, Northern Manitoba, Nunavut, parts of rural Manitoba and Northwestern Ontario.  St. Boniface General Hospital is a tertiary care center that serves as a referral site for Winnipeg and many parts of rural Manitoba.  In total we serve a referral area of over 1.2 million.

THE GASTROENTEROLOGY FELLOWSHIP PROGRAM

All trainees are expected to develop a solid understanding of basic GI pathophysiology, diagnosis and treatment of both acute inpatient and chronic outpatient GI disorders.  To achieve this goal, rotations on the busy GI in-patient consultation service as well as hepatology service will be undertaken.  In addition, the trainee will have the option of several outpatient based rotations including: IBD, motility, nutrition, hepato-biliary, pathology, radiology, pediatric GI, rural GI experience and GI ambulatory care.  As well, each trainee will be assigned a single preceptor who will provide direct supervision during the 2 year, long-term outpatient continuity clinic.  An evidence based approach is emphasized where applicable.

All trainees will have the benefit from significant exposure to the IBD Clinical and Research Center.  Established in 1994 by Dr. Charles Bernstein, it has received both national and international recognition as being a center of excellence in terms of research and clinical management of IBD patients.  

All trainees will also benefit from the numerous regularly scheduled teaching rounds including: Pathology rounds, Fellow’s seminar series, GI journal club, Physiology Rounds, CAG physiology lecture series, Clinical Case Rounds, City wide evening GI Journal Club, GI Literature Review & Critical Appraisal Rounds.

THERAPEUTIC ENDOSCOPY

Approximately 10,000 endoscopies were performed at HSC and SBGH in 2007.  As well, approximately 1200 ERCPs, 300 EUS cases and 80 capsule endoscopies were completed in 2007. 

All GI endoscopic procedures are done using state of the art high definition video endoscopes.  Trainees will become skilled and proficient in diagnostic and therapeutic endoscopy including but not limited to: Gastroscopy, colonoscopy, push enteroscopy, percutaneous entero-gastrostomy, polypectomy, chromoendoscopy, argon plasma coagualtion, variceal banding, hemostasis techniques, dilation, and narrow band imaging.  Exposure to advanced endoscopy will be provided during a separate pancreatico-biliary rotation where ERCP and EUS will be introduced.  Techniques such as sphincterotomy, temporary and permanent biliary and pancreatic stent placement, therapeutics for chronic pancreatitis, transgastric pseudocyst drainage, EUS-guided FNA, celiac plexus neurolysis, and endoscopic mucosal resection will be demonstrated.  Exposure to capsule endoscopy and enteric stent placement is also available.

During their training, trainees can take advantage of our two state of the art endoscopic simulators housed in the new Clinical Learning and Simulation Facility – an 11,000 square foot ultra high-tech facility, one of Canada’s most comprehensive clinical learning and simulation centers.  Gastroscopy, colonoscopy and ERCP are available simulator options.  Early on in the GI Residency Training program, trainees will have teaching sessions on the simulators with direct faculty interaction. 

RESEARCH

To facilitate the acquisition and development of research skills, trainees will have monthly teaching sessions dedicated to critical appraisal of the literature including in depth discussions focusing on research methodology and study design.  Dedicated research time (up to 4 months) in conjunction with our section members’ diverse research interests will provide an enriched medium for the trainee to carryout research.  All trainees are encouraged to present their research at both national and international meetings as well submit their work for publication.

Research may be further expanded during a third year where the trainee may also take advantage of the Diploma in Population Health Program offered through the Department of Community Health Sciences at the University of Manitoba.  The Department of Community Health Sciences also offers Master’s (MSc and MPH) and PhD degree programs. 

A brief summary of some of the research interests of our section include:

Dr. Charles Bernstein (IBD and Capsule endoscopy): IBD epidemiology and outcomes research; IBD etiology research; optimizing disease diagnostics and prognosticators in IBD; clinical trials in IBD and IBS.  Colorectal cancer screening approaches.

Dr. Laura Targownik (GI bleeding outcomes research): Pharmacoepidemiology of proton pump inhibitor use; process of care issues regarding the management of gastrointestinal bleeding.  Prevention of NSAID related gastrointestinal complications.

Dr. Michael Cantor (Endoscopic Ultrasound):  Endoscopic ultrasound outcomes research.  The role of endoscopic ultrasound in the diagnosis of pancreatic cysts and gastrointestinal subepithelial lesions.

Dr. Dana Moffatt (ERCP and therapeutic endoscopy): ERCP outcomes research, ERCP complication prevention research, gastrointestinal radiology/gastroenterology interface and endoscopy clinical trials.

Dr. Harminder Singh (Clinical outcomes research): Colorectal cancer screening, prevention, wait times, endoscopy outcomes, sedation for colonoscopy.

Dr. Don Duerksen (Nutrition): Celiac Disease, Nutrition Support and Home enteral and parenteral nutrition.

Dr. Alex Ilnyckyj (Motility and Functional GI disorders): Fecal incontinence.  Therapeutics of IBS. Quality assurance pertaining to GI motility. 

The Section of Gastroenterology has an extensive network of local collaborators from the fields of clinical epidemiology (Drs James Blanchard, Donna Kennedy, Alain Demers), clinical health psychology (Drs Lesley Graff and John Walker), bone health (Dr. William Leslie), nutrition (Ms. Kathy Vagianos) and an extensive network of national and international collaborators. These interactions can facilitate and expand trainees’ research endeavors.


Application Deadline:  August 25th of the year preceding program commencement.

Objectives:    PDF

Program Dates:  Two year program from July 1st in year one until June 30th in year two. All applicants must have proof of Canadian citizenship or landed immigrant status.

Remuneration:  Residents will be paid according to the Professional Association of Residents of Manitoba (PARIM) agreement concerning remuneration of residents commensurate with their number of years of post-graduate training.

For further information regarding the Gastroenterology Residency Training Program please contact:

Suzanne Doyle
Education Coordinator, Gastroenterology
University of Manitoba
Room 804G John Buhler Research Centre
715 McDermot Avenue
Winnipeg, Manitoba
R3E 3P4
Phone: (204) 789-3888
Fax: (204) 975-7746
Email: sdoyle1@hsc.mb.ca

 

Contact:
Dr. M. Cantor, Director
Gastroenterology Subspecialty Training Program
University of Manitoba
Room 804G John Buhler Research Centre
715 McDermot Avenue
Winnipeg, Manitoba
R3E 3P4
Phone: (204) 789-3888
Fax: (204) 975-7746
Email: sdoyle1@hsc.mb.ca