Rotations | Gastroenterology Fellowship

The first year of fellowship provides broad exposure to both inpatient and outpatient gastroenterology, with a focus on developing a strong foundation in endoscopy and consultative care. Many incoming fellows have limited procedural experience, so the curriculum emphasizes building essential cognitive and technical skills in endoscopic diagnosis and management across diverse clinical settings.

Each academic year is divided into thirteen 4-week blocks. For first-year fellows, this includes:

Eleven clinical blocks

• 4 blocks on the inpatient gastroenterology service as a consult fellow at MaineHealth Maine Medical Center – Portland (MHMMC-Portland)
• 5 blocks in outpatient gastroenterology at MaineHealth Maine Medical Center – Biddeford (MHMMC-Biddeford)
• 1 block in hepatology (combined inpatient and outpatient) at MHMMC-Portland
• 1 elective block

Two non-clinical blocks

• 1 block of dedicated research
• 1 block of vacation

Fellows also attend a weekly half-day continuity clinic and participate in GI Conferences throughout the year.

Gastroenterology Consult Service – Consult Fellow (MaineHealth Maine Medical Center-Portland)

Four blocks in the first year are dedicated to an intensive inpatient rotation at MaineHealth Maine Medical Center – Portland, the system’s flagship Level I trauma and tertiary care hospital located in downtown Portland. During this rotation, fellows build upon the foundation of their internal medicine training and learn the core skills of gastroenterology inpatient consultation.

Fellows lead the inpatient consultative service under the direct supervision of a dedicated inpatient GI attending. The service is structured with a senior procedure GI fellow (Year 2 or 3), and advanced practice providers (APPs). APPs maintain an independent patient panel and provide cross-coverage when fellows are in continuity clinic, attending didactics, or unavailable due to illness or leave. Importantly, APP responsibilities are designed to complement, not replace, the fellow’s clinical learning experience.

Outpatient Gastroenterology at MaineHealth Maine Medical Center-Biddeford

Five blocks of the first year are dedicated to outpatient gastroenterology at MaineHealth Maine Medical Center – Biddeford, located about 25 minutes south of Portland. The rotation takes place in a large outpatient clinic situated within a medical office building adjacent to the hospital. The site is staffed by five full-time gastroenterologists and three advanced practice providers (APPs), offering fellows a diverse and busy clinical experience.

Fellows work directly with an attending each day and divide their time between the hospital-based endoscopy suite (approximately 75%) and the attending’s outpatient clinic (approximately 25%), gaining broad exposure to both procedural and longitudinal outpatient care.

Hepatology at MaineHealth Maine Medical Center-Portland

Fellows gain valuable knowledge and skills in the care of patients with advanced liver disease. This is a mixed inpatient and outpatient experience. Approximately a third of the time is devoted to inpatient hepatology consults at MHMMC-Portland, half of the time in outpatient clinic at the Adult Specialty Care Clinic-Portland (an office building on MHMMC-Portland’s campus), and the remainder of the time devoted to a mixture of one-half day of outpatient endoscopy on hepatology patients, fellows’ continuity clinic, and educational activities. The fellow presents patients during bedside rounds with the hepatology attending. The fellow is supervised by a hepatology attending in the clinic at the Adult Specialty Care Clinic-Portland. The half day of endoscopy is with a hepatologist within the gastroenterology suite located on MHMMC-Portland and allows the fellow to perform endoscopies on mostly hepatology patients (e.g. variceal band ligation treatment).

Fellows’ Continuity Clinic at MaineHealth Maine Medical Center-Biddeford

Each week the fellow participates in their continuity clinic experience in Biddeford, ME. This clinic is located in the same clinic where the GI fellows participate in the SMHC GI attending’s clinic. This consists of a half-day and the average patient panel number for the first-year fellow is 4 to 6 patients. This clinic experience represents equally both male and female patients and disease presentation to encompass the full breadth and depth of gastroenterology.

Elective

First-year fellows are allotted one block of elective time, designed to provide concentrated exposure to areas of special interest. Electives may focus on a gastroenterology subspecialty (e.g. motility, inflammatory bowel disease) or on a related discipline (e.g. body radiology, colorectal surgery, pediatric gastroenterology/nutrition).

