Monday 22-4-2019 Latest Update : 22-04-2019 AT 14:03


Gastrointestinal Diseases

The evolution of Medicine Gastroenterology and Liver - branching of the internal diseases of public - a major development during the last two decades where he became a note of the theoretically and practically and technically very broad, with no room for the acquisition of theoretical knowledge and practical skills and clinical it without frequenting this area and to practice it for several years, the two years prior to the of time and is now three years, and there in some European countries are training programs for four years in this specialty.

 

The stunning development in this field has become requires information theory and skills of clinical practice devices of a particular kind, must be the doctor to be on the knowledge, experience, knowledge and holder of a Certificate of Specialization in internal medicine general and then move to the train in the area of ​​this medicine for a period of not less for three years to be able to specialize in this knowledge and be able to deal with patient needs in this area, so it is a sub-specialized, accurate and advanced medical care in the hierarchy of the patient.

Objectives of the residency program:
    

At the end of the training period the trainee should be able to do the following:
1 - patient care in terms of problems related to the digestive canal, liver and pancreas.
2 - Provide advice to colleagues in other disciplines with regard to Pachtsas.
3 - Note and follow-up developments of the patient's condition.
4 - to know itself in its competence and shall be read in-depth analysis of data Ghaderaaly correctly.
5 - to be able to make all the necessary tests to the patient during endoscopic devices and related Alphipprscopah for diagnostic purposes.
6 - to be able to make some treatment methods through these devices and familiar with the Endowment in the field, including the digestive system.
7 - should be familiar with ultrasound of the abdomen through which the processors.
8 - to be able to training in the field of specialization.


Duration of training:

Training period is three years in a row in diseases of the digestive system and liver valuable trained hospitals recognized by the Arab Council for terms of reference for health.

 

 

The Training Plan:

The First Year:

The trainee in the first year of residency should have finished the following program:

1-Good theoretical knowledge in Anatomy and Histological Anatomy for Oral, Esophagus, Stomach, Duodenum, Small and Large Intestine, Rectum, Anus,  Liver Bile Duct, Gall Bladder and Pancreas.

2-Follow up with patients suffering from liver and digestive system diseases in the hospital, in outpatient clinic and also in emergency unit.

3-Must have good theoretical knowledge in installing different endoscopic apparatuses of the digestive system, and how to sterilize and take good care of them. They must know how to deal with apparatuses in a safe way to ensure patient safety during usage.

4-Must know the physical forms of theses organs. He must be able to recognize theses organs through daily practice, and attend fiber endoscopic sessions to different organs of the digestive system.

5-Must have good theoretical knowledge, must start a practical application under the supervision of the trainer, to apply endoscopy to the upper and lower digestive tract and to apply endoscopy to the Pancreas and the Liver bile duct.

The trainee must have a theoretical knowledge in all information related to ability to take different biopsies from different parts of the upper and lower digestive tract, whether from the normal or from the affected parts. He must apply this practically under the supervision of the counselor trainer.    

6-Must have good theoretical knowledge to all indications of taking a biopsy from the liver, and to know how to apply the procedures under the supervision of a counselor then doing that independently. Total awareness of all complications and their treatments. He also must know all cases that prevent such medical procedure, and follow up these biopsies and observe them with the counselor responsible for training in the Pathology department. The trainees must also observe the pathological changes under the supervision of the counselor.

7-Follow up patients in hospitals, clinics, and he should be trained to take a medical decision based on right foundations of methodology.   

8-Evaluating the trainee at the end of the first year, in all aspects related to practical and theoretical knowledge of what mentioned before to make sure that he is familiar with the theoretical and practical knowledge in an accepted way. He must be evaluated from all counselors in the department.  Decision must be taken from all counselors in order to transfer the trainee to the second year of fellowship in Gastrointestinal medicine.

The Second Year:

The trainee in the second year of residency must be trained to do the followings:

1-He must practice widely all applicable diagnostic methods and some therapeutic methods under a direct supervision from the counselor.

2-He must be given more opportunity to practice diagnostic endoscopy to the upper and lower tract and start to train himto be able to practice therapeutic methods through theses diagnostic methods. To observe him closely to see if he can do the practice, and if it possible for him to be left alone in some simple cases in which there is no possible complications which need no experience and long term practice.

3-Must be familiar with the abdominal ultra sound waves and its therapies.

4-He can start to do Sphincterotomy and Lithectomy from Liver Bile Duct and to do some required treatments under direct supervision. Also to put stent when there is a need and to do cannels expansion.

5-Know how to manage bleeding from the upper and lower tract by all known and different ways of treatment.   

6-He must be familiar with the methods of  basic scientific research, and begin to contribute in one scientific research during the current year. 

7-Must be familiar with ways and methods of measuring kinetics of the digestive tract especially in nanometer study, also kinetics of esophagus, rectum, stomach, and Liver bile ducts.  

8-Must start practical practice to ways of dilating malignant and benign esophagus strictures and their complications, in all ways known in the Gastrointestinal medicine at this time; he must know methods of treating these complications under the supervision of the counselor or by his own.

9-Must start practical application and effective practice to cut polyps of the upper and lower tract. This must be done under the supervision of the counselor, then doing it by his own.

10-The trainee must be evaluated in the end of the year from the counselors, they must make sure that he is doing all diagnostic and therapeutic procedures in all subjects mentioned in the program of this year in a professional way. Must make sure of his theoretical knowledge in managing the practical application aspects and its complication and how to prevent and treat it. Must insure safety of the outcomes to all procedures until he is able to move to the third training year.     

The Third Year:

The trainee in the third year of his training in Gastrointestinal medicine should be professional in the following skills:

1-Must have full knowledge and must be capable of analyzing all radiologic outcomes, isotopic, ultra sound, CT/scans, MRI to all parts of the Digestive system, bile ducts imaging by using MRCP.   

2-Must perform endoscopy to the Esophagus, Stomach and Duodenum. He should have performed not less than 500 endoscopic procedures to the upper digestive tract through the training period, half of this period must be under supervision and the other half without supervision. 

3-Must perform proctosigmoidoscopy, the trainer should have performed not less than 200 endoscopic procedures to the lower part of the digestive tract. 100 procedures are under supervision and the other 100 are done alone and without supervision.

4-The trainee must perform total Colonoscopy. He should have participated in not less than 300 endoscopic procedures of this kind. 100 procedures are done under supervision and the other 200 are done alone and without supervision.

5-Must perform polypectomy by Electyocautery. The trainee should have performed 30 procedures professionally undersupervision and should have performed 20 procedures alone and without supervision.

6-The trainee must be professional in taking biopsies, histological examination slides, and also taking samples from pathological cells from each organ.

7-The trainee should have performed liver biopsies. He should have done more than 20 biopsies under supervision and 20 biopsies alone and without supervision, this must be done during the training period. He should have trained to be familiar with the present  pathological assets during a microscopic examination and under the supervision of the counselor responsible for the department of pathology. He must provide this to the counselor when he is asked to.

8-He should have done procedures like dilating Esophagus, Duodenum, the Colon,  malignant and benign strictures by using well- known methods. he should have done dilation to Esophagus, Duodenum, the Colon,  malignant and benign strictures by using different methods. He should have done more than 10 cases under supervision and at least 5 cases alone and without supervision.

9-Bile duct and pancreas endoscopic imaging. He should have done at least 50 procedures. He should have done 25 procedures alone and by himself.

10-Papillosphincterotomy by using endoscopy, using electro coagulation and extracting stones from the Bile Duct. He should have done at least 25 procedures alone and by himself.

11-Fix the stent in the pancreatic duct in case of benign or malignant occlusion. He should have done at least 10 procedures and at least 5 procedures alone and by himself.

12-Must be informed with the bile duct imaging through the coetaneous and through the liver.

13-Must inject the Esophagus and the Stomach varies with a sclerogenic materials, or apply banding by using endoscopy or by any other known methods at this time.

14-Treat the digestive bleeding by using endoscopy especially digestive ulcer bleedings with all known and available methods.

15-The trainee must know ways and methods of measuring the kinetics of the digestive system especially the nanometric study and the kinetics of the Esophagus, Rectum, Stomach and the Bile Duct.

16-The trainee must know all the scientific and clinical methods. He must participate at least in one scientific research during his training period .

17-Examinations and other medical procedures: in this field and during the training period the trainee must know how to perform all examinations and must possess a theoretical knowledge about these methods and the ways of applications and their complications.

These procedures are as follows:

- Must know how to put a stent in case of esophagostenosis, and must know the complications of the self expanding metallic stent which is used as a stent for this purpose. He must know how to use the plastic stent.

- Must have a theoretical knowledge about the indications and the internal abdominal endoscopy.

- Make his diagnose by using the fiberendoscopic apparatuses.    

- Apply an endoscopy to the small intestine by using the     fiberendoscopic apparatuses medically and surgically.

- Must use Laser imaging in treating hemorrhage in the upper and lower digestive tract by using endoscopic apparatuses whenever its available.

Use the Capsule in the small intestine endoscopy. He should know its indication.

General instructions:

1 - The trainee must be kept in the section of the rotor to him, and must not leave his place of work without informing the President of the Division of Gastroenterology and liver.
2 - must not exceed the annual leave to the trainee for four weeks.
3 - encourages the trainee to wonder and creativity in presenting and discussing the problems and the management of man who is compatible and effective.
4 - The education and training of trainees oriented scientific research, and all trainees to attend at least one scientific research during his training period.
5 - must be given great importance to the conduct and relations with intern applicants from colleagues, colleagues and others, and new doctors, nurses, and patients.


5 - Residency Program:

Residency program is divided into three sections:
A - Basic Medical Sciences of the digestive system, liver and pancreas.
B - clinical science and clinical training on patients.
C - Applied and practical training on all procedures performed on patients in this specialty field.
 
This requires participation in scientific activity to the Division of Gastroenterology and activities of the Department of Internal Medicine of the digestive system, liver, and the details of the following:

A - Basic Medical Sciences:
- Anatomy and histological anatomy of all the members of the digestive system, liver and pancreas.
- The Science of jobs for these organs.
- Pathology of diseases of the digestive system and liver.
- Introduction to generic drugs and their relation to the digestive system.

B - Clinical Sciences:
The trainee should be able to diagnose and treat and follow up all cases in medical diseases of the digestive system through in-depth biography of access to his illness and clinical examination and laboratory tests targeted to the patient's condition.

A - Applied Science:
     
The trainee has full knowledge of everything related to the digestive system of medicine and medical procedures previews diagnostic and treatment through the various devices used in this area and this requires to begin the identification of normal and proper functioning of these organs and then move on to the different forms of disease.

Duties of the public during all the years of training:

1 - a trainee in gastroenterology preparation of all cases of medical consultations in terms of taking the health history and clinical examination and laboratory tests for all cases in the area of ​​the digestive system, liver, and prepared and submitted well in all respects to the consultant responsible for making the right decision right, and follow up the implementation of each determined by the consultant in charge right and in writing so all the money linked to the medical file of the patient.
2 - the trainee in gastroenterology, full knowledge of all cases of diseases of the digestive system located inside the hospital and be thus directly responsible for what he is doing new resident and the resident is responsible for these cases and follow up on everything related to it closely and see these cases, once before the passage of Counsel charge and again in the last official day with the resident and the rest of the group working in the medical diseases of the digestive system and liver.
3 - Prepare cases for hearings or meetings of the scientific debate various practical activities both in the digestive system or the Department of Internal Medicine and its responsibility in this setting directly in coordination with the Resident in charge and all the medical group in the unit.
4 - to attend all scientific activities for the Division of Gastroenterology Department of Internal or daily and directly responsible for each case received by these sessions from the Division of Gastroenterology and participation must be effective and preparation prior to a decent level of fellowship in gastroenterology. And to be following up and familiar with all the lab tests and X-rays and all the tests related to this situation and have been studied previously with either advisor responsible radiotherapy or counselor responsible in pathology or any adviser responsible in any jurisdiction related to this case in addition to the advisor in charge of this case in the Division of the digestive system.

evaluation of the trainee:

Evaluation is as follows:

1 - a letter from the supervisor of the training that the trainee has completed training in clinical skills and technical requirements as set out in the training program.

2 - a comprehensive final exam at the end of the training period at the place determined by the relevant committee diseases of the digestive system and liver in the Arab Council for terms of reference for health.


Final exam:

The trainee has to pass the final exam after completion of training in the third year and master all the skills required, and this exam is a three parts: the written, clinical and practical, and he has to succeed in every part of this exam.

1 - Written exam:

 
Author of one paper containing 100 questions MCQs.

If the success of the trainee in the written exam is eligible to apply for the clinical exam

2 - Clinical examination:

 
Consists of two parts:

A - endoscopic examination skills: by conducting Endoscopy Endoscopy Colon and biliary channels under the auspices of the test cases and subject to availability.

B - a test of clinical skills and be of two parts:

1 - the case of a long duration of 45 minutes, 45 minutes and discussion

2 - three cases each case a short fifteen minute


Tags:

1 - assesses success in exam skills endoscopic degree of pass or fail depending on the efficiency of the trainee in an endoscopy.

2 - The mark of success in clinical skills is 60%, (distributed mark this test case so that the mark 70% of long and short-mark cases 30%)

3 - You should work trainee in every part of the exam to achieve any clinical sign of at least 60%.

4 - In case of failure in any part of the clinical exam (endoscopic skills and clinical skills) by the return of all parts of the exam.

8 - opportunities for advancement for the exam:

   
1 - Trainee shall be entitled to apply for the written final exam four attempts not to exceed twice the last attempt by the duration of the training set. The Scientific Council shall be entitled to grant an exceptional opportunity so as to leave to the President of the Scientific Council, Mr. Secretary-General the power to determine the reasons for giving this opportunity. In the event exhausting opportunities for advancement Ergn bound him for good.
   
2 - the right to apply for trainee clinical practical exam four attempts Examination + an exceptional opportunity in the same condition so that the former last up to twice the duration of the training effort. In the absence of its success must be re-written the final exam, and is entitled to two chances to re-writing the final exam. In the event that separates success from the program and Ergn registered.
But if successful, his chances are entitled to apply for clinical and oral exam. In the event that separates success from the program and delete his registration.
9 - the certificate:

Give the trainee a certificate of the Arab Council for terms of reference for health in diseases of the digestive system and liver after to succeed in the final examinations scheduled.

10 - Supplement for a detailed program of scientific and practical training program in diseases of the digestive system and liver.

 
Appendix - A
Appendix - B


- That have completed residency in internal medicine residency program of public recognized by the Arab Council for terms of reference for health and received a certificate of the Arab Council or the local or the global equivalent of certificates in general internal medicine.
2 - should be registered permanently Olgayat training in the Medical Association and licensed by the Ministry of Health to practice in that country.
3 - full-time to train the length of years of training.
4 - to be medically fit.

NameCountryTitleAdressPhoneFaxE-mail
Announcment NumberAnnouncment DateAnnouncment Title