The GI Fellowship Training Program

The 3-year fellowship training program in gastroenterology at the University of Tennessee Health Science Center in Memphis is comprised of three basic components: a 20 month core curriculum, 3-4 months of research, and 12 months of senior "elective".

Core Curriculum

The level 1 core curriculum is uniform for all fellows and includes 18 months of hospital-based consultative gastroenterology and hepatology, 2 months of focused training (motility, nutrition, radiology, oncology), two longitudinal general GI clinics (for the entire 3 years), and a series of conferences designed to augment the clinical training goals of the curriculum.

Consultative in-patient gastroenterology/hepatology is performed at three separate but geographically contiguous hospitals. Each offers a unique patient population and educational experience. The Division of Gastroenterology and Hepatology runs an active liver service at Methodist University Hospital (MUH), where training in the management of complex liver cases including pre- and post-transplantation care occurs. The endoscopy suite at MUH supports routine endoscopy, advanced biliary endoscopy, and EUS. The Memphis VA Medical Center is among the largest single hospitals in the VA system. It offers extensive exposure to GI pathology with emphasis on GI malignancy, alcoholic liver and pancreatic diseases, and chronic viral hepatitis. A well-equipped endoscopy suite at the VA supports advanced biliary endoscopy, enteroscopy, EUS, capsule endoscopy, argon coagulation, and motility studies in addition to over 2500 more routine endoscopic procedures each year. The VA is also the site of one of the two longitudinal clinics for GI fellows. The Regional Medical Center is a 300 bed (50 medicine) acute care city hospital serving Memphis and surrounding Shelby County. It provides exposure to a variety of acute GI disorders, including those associated with trauma (The Med is the level 1 trauma center of Memphis). It is a modern hospital with a recently expanded endoscopy suite and is the site of the second longitudinal GI clinic. These three hospitals (university, VA, and county) provide a variety of clinical exposures in distinct operational facilities. Fellows will rotate 6 months total through the in-patient consultation services of each hospital during the first two years of the fellowship.

In addition to the 12 months of hospital-based consultative general gastroenterology and 6 months of hepatology, all fellows will receive 2 months of clinical training in motility, nutrition, and radiology. This includes technical experience in basic GI motility and radiology. The core curriculum also provides extensive level 1 training in upper endoscopy, variceal sclerotherapy and banding, esophageal dilatation, PEG placement, flexible sigmoidoscopy, colonoscopy with polypectomy, liver biopsy, and therapeutic paracentesis. Exposure to endoscopic stent placement, tumor ablation with argon coagulation, enteroscopy, and capsule endoscopy is also provided. Evening and weekend emergency call provides sufficient exposure to therapeutic endoscopy and the management of acute GI hemorrhage. In addition to direct patient care responsibilities, fellows will be required to attend and participate in divisional conferences and lectures designed to supplement the patient care experience. A weekly Clinical Conference and regularly scheduled pathology, physiology, journal club, M&M, and multidisciplinary conferences are also included.

Research

Three to four months of protected research time will be available to all fellows. During this period, fellows will have limited direct patient care responsibility. They will be expected to involve themselves with clinical or basic science research projects under the mentorship of faculty investigators. For those fellows interested in clinical practice, it is assumed that they will use this research time to initiate one new clinical study and assist in the implementation of ongoing studies under the guidance of a faculty member of the Gastroenterology Division. For those fellows interested in an academic investigative career (clinical or basic science), it will be necessary to extend this research block into the elective 3 rd year. The NIH-funded Clinical Research Center (CRC) at Methodist University Hospital provides an excellent investigative environment for those interested in clinical and/or outcomes research and the Hepatology section currently has a large NIH-supported project that studies the racial differences in hepatitis C expression and treatment. Fellows interested in a basic science academic career can receive bench research training under the mentorship of a funded GI research faculty members or a faculty member in the basic sciences. The Department of Physiology at UT-Memphis has a strong interest in GI physiology under the leadership of Dr. Leonard Johnson, editor-in-chief of the renown textbook "Physiology of the Gastrointestinal Tract".

All fellows will take the research block in the second year. This will provide them with the opportunity to continue their project during the elective year. It is anticipated that all fellows will accumulate sufficient data to prepare an abstract for presentation at one of the national meetings and/or submit a manuscript for publication in a peer-reviewed journal.

Electives

The third year of the fellowship will be elective time. During this time, fellows will have the opportunity to modify their training based on individual career goals. Those fellows interested primarily in clinical gastroenterology will have several options. The Division of Gastroenterology at UTHSC-Memphis currently offers subspecialty (level 2) training in either advanced biliary endoscopy or transplantation hepatology. Satisfactory completion of level 1 (core curriculum) training is required before level 2 training can begin. Those fellows who enroll in one of these level 2 tracts will spend most of their elective time receiving intensive training in that subspecialty. Senior fellows on biliary endoscopy will spend 3 months at Methodist University Hospital were additional endoscopic experiences (endoscopic GERD treatment, ERCP, stent placement, etc.) and ambulatory exposures in a private practice setting are provided. Lastly, clinical fellows interested in furthering their general GI training can instead use the elective year for targeted rotations in hepatology, ambulatory IBD, nutrition, GI radiology, surgery, pathology, motility, pediatric GI and/or research.

Those fellows interested in an academic investigative career (clinical or basic science) will dedicate most of their elective year to research endeavors. The Clinical Research Center (CRC) at MUH is an ideal environment for support and training in quality clinical and outcomes research. Fellows with a background or interest in basic science research can work with funded GI faculty or basic science faculty outside the GI Division.

The City

Memphis is a city of >600,000 people located on the Mississippi River in the southwest corner of Tennessee. It is the 18th largest city in the nation, with surrounding suburban communities that bring the metropolitan population to approximately 1 million. Memphis is the cultural center of the Mid-South. The Memphis Symphony Orchestra, Ballet, and Opera provide classical entertainment while the blues clubs on historic Beale Street highlight Memphis' designation as the blues music capital of the world. Other sites in the city include the FedEx Forum, home of the NBA's Memphis Grizzlies, Autozone park, home of the AAA baseball Memphis Redbirds, the Orpheum Theater, featuring traveling Broadway shows in grand style, the Peabody Hotel and Plaza, with luxurious accommodations and entertainment, the Pyramid, site of large concerts and sports events, and the infamous Lorraine Motel, now site of the National Civil Rights museum. The city and surrounding communities are further enriched by 15 colleges and universities, many theaters, art and children's museums, a zoo, a planetarium, almost 200 parks, and many public (and private) golf courses. Memphis is also the site of the Liberty Bowl, Libertyland (an amusement park), and Graceland, the home of Elvis Presley. In addition, large casinos with entertainment and gambling are about 20 minutes from the city in Tunica, Mississippi. Outdoor enthusiasts find the land, lakes, and rivers in the tristate area (Arkansas, Mississippi, and Tennessee) great for hunting, fishing, boating, and swimming. Vacationers appreciate the fact that Memphis is just a day's drive from the Smoky Mountains National Park, the beautiful Ozark Mountains of Arkansas and Missouri, and the gulf coast beaches of Alabama and Florida. The Memphis International Airport, a hub for Northwest Airlines, is conveniently located within a 30 minute drive from anywhere in town and accesses all major cities in the U.S. Memphis and its airport also serve as the corporate and business headquarters for Federal Express, a major employer.

Southern hospitality and manners continue to exist in Memphis, despite its size and metropolitan pace. It is a culturally diverse city, where virtually all ethnic and religious groups can be found (in addition to a wide array of Christian churches, the city contains 7 Jewish synagogues, 4 Mormon temples, 2 Unitarian churches, 2 Islamic mosques, and a Buddhist temple). Memphis restaurants offer cuisine from all parts of the world. The Mid-South climate is conductive to almost year-round sports. Winters are short and mild while summers are sunny and hot. The long spring and fall seasons are particularly pleasant times of the year. In general, Memphis is a family-oriented community, with affordable real estate, a modest cost of living, and an enthusiasm for out-door activities and children's sports.

Our Faculty

Charles M. Mansbach, II, M.D.
Professor of Medicine and Physiology
Basic Science Investigator

Dr. Mansbach obtained his medical degree from New York University and received his gastroenterology training at Duke University. He was on the Duke faculty for 16 years before coming to Memphis in 1986 as GI Division Chief. After 15 years as Division Chief, Dr. Mansbach stepped down in 2002 to focus more time on his research on intestinal lipid metabolism and intracellular transport. Cell and molecular biological techniques are being used in his laboratory to study the rate-limiting steps in the trafficking of triglycerides through the intestinal enterocyte. His research is supported by grants from the NIH and the Veterans Administration. Dr. Mansbach is past President of the Faculty Senate at UTHSC Memphis and former member of the GMA-2 Study Section at the NIH. His clinical areas of interest are diarrhea and malabsorption.

Christopher R. Marino, M.D.
Professor of Medicine and Physiology
Chief, Division of Gastroenterology and Hepatology
Chief, Gastroenterology Section, VAMC Memphis
GI Fellowship Training Director
Basic Science Investigator

Dr. Marino graduated from Cornell University Medical College and obtained his gastroenterology fellowship training at Yale University. After spending 5 years on the Yale faculty, he came to Memphis in 1995 as Chief of Gastroenterology at the VA. He was served as director of GI training programs for both residents and fellows for the GI Division and accepted the position of Division Chief in July, 2002. Dr. Marino has served on the AGA Research Committee and the scientific advisory committee of the Canadian Cystic Fibrosis Foundation, and is currently President of the Southern Society for Clinical Investigation. He is actively involved in research on the cellular and subcellular distribution of CFTR, the cystic fibrosis chloride channel, in pancreatic duct and other gastrointestinal epithelial cells. Supported by a VA Merit Review, Dr. Marino's laboratory is now focusing on the regulation of plasma membrane CFTR expression and trafficking. His clinical interests are focused on diseases of the pancreas.

Caroline A. Riely, M.D.
Professor of Medicine and Pediatrics
Hepatology
Clinical Investigator

Dr. Riely is a medical graduate of Columbia University who did a clinical hepatology fellowship at Yale University under the late Dr. Gerald Klatskin. She served on the Yale faculty for 13 years before coming to Memphis in 1988 to establish the UT Liver Center. Dr. Riely is internationally known as an expert on the liver in pregnancy and has been active in both the American Gastroenterological Association (who awarded her a Distinguished Clinician Award) and the American Association for the Study of Liver Diseases. She was principle investigator on a large NIH grant to study differences in HCV response to therapy between Caucasians and African-Americans that is still ongoing. Her other clinical interests include cholestatic liver disease in children and viral hepatitis. Dr. Riely has retired from full-time status and is now part-time faculty, seeing hepatology patients in her clinic and lecturing.

J. Lacey Smith, M.D.
Professor of Medicine
Chief, Medical Service, VAMC Memphis
Gastroenterology and Biliary Endoscopy

Dr. Smith obtained his medical degree and gastroenterology training at Baylor College of Medicine. He came to Memphis in 1988 as Chief of Gastroenterology at the VA and is now Chief of the Medical Service. Dr. Smith's research interests have focused on gastric acid secretion, peptic ulcer disease, NSAID gastropathy, and the pharmacology of acid suppression therapy. He has been active in the American College of Gastroenterology as former Chairman of the Research Committee and a reviewer for many GI journals. Dr. Smith's clinical interests include acid-peptic disease and esophageal dysmotility syndromes. He is also an accomplished hepatobiliary endoscopist.

Jaquelyn Fitch Fleckenstein, M.D.
Associate Professor of Medicine
Chief of Hepatology
Clinical Investigator

Dr. Fleckenstein obtained her M.D. degree from St. Louis University and did her residency, including Chief Medical Residency, at the University of Michigan. She did a three-year gastroenterology fellowship at The Johns Hopkins University followed by a fourth year in transplantation hepatology. Dr. Fleckenstein came to UT-Memphis in 1997 after two years on faculty at Johns Hopkins. Although she obtained both basic science and clinical research experience during her training, Dr. Fleckenstein's current interest is in clinical hepatology, transplant hepatology, and clinical research. She is co-investigator on the large NIH center grant to study differences in HCV response to therapy between Caucasians and African-Americans.

Bradford Waters, M.D.
Associate Professor of Medicine
Transplant Hepatology and Gastroenterology, VAMC Memphis
Clinical Investigator

Dr. Waters is a graduate of Vanderbilt University School of Medicine and the University of Tennessee Memphis Gastroenterology Fellowship program. He did an additional one year hepatology fellowship here at UT before joining the faculty in 1991. Dr. Waters has been involved in several local and multicenter clinical trials on the treatment of chronic viral hepatitis and also has clinical research interests in drug-induced liver disease and medication clearance by the diseased liver. His clinical interests include viral hepatitis, liver transplantation, and the management of portal hypertensive complications. Dr. Waters is also an active participant in the GI consultation service at the VA.

Joel I. Bessoff, M.D.
Assistant Professor of Medicine
Chief, Gastroenterology at The Med
Clinical Gastroenterology and Endoscopy

Dr. Bessoff is a graduate of Tufts University School of Medicine who obtained his clinical GI training at the Yale affiliate GI training program at Hartford Hospital and Yale-New Haven Hospital in the mid-1970's. For the past 30 years, Dr. Bessoff has practiced general gastroenterology in Springfield, Massachusetts with clinical appointments at Tufts, U. Mass., and U. Conn. He has served as Chief of Gastroenterology at Bayside Medical Center and has been director of their GI Lab. After a long career in mostly private practice gastroenterology, Dr. Bessoff joined our full-time faculty in 2004 to fulfill a long standing interest in clinical teaching. He also brings a wealth of experience in the business aspects of gastroenterology practice and has actively pursued the remodeling GI services at The Med.