Most electives take place at MHMMC-Portland or MHMMC-Biddeford, though outside electives may be arranged on a case-by-case basis. Fellows meet with the program director early in the academic year to discuss interests and plan their elective experience.

Research

Each fellow receives one dedicated research block during the first year of training. Completion of at least one scholarly project is a requirement for graduation from the fellowship. MaineHealth is a clinically focused medical community, and research activities are expected to align with patient care. Typical projects include case reports, chart reviews, systematic reviews, and quality improvement initiatives. Fellows are expected to present their work internally within MaineHealth and are strongly encouraged to pursue publication and/or presentation at regional and national gastroenterology and hepatology meetings.

Vacation

Each fellow will be given 4 weeks of vacation per academic year.

The second year of fellowship builds upon the foundation established during the first year. By this stage, fellows are expected to feel comfortable managing a wide range of inpatient and outpatient gastroenterology conditions and to have developed a solid grounding in endoscopy.

During the second year, fellows:

• Continue to advance their clinical and procedural skills in general gastroenterology
• Complete an additional hepatology block
• Gain initial exposure to advanced endoscopy through participation on the pancreaticobiliary service
• Develop leadership and teaching skills by mentoring first-year fellows, internal medicine residents, and medical students rotating on GI services

This year emphasizes both continued growth in core gastroenterology training and the early steps toward subspecialty exposure and professional leadership.

Each academic year is divided into thirteen 4-week blocks. For second-year fellows, this includes:

Eleven clinical blocks

• 4 blocks on the inpatient gastroenterology service as a procedure fellow at MaineHealth Maine Medical Center – Portland (MHMMC-Portland)
• 2 blocks on the inpatient gastroenterology service as a consult fellow at MaineHealth Maine Medical Center – Portland (MHMMC-Portland)
• 1 ½ blocks in outpatient gastroenterology at MaineHealth Maine Medical Center – Biddeford (MHMMC-Biddeford)
• 1 ½ blocks in hepatology (combined inpatient and outpatient) at MHMMC-Portland
• 1 block pancreaticobiliary
• 1 elective block

Two non-clinical blocks

• 1 block of dedicated research
• 1 block of vacation

Fellows also attend a weekly half-day continuity clinic and participate in GI Conferences throughout the year.

Gastroenterology Consult Service – Procedure Fellow (MaineHealth Maine Medical Center-Portland)

In the second year, four blocks are devoted to an intensive inpatient rotation at MaineHealth Maine Medical Center – Portland, the system’s flagship Level I trauma and tertiary care hospital in downtown Portland. This procedure-focused rotation builds on the consult-heavy experience of the first year, with fellows performing the majority of inpatient procedures on the general gastroenterology service.

All procedures are performed under the direct supervision of a GI attending. The service is led by a separate consult fellow along with advanced practice providers (APPs). The procedure fellow provides cross-coverage for the consult fellow when needed. APPs manage an independent patient panel and support service coverage during fellows’ continuity clinic, didactics, or absences due to illness or leave. Their role is structured to enhance patient care while ensuring fellows remain the primary learners on the service.

Gastroenterology Consult Service – Consult Fellow (MaineHealth Maine Medical Center-Portland)

Two blocks in the second year are dedicated to an intensive inpatient rotation at MaineHealth Maine Medical Center – Portland, the system’s flagship Level I trauma and tertiary care hospital located in downtown Portland. During this rotation, fellows continue to build upon the foundation of their first year to learn the core skills of gastroenterology inpatient consultation.

Fellows lead the inpatient consultative service under the direct supervision of a GI attending. The service is structured with a procedure fellow (see above), and advanced practice providers (APPs). APPs maintain an independent patient panel and provide cross-coverage when fellows are in continuity clinic, attending didactics, or unavailable due to illness or leave. Importantly, APP responsibilities are designed to complement, not replace, the fellow’s clinical learning experience.

