Graduate Medical Education - Residencies and Fellowships

 

 Overview

 
  • Program Administrator: Geraldine (Gerry) Sualnier
    (619) 532-9666

    The Gastroenterology fellowship at Naval Medical Center San Diego is a rigorous 3 year training program that will prepare fellows to become fully functional independent gastroenterologists within the military health system utilizing the civilian sector to augment training. The selection process is competitive, and priority is given to those candidates from the DoD services.

    The fellowship stresses training in clinical gastroenterology; however several months throughout the three years are allotted strictly for the fellow to perform independent research with guidance from a staff mentor. All fellows will be fully trained in general gastroenterology with exposure to advanced gastroenterology procedures and liver transplantation. Fellows will have a great deal of experience with both ambulatory and inpatient gastroenterology issues as well as significant time spent in endoscopy. Upon completion of the fellowship, fellows will be fully competent in diagnostic and therapeutic EGD/colonoscopy, performance of liver biopsies and paracentesis, as well as interpretation of small bowel video capsule endoscopy, esophageal manometry and pH/impedance testing. Fellows will also gain some experience participating in ERCP, EUS and balloon enteroscopy. Successful completion of the program will prepare the fellow to sit and pass the ABIM Gastroenterology certification exam.

    The vast majority of the first year of fellowship is spent at NMCSD, whereas the fellow will spend several months their second and third years on out-service and elective rotations. All fellows will spend time at various programs within the San Diego region, gaining additional exposure to general gastroenterology, hepatology and liver transplantation. Throughout their training, fellows will rotate at UCSD, Sharp Healthcare System, Scripps Green Hospital and Kaiser Healthcare System, with opportunities to do elective rotations out of the San Diego area as the schedule and funding permits.

    Fellows will work closely with staff on a daily basis discussing both outpatient and inpatient gastroenterology cases as well as working with a mentor to help them facilitate research. Each fellow is expected to develop and participate in a research project with the overall goal of presenting that research at a national conference or submitting it for publication. Fellows are also expected to participate in weekly departmental academics (management conference, lectures, journal club, M+M, etc...) along with inter-departmental surgery, radiology and pathology conferences.

 

 Program History

 
  • The Gastroenterology department has been a vital part of NMCSD for decades. The Gastroenterology fellowship program was started in the late 1970s and over the years has produced dozens of gastroenterologists that have served out their careers in the military and community. NMCSD Gastroenterology has well-established relationships with many San Diego academic medical centers and several former graduates of this program continue to reside and practice in town. Fellows will have the opportunity to train alongside many former Navy gastroenterologists as they rotate through these other medical centers.

    The Combined Endoscopy Center (CEC) is a state of the art endoscopy facility that opened in September 2015. NMCSD is the only military facility where both gastroenterology and surgery perform endoscopic procedures utilizing the same space. This facility was designed to centralize all endoscopic procedures in one area in order to provide patients with a better overall experience. The CEC also allows us to have a close working relationship with the surgery department with consistent anesthesia support for patients requiring monitored anesthesia care during their procedure.

    Recent graduate placements:

    2017: LCDR Edward T. Stickle, USN—GI staff at NMCSD, San Diego CA

    2016: MAJ Michal Sherman, USAF—GI staff at Malcolm Grow Medical Clinic, Joint Base Andrews, MD

    2015: MAJ Aaron Lewis, USAF—GI staff at Nellis AFB, Las Vegas NV
    LCDR Brent Lacey, USN—GI staff at Naval Hospital Pensacola, Pensacola FL

    2014: CDR Leonard Philo, USN—GI staff at NMCSD, San Diego CA
    LCDR Rebecca Ensley, USN—GI staff at NMCSD, San Diego CA*

    2013: CDR David You, USN—GI staff at CAPT James A Lovell Federal Health Care Center, Great Lakes IL
    LCDR Sean Caufield—GI staff at Naval Medical Center Portsmouth, Portsmouth VA**

    2012: CDR Robert Lawson—GI staff at NMCSD, San Diego CA. Dr. Lawson also completed a fellowship for the 2012-2013 academic year in advanced gastroenterology at UCSD

    *As of September 2017, Dr. Ensley works for Sharp Gastroenterology Medical Group
    **As of July 2016, Dr. Caufield is in private practice at Centers for Gastroenterology, Loveland CO

    Additional program alumni currently work at Scripps Green, La Jolla, CA; Sharp Rees-Stealy, San Diego, CA; Kaiser Healthcare System, San Diego, CA

 

 Academics

 
  • Departmental academics are held on a weekly basis from 0730 to approximately 1000. Academic sessions are predominantly driven by the fellows with lecture provided by GI staff and guest lecturers. GI staff will be present at all academic conferences to provide specialized expertise and input.

    Sample academic conference schedule:

    Clinical case management conference (weekly)
    Fellow assigned topical lecture (weekly)
    Journal club (monthly)
    Radiology conference (every other month)
    Pathology conference (monthly)
    Nutrition conference (monthly)
    M+M conference (monthly)
    Guest or GI staff lecture (1-2x per month)
    Med student or IM resident rotator lecture (monthly)
    Fellowship meeting with program director (monthly)

    Clinical Rotations (Sample Schedule):

    ​FY ​JUL ​AUG ​SEP ​OCT ​NOV ​DEC ​JAN ​FEB ​MAR ​APR ​MAY ​JUN
    ​1 ​OP GI ​IP GI ​OP GI ​IP GI ​UCSD ​IP GI ​Endo ​IP GI ​OP GI ​IP GI ​OP GI ​RSH
    ​2 ​IP GI Kaiser ​RSH ​Endo Kaiser ​RSH ​OP GI ​Scripps ​Sharp ​SHarp ​Endo ​RSH
    ​3 ​RSH ​OP GI ​Elec ​Scripps ​Scripps ​Elec ​Elec ​RSH ​Kaiser ​Endo ​Jr Staff ​Endo

    OP GI: outpatient (ie, ambulatory) gastroenterology *
    IP GI: Inpatient GI service**
    RSH: Research month (will have one clinic and one procedure block per week)
    Endo: Full time endoscopy block
    Jr Staff: Junior staff month

    All fellow are required to have at least weekly continuity clinic regardless of which rotation they doing. Fellows who are on out-service rotations will have their continuity clinic on Fridays after academic conferences.

    *The outpatient fellow will predominantly see clinic, however will have 2-3 procedure blocks per week as well.

    **The inpatient fellow will have a weekly continuity clinic as well as 1 procedure block per week.

 

 Curriculum

 
  • ​Our Fellowship program consists of three years of training in core clinical practices and advanced gastroenterological procedures. The first year of training focuses on basic consultative gastroenterology and is outlined in greater detail in the Curriculum Section. Hands-on training for procedures, small group discussions, one-on-one meetings with attendings, and other learning opportunities provide the support necessary to ensure that the fellow gains a strong understanding of the full spectrum of gastrointestinal, biliary, hepatic, and pancreatic diseases.

    As training progresses, the fellow is expected to acquire the leadership skills needed to coordinate manpower and resources in order to perform consultative services in the context of a rigorous academic environment. The latter part of training allows the fellow to gain even more experience as part of a tertiary referral hospital.

    The second and third years of the Fellowship program are centered on mastering more advanced gastroenterological procedures. Still operating with the full support and guidance of the GI staff, the fellow will focus on patients who need more advanced diagnostic and therapeutic procedures. The fellow will attend a variety of conferences, and a comprehensive rotation schedule will give him or her a well-rounded knowledge base and invaluable experience in an assortment of hospital settings.
 

 Faculty

 
  • LTC Joseph Cheatham, USA: Fellowship Program Director, 2015 - present
    Internal Medicine Residency—Walter Reed Army Medical Center, Washington, DC
    Gastroenterology Fellowship—National Capital Consortium (WRAMC/NNMC), Bethesda, MD

    CDR Adam Deising, USN: Gastroenterology Department Head, 2014 – present
    Internal Medicine Residency—Naval Medical Center San Diego, San Diego CA
    Gastroenterology Fellowship—National Capital Consortium (WRNMMC), Bethesda MD
    Transplant Hepatology Fellowship—Georgetown University Hospital, Washington, DC

    CDR Robert Lawson, USN: Director of the Combined Endoscopy Center, 2013 – present
    Internal Medicine Residency—Naval Medical Center Portsmouth, Portsmouth VA
    Gastroenterology Fellowship—Naval Medical Center San Diego, San Diego CA
    Advanced Gastroenterology Fellowship—UCSD, San Diego CA

    CDR Leonard Philo, USN: Clinical staff gastroenterologist, 2014 - present
    Internal Medicine Residency: Naval Medical Center San Diego, San Diego CA
    Gastroenterology Fellowship—Naval Medical Center San Diego, San Diego CA

    LCDR Edward Stickle, USN: Clinical staff gastroenterologist, 2017 - present
    Internal Medicine Residency—Naval Medical Center Portsmouth, Portsmouth VA
    Gastroenterology Fellowship—Naval Medical Center San Diego, San Diego CA

    Leybelis Padilla, MD: Clinical staff gastroenterologist, 2017 - present
    Internal Medicine Residency—University of North Carolina, Chapel Hill NC
    Gastroenterology Fellowship—Carolinas HealthCare System, Charlotte NC

    Alerice Walker, PA-C: Clinical gastroenterology physician’s assistant, 2016 - present

 

 scholarly activity

 
  • LCDR Amie Harvey, USN: PGY5 fellow’s article “Chronic autoimmune urticarial as the presenting manifestation of primary hyperparathyroidism” published in Annuals of Allergy, Asthma & Immunology Journal.
    LCDR Daryl Fick, USN: PGY4 fellow doing IRB research on Eosinophilic Esophagitis.
    LT Ryan Fawley, USN: PGY 5 fellow presented a poster at the American Gastrological Association annual scientific meeting on “Klebsiella Oxytoca: A Commonly Unrecognized Cause of Hemorrhagic Colitis”.
    LTC Joseph Cheatham, USA: Program Director’s article “Continuing Medical Education Questions: November 2016” was published in the American Journal of Gastroenterology.