This document discusses issues facing gastrointestinal fellowship programs of different sizes. It provides details on the core and advanced fellowship programs at Mayo Clinic-Rochester, including the number of fellows per year and currently in each track. The main issues discussed are the challenges of having many fellows and faculty to oversee, the significant time commitment required by the program director and leadership, issues that can arise with trainees, and the additional workload of administering advanced fellowship programs separately.

1. GI-Face Off:
Issues Facing Small, Medium
and Large Programs
Amy S. Oxentenko, MD, FACP, FACG
Associate Professor of Medicine
Fellowship Director, Mayo Clinic-Rochester

2. Our Core Program Size
Tracks # Per Year # Currently
In Match 7
NIH 1-2 6
Clinical Scholar 5-6 16
Not in Match*
Clinical Investigator 0-3 6 (+2)
Total 7-10 28
Approved by ACGME 30
*Match into fellowship at time of residency match

3. Our Advanced Program Size
Advanced Programs # Per Year Accredited?
Transplant Hepatology 3 Yes
Advanced Endoscopy 1 No
Inflammatory Bowel Disease 1 No
Pancreas 1 No
Motility 1 No
Esophageal 1 No
GI Neoplasia 1 No
TOTAL 9

4. The Big Issues
• Many fellows (39) and staff (~78)
– Repeat contact for adequate teaching and feedback
– # to educate on requirements/faculty development
• Overall time (PD and EPC)
– Schedules, semi-annual reviews, interview season,
letters for jobs/advanced training/awards/etc
– Worse w/milestones and competency committees
• Trainee issues
– Absences, personal issues, behavioral issues
• Advanced training
– Additional interviews, separate program goals and
measures, same internal review workload, 2 PDs