Rene Davila, M.D.
Assistant Professor of Medicine
Gastroenterology and Transplant Hepatology
Biliary Endoscopy

Dr. Rene Davila graduated from the University of Pennsylvania College of Medicine, did his residency at UCLA, and obtained his gastroenterology and hepatology training at Stanford University. Dr. Davila came to UT-Memphis in 1999 after a brief tenure as a member of the Stanford hepatology faculty. He is a UNOS-certified transplant hepatologist and fully trained gastroenterologist. His research interests are in the management of hepatocellular carcinoma and other liver tumors. Clinically, Dr. Davila functions as a gastroenterologist, hepatologist, and biliary endoscopist.

Mohammad Kashif Ismail, MD
Assistant Professor of Medicine
Associate Fellowship Training Director
Director, GI Lab, VAMC Memphis
Gastroenterology, biliary and capsule endoscopy, EUS

Dr. Ismail obtained his medical degree from Dow University in Pakistan, graduating at the very top of his class. He completed his residency and GI fellowship training here at UT-Memphis. Following a 4 th fellowship year in hepatology, Dr. Ismail was recruited to the faculty in 2001 and is now full-time VA staff as well as Director of the VA GI Lab. His clinical interests are in general gastroenterology and endoscopy, with capabilities that include therapeutic biliary endoscopy, capsule endoscopy, photodynamic therapy, motility, and EUS. His academic interests are in endoscopy and clinical education.

B. Kay Jackson, M.D.
Assistant Professor of Medicine
Staff Physician, VAMC Memphis
Gastroenterology and Endoscopy

Dr. Jackson received her medical degree and gastroenterology training from the University of Tennessee Memphis. After a brief time in private practice, she returned to academia as a clinical gastroenterologist at the VA. Dr. Jackson is currently a part-time faculty member who focuses on the clinical teaching of general endoscopy to fellows and residents. She is also manager of the GI Clinic at the VA. Dr. Jackson is interested in all areas of clinical gastroenterology, but has a particular interest in microscopic colitis and the management of inflammatory bowel disease.

David D. Sloas, MD
Clinical Assistant Professor in Gastroenterology
Methodist University Hospital

Dr. Sloas graduated from the University of Tennessee Memphis medical school in 1981 and remained here for his medical residency and a subsequent year as Chief Medical Resident. He then went on to the University of Alabama Birmingham to train in gastroenterology. Dr. Sloas came back to Memphis to join the Gastroenterology Center of the MidSouth practice group. He has had a long-standing academic affiliation with Methodist University Hospital, currently running the GI teaching service there and serving as Chief of the Department of Medicine and Director of the GI Lab. He also supervises our 3 rd year GI fellows during their 3 month rotations at Methodist University Hospital. Dr. Sloas has a special interest in the clinical management of inflammatory bowel disease and has a busy practice with a broad spectrum of GI diseases represented.

Claudio Tombazzi, MD
Assistant Professor of Medicine
Gastroenterology and Transplant Hepatology
Biliary Endoscopy and EUS

Dr. Tombazzi obtained his medical degree in 1986 from the University of Carabobo and his GI training at Central University of Venezuela in Caracas. After 5 years as a full-time academic gastroenterologist and clinical investigator on the faculty of Central University, he came to the United States for advanced training in biliary endoscopy and EUS at Georgetown University, followed by transplantation hepatology training here at UTHSC-Memphis. We were very fortunate in convincing Dr. Tombazzi to remain in the U.S. and join our faculty in 2001. His interests are broad in the areas of clinical investigation, with particular interest in hepatobiliary and pancreatic diseases. Dr. Tombazzi is also coordinator of clinical research in gastroenterology for fellowship trainees.

More Information

For more information about fellowships in the Division of Gastroenterology and Hepatology at UTHSC-Memphis, visit our website or call any faculty member or Ms. Becky Potter, Admin. Services Assistant at (901) 448-5813.

Gastro instrument endoscope

Contact Us

Division of Gastroenterology and Hepatology
956 Court Ave, Suite H314
Memphis, TN 38163
Phone: 901-448-2510
Fax: 901-448-7836
Site contact: Donna Heath

A division of the
Department of Internal Medicine