Outpatient Gastroenterology at MaineHealth Maine Medical Center-Biddeford

During the second year, fellows spend one and a half blocks in outpatient gastroenterology at MaineHealth Maine Medical Center – Biddeford, located about 25 minutes south of Portland. Training takes place in a large outpatient clinic within a medical office building adjacent to the hospital, staffed by five full-time gastroenterologists and three advanced practice providers (APPs). This setting provides a diverse and high-volume clinical experience.

Fellows work closely with an attending each day, spending approximately 75% of their time in the hospital-based endoscopy suite and 25% in outpatient clinic, ensuring balanced exposure to both procedural training and longitudinal patient care.

Hepatology at MaineHealth Maine Medical Center-Portland

One and a half blocks of the second year are devoted to hepatology. Fellows gain valuable knowledge and skills in the care of patients with advanced liver disease. This is a mixed inpatient and outpatient experience. Approximately a third of the time is devoted to inpatient hepatology consults at MHMMC-Portland, half of the time in outpatient clinic at the Adult Specialty Care Clinic-Portland (an office building on MHMMC-Portland’s campus), and the remainder of the time devoted to a mixture of one-half day of outpatient endoscopy on hepatology patients, fellows’ continuity clinic, and educational activities. The fellow presents patients during bedside rounds with the hepatology attending. The fellow is supervised by a hepatology attending in the clinic at the Adult Specialty Care Clinic-Portland. The half day of endoscopy is with a hepatologist within the gastroenterology suite located on MHMMC-Portland and allows the fellow to perform endoscopies on mostly hepatology patients (e.g. variceal band ligation treatment).

Pancreaticobiliary Service – MHMMC Portland

In the second year, fellows spend one block on the hospital-based pancreaticobiliary service, which provides care for both inpatients and outpatients. While the rotation emphasizes pancreaticobiliary disease, fellows are also exposed to a broad range of advanced therapeutic endoscopy performed by the same team. This includes procedures such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), endoscopic mucosal resection (EMR), and complex polypectomies.

Fellows manage inpatient pancreaticobiliary consults independent of the general gastroenterology service and also participate in outpatient procedures. They work closely with an attending physician and share the service with an advanced practice provider (APP). The APP maintains an independent patient panel and may provide cross-coverage when the fellow is attending continuity clinic, didactics, or is unavailable due to illness or leave. Importantly, APP responsibilities are structured to support patient care while ensuring fellows remain fully engaged in procedural and consultative learning.

A unique strength of this rotation is that there is no fourth-year advanced endoscopy fellow at MHMMC. This means second-year fellows gain direct, high-yield exposure to advanced procedures without competition, creating an outstanding early training experience in therapeutic endoscopy.

Fellows’ Continuity Clinic at MaineHealth Maine Medical Center-Biddeford

Each week the fellow participates in their continuity clinic experience in Biddeford, ME. This clinic is located in the same clinic where the GI fellows participate in the SMHC GI attending’s clinic. This consists of a half-day and the average patient panel number for the second-year fellow is 6 to 8 patients. This clinic experience represents equally both male and female patients and disease presentation to encompass the full breadth and depth of gastroenterology.

Elective

Second-year fellows are allotted one block of elective time, designed to provide concentrated exposure to areas of special interest. Electives may focus on a gastroenterology subspecialty (e.g. motility, inflammatory bowel disease) or on a related discipline (e.g. body radiology, colorectal surgery, pediatric gastroenterology/nutrition).

Most electives take place at MHMMC-Portland or MHMMC-Biddeford, though outside electives may be arranged on a case-by-case basis. Fellows meet with the program director early in the academic year to discuss interests and plan their elective experience.

Research

Each fellow receives one dedicated research block during the second year of training. Completion of at least one scholarly project is a requirement for graduation from the fellowship. MaineHealth is a clinically focused medical community, and research activities are expected to align with patient care. Typical projects include case reports, chart reviews, systematic reviews, and quality improvement initiatives. Fellows are expected to present their work internally within MaineHealth and are strongly encouraged to pursue publication and/or presentation at regional and national gastroenterology and hepatology meetings.

Vