What are our program aims?
Our program aims to provide our fellows an outstanding foundation in clinical knowledge and skills that integrate basic, clinical and translational sciences in gastroenterology and hepatology. We instill a commitment to understanding the special challenges and requirements of our diverse patient population to achieve the highest level of healthcare in an environment of humanistic, compassionate and ethical patient care with skills in effective communication and a commitment to education and teaching. We aim to provide them with an understanding of scientific methods and their applicability to clinical practice and research, and the scientific knowledge, skills and techniques to become recognized investigators pursuing innovative and significant research. Finally, we aim to provide our fellows with the ability and expertise to become leaders within our profession. By utilizing our diverse faculty and five hospital sites, we can provide trainees with a robust clinical and research experience to develop careers as academic gastroenterologists.
How does the program achieve/ensure diversity in fellow experience and training?
The UCLA Vatche and Tamar Manoukian Division of Digestive Diseases along with the David Geffen School of Medicine at UCLA aim for excellence in the areas of education, research, community engagement, and clinical care. Our core values of diversity and inclusion are absolutely inseparable from these institutional goals. Not only do we encourage, promote, and recruit diversity amongst our fellows, staff, and faculty, we believe that it is the key to our success and continued progress as a division and training program.
We provide opportunity for fellows to serve to large and diverse populations at our five hospital sites, which include two county hospitals which care for underserved populations and the Venice Family Clinic’s Simms/Mann Health and Wellness Center, which is the nation’s first health, wellness, and integrative medicine program offered at a free clinic. We are incredibly proud of the training program that we have created and continue to strive for improvement from year to year. We are also strongly committed to equity, diversity, and inclusion and believe that we serve as an example for open dialogue, life-long learning, and compassionate quality care. In addition, we have faculty within our division like Dr. Folasade May who is co-director of Resident and Fellow Global Health Education at the UCLA Center for World Health for the Global Health Education Program and is involved in research with the Center for Health Equity which focuses on reducing disparities in incidence, prevalence, mortality and burden of disease experienced by disadvantaged and underserved populations.
At UCLA our fellows have the opportunity to engage in a number of equity, diversity and inclusion (EDI) activities to promote community building, open dialogue and lifelong learning in the health equity and advocacy space. Check out highlights from our GME Equity and Diversity Inclusion and our Department of Medicine Office of Equity, Diversity and Inclusion (DOMEDI), to learn more.
Dr. Chang (program director) and the fellowship program participate in activities to support women in gastroenterology. Dr. Chang has participated in the faculty development course for leadership for women in academia at UCLA. She has also participated as a panel member and co-organizer for the first women’s event of the newly formed Southern California GALS (GI and Liver Society), an organization started by two of our previous GI fellows. The society aims to provide opportunities to network and obtain mentoring for women in GI and hepatology to residents, fellows, faculty and practicing GIs in the southern California area. One of our current fellows is currently spearheading a Women in Gastroenterology Mentorship Program at UCLA. We take pride that in the past 7 years, 39 percent of our GI fellows were women, and in the past 3 years, 62 percent of the fellows are women, which is higher than the national average.
In response to the #HCW for #BLM movement, we are forming a Diversity, Inclusion, and Community Engagement (DICE) taskforce in our division for 2020-21 comprised of faculty and fellows focused on community outreach, advocacy, reducing disparities via research initiatives, and other activities such as book clubs and story slams.
What kind of applicant is the program looking for?
We are seeking the future academic GI leaders of tomorrow. Many of the leaders in gastroenterology and hepatology graduated from the UCLA GI Fellowship Training Program, 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 commitment 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 highly rated 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 ~40-50 applicants for our 7 slots per year. Thus, the process is competitive. However, 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 seven fellows per year. Thus, there are up to 21 fellows in the program at any given time. Of these seven, roughly five matriculate into our clinical scholar track, and two into our research scholar track. This may vary slightly from year-to-year depending on the applicant interest.
How are the various hospitals and clinic sites used to augment the curriculum?
The UCLA GI Fellowship Training Program is among the largest in the nation. We currently have 5 hospitals in our harmonized program, and fellows have equal opportunities to rotate through all of the sites. This provides a tremendous 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 complex disorders, transplant medicine and the full range of digestive diseases. The VA Greater Los Angeles Healthcare System 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, IBD, functional GI, motility disorders, interventional endoscopy, pancreaticobiliary disorders, and GI and hepatic malignancies. Both Olive View-UCLA Medical Center and Harbor-UCLA Medical Center provide trainees with exposure to busy county hospitals known for an excellent teaching and endoscopic experience. Finally, the UCLA Medical Center-Santa Monica, which is part of the integrated UCLA Healthcare System, provides exposure to a community-based secondary-care hospital with particular expertise in medical oncology, hepatology and geriatrics, among many other specialties. There are also multiple UCLA Health community clinical which provide trainees with an even broader outpatient experience. View our affiliated hospitals
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, all fellows participate in the Fellows Committee which meets monthly with the program director and associate program director to discuss and effectively address any fellowship-related activities, rotations and other issues. Both committees allow real-time feedback and provides mutual opportunities for ongoing program enhancements and fine-tuning. Third, the faculty meet at the annual faculty retreat to review the curriculum, teaching methods, and overall goals and objectives of the program. Fourth, the fellows meet together regularly, including the weekly journal club and core curriculum lectures, hepatology conference, bi-weekly esophageal, inflammatory bowel disease (IBD), pathology and clinical case conferences. We have video conference capabilities that will allow teaching conferences at one hospital to be seen at the other facilities. All teaching evaluations are harmonized through MedHub, a web-based residency management system designed to track and document a variety of critical program and resident activities including a unified source of evaluations, a core set of reading and journal articles, as well as goals and objectives and policy and procedures. The system, also provides fellows and faculty with a core set of reading, full set of rotation-specific goals and objectives, and the full set of updated policies and procedures.
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 core hospitals.
What are the core clinical training requirements of the program?
All fellows, independent of whether in the research scholar track or clinical scholar track, complete a minimum of 18 months of clinical training, and a one half-day-per-week continuity clinic throughout the three-year fellowship program. During the first year, each fellow spends 1-2 month blocks on the inpatient services at the Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica and VA Greater Los Angeles Healthcare System for 10 months out of the year. In addition, all fellows must complete five months of hepatology. There is inpatient and outpatient hepatology experience at Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica and the VA Greater Los Angeles Healthcare System. All clinical track fellows must also complete 1 month of pancreaticobiliary training and interventional endoscopy training and 1 month of motility/functional GI training. Additional clinical time is variably spent at Harbor-UCLA (1-2 months), Olive View UCLA (1-2 months), and electives (e.g., IBD, motility, general and interventional endoscopy). All fellows receive directed training in nutrition and GI radiology during a 4-week block at the VA Greater Los Angeles Healthcare System and the Ronald Reagan UCLA Medical Center. First year fellows have two months of electives consisting of outpatient GI clinics, endoscopy, as well as dedicated research time.
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 the VA GI clinic. Thereafter the continuity clinics occur in 6-month blocks at any of the hospital sites. The fellows' interests in working at specific clinics are given consideration when clinic assignments are arranged.
Is research required for everyone?
Yes. All fellows, regardless of being in the research scholar track or clinical scholar track, must perform research. Fellows in the research scholar track conduct 18 months of research during their first three years of training (typically nine months in both the second and third year of fellowship), and those in the clinical scholar track can receive 4-6 months of protected research time.
What is the clinical scholar track?
When you apply to our program, you will be asked to apply to either our research scholar track or clinical scholar track. We have separate committees and separate interview days for each track. We do not have a set quota on how many we select from each track - that varies year by year, although it tends to be five in the clinical scholar track and two in the research scholar track per year. The total from both tracks will be seven fellows. Fellows in the clinical scholar track will spend 36 months in our program. True to its name, this track is designed to nurture clinical investigators and includes a research component. All fellows in the clinical scholar track receive up to 4-6 months of block time for research. Even though fellows in this track are not supported by a research scholar track grant (i.e. NIH Training Grant(s) or STAR program, described below), they are still expected to complete research, including an abstract submitted to a professional meeting and a subsequent manuscript.
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. Although all fellows obtain some hands-on training in advanced endoscopy procedures during the 3-year program there will not be any certification of advanced procedures. However, fellows who apply to a fourth year of advanced interventional endoscopy procedures training, anywhere in the U.S. or Canada will be permitted, if they wish, to do up to three months of concentrated hands-on advanced endoscopy procedure training before they commence the fourth year advanced training.
Clinical 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 academic track must complete the basic core training requirements, outlined above. In our recruitment process for the clinical academic track, we are seeking candidates who are focused on becoming clinical academicians upon completion of their training period. Candidates will be at an advantage if they have carefully considered their area(s) of clinical interest, and have developed specific objectives and goals for what they hope to accomplish within the context of clinical academics.
What is the research scholar track?
The research scholar track is designed to train and support fellows who intend to focus principally on research in their future academic careers. This track is available in either clinical investigation or in basic/translational research. Fellows in the research track will still need to complete the ACGME requirements for all GI fellows, 18 months of clinical training, half day per week of continuity clinic for three years, five months of hepatology, etc. However, these fellows will have protected time for research, which typically occurs in the second and third years of fellowship.
Research scholar fellows are encouraged to apply for the UCLA Specialty Training and Advanced Research (STAR) Program (see link below). The UCLA STAR Program is a UCLA Department of Medicine supported track which provides mentorship and support, in addition to that provided by the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases, to promote protected time for research. It has four career tracks: basic science (PhD), health services (PhD), post-doctoral (for those who already have a PhD), and clinical investigator (masters of science clinical research [MSCR]). Typically, the clinical investigation pathway requires four years to complete the clinical and research training. Basic and translational research PhD pathway usually requires a 5-year program to complete the clinical and research training.
There are several different funding mechanisms that provide guaranteed salary and research support, including a NIH T32 training grant, to fellows in the research scholars track. All research scholar track fellows need to identify a research mentor and develop a specific research plan. Fellows submit a written research and mentoring proposal to the Training Grant Committee with assistance from their mentor. If accepted, funding is available at the start of the second or third year of training. Please note that candidates for STAR or NIH Training Grant support must be permanent residents or citizens of the U.S. to apply.
Please note that candidates for STAR or NIH Training Grant support must be permanent residents or citizens of the U.S. to apply.
More about our GI research programs | More about the UCLA Specialty Training and Advanced Research (STAR) Program
How do I decide whether to do the research scholar track or clinical scholar track?
This can be a difficult decision, but each applicant needs to decide for him/herself based on their personal vision and objectives. A question to ask yourself is: "Do I intend to principally make a living doing research in my future career or not?" Those fellows who intend to focus principally on research in their future academic careers and to obtain independent funding through major grants should consider the research scholar track. If your goals are to pursue an academic career primarily in education and patient care activities, then the clinical scholar track is probably a better choice. For the purpose of applications, there is no strategic advantage to selecting one track over the other. Each applicant should consider their future direction and then decide which track provides the best avenue to achieve these goals. Although the fundamental clinical education in gastroenterology and hepatology is similar, each track is designed to provide advanced training towards very different and specific career goals. If you have any questions, please contact the training program leadership to discuss your goals and receive advice regarding which track would be best for your career plans. It is very important to us that you choose a track which meets your goals and provides you with the proper training to launch your career.
Those interested in the research scholar track are encouraged to explicitly outline their research goals and expectations for training in the personal statement and ask a research mentor to write a letter of recommendation. There is no strict quota for the number of positions we accept in each track. Instead, we consider each applicant on his/her own merits and make decisions about acceptance on that basis. Our goal is to find the best applicants who will benefit from training in the UCLA GI Fellowship Program to prepare them for an academic career.
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 created by the fellowship program along with feedback from the fellows to ensure adequate breadth and depth so that all fellows are exposed to a wide range of topics in gastroenterology, hepatology and nutrition (also known as "Entrustable Professional Activities"). Fellows located at UCLA meet weekly for Journal Club and bi-weekly for clinical case and pathology conferences at UCLA. Other conferences at UCLA include weekly hepatology case conference and bi-weekly esophageal and IBD conferences. Fellows at Santa Monica and the VA are able to participate in the weekly Journal Club and bi-weekly clinical case conference at UCLA via videoconference. Fellows located at Olive View, UCLA Santa Monica and Harbor, have separate Journal Club meetings and conferences during their time at those hospitals.
What electives are available?
All fellows have the opportunity to take electives after their first-year of fellowship. These include the following:
Motility Elective: This is a 4-week elective offered at UCLA. 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 state-of-the-art esophageal manometry, esophageal pH studies, esophageal motility with provocative agents, radionuclide gastric emptying studies, small bowel motility, colonic transit measurements, anal sphincter manometry, and wireless motility capsule studies. 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. This elective also offers opportunities to participate in outpatient clinics e.g. functional GI, ENT/speech pathology swallowing clinic (MBSS), fore-gut surgery clinic.
Nutrition/Radiology Elective: This is a 4-week elective offered at the VA Greater Los Angeles Healthcare System, Ronald Reagan UCLA Medical Center and UCLA Medical Center, Santa Monica. This elective provides an in-depth understanding and clinical experience in nutritional assessment and management, with a focus on complex cases. Fellows will rotate through the nutrition clinics at each site as well as the TPN and celiac clinics at Ronald Reagan UCLA Medical Center. The radiology portion provides experience into diagnostic and therapeutic modalities in GI radiology. Fellows will rotate through the VA and Santa Monica radiology reading rooms.
Gastrointestinal Endoscopy Elective: This is a 4-week elective offered at Olive View-UCLA, 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.
Interventional Endoscopy Elective: This is a 4-week elective offered at Ronald Reagan UCLA Medical Center. 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.
Tailored Electives: Fellows who are interested in pursuing a more focused subspecialty training experience have the opportunity to create a tailored elective (e.g., GI oncology, hepatology, interventional endoscopy, IBD).