Gastroenterology Training Program

Program Instructor: Shujiro Yasumi

1. Characteristics and Objectives of Gastroenterology Training

Gastrointestinal diseases are common and trainees often encounter them in emergency outpatient clinics, making them one of the diseases that require knowledge of initial response. Since the training period is limited to six weeks, through training in the ward,

(1) First, as a basic skill that a doctor must acquire, we will teach you how to practice team medicine in cooperation with doctors (gastroenterology and other departments) and paramedical staff such as nurses.

(2) Furthermore, the goal is to acquire the knowledge that should be acquired in gastroenterology (how to respond initially to cases such as vomiting blood and diarrhea, how to examine the abdomen, how to interpret images, abdominal ultrasound, etc.).

2. Guidance system

Kitano Hospital opened a Digestive Center in April 2006. The Digestive Center includes the Departments of Internal Medicine, Surgery, Endoscopy, and Inflammatory Bowel Disease.
As a general rule, students are supervised by specialists and certified physicians of the Japanese Society of Gastroenterology. Under the supervision of a specialist, students become doctors in charge of hospitalized patients and gain experience in diagnosis, examinations, treatment, etc.

3. Goal

The training period is limited to six weeks. Inpatients are admitted because they have some kind of clinical problem. Even if the medical department is different, the process of creating a problem list, assessing each patient, creating and implementing a plan, and guiding the patient to problem resolution remains the same. By practicing the following, you will learn how to think about solving clinical problems and gain knowledge about gastrointestinal diseases.

[Must do]

1. When a new patient is admitted, be sure to complete a medical history, physical examination, problem lists, initial assessment and plan before they are discharged.
   (In the case of emergency hospitalization, provide the minimum information.)
   Also, whenever possible, have a senior doctor check and sign the document.
2. Even if your patients are calm, make rounds twice a day, in the morning and evening.
3. If there are no major changes, the patient's medical record only needs to be recorded once a day, but after the examination, the patient's abdominal findings and test data must be checked to ensure that no complications have occurred after the procedure. In addition, the test results must be explained to the patient and their family together with a senior doctor.
4. The department head makes rounds every Thursday, so please write a weekly summary before returning home on Wednesday.
5. Cancer patients should register by going to the Medi-bank Cancer Registry and clicking on the blue Cancer stage. After completing the examination or when staging before administering anti-cancer drugs, they should have a senior doctor check and input the information.
6. If the patient's condition suddenly changes, report it to a senior doctor immediately and follow their instructions on how to respond. However, if the patient is calm, be sure to do some research and ask the senior doctor questions with your own opinion (about the patient's prescription, infusions, antibiotic use, tests that should be performed, etc.).
7. The discharge summary should be reviewed by a senior resident and then reviewed by Yasumi.
8. If a patient's condition suddenly changes, be sure to participate in and help with treatment. When doing so, check what happened to the patient and how you responded, and use that as your own experience.

There is a limit to what one doctor can experience. Therefore, in order to gain even a little experience, if a patient's condition suddenly worsens (especially if complications arise) or if another doctor is treating an interesting patient, be sure to observe or ask to see images. Also, the purpose of the summary is to confirm what you learned from the patient you treated. Therefore, be sure to check it when the patient is discharged and have a senior doctor confirm whether what you thought was correct.

During gastroenterology training, endoscopic training is conducted using models.
Motivated trainees may be asked to perform endoscopic operations after successful completion of endoscopic treatments, with the consent of the patient in charge.

4. Weekly Schedule

5. Evaluation of training achievements

During the six-week training period,SR training evaluation sheetWe create an SR training evaluation sheet and provide focused instruction on areas that each person believes to be weak before the training. Please refer to the SR training evaluation sheet for details.

6. Characteristics of our department

In our department, we have a policy of informing patients of the name of malignant disease. In addition, when there are multiple methods of testing or treatment, we explain the advantages and disadvantages of each method using data, and ultimately let the patient make the decision.

Results for 2009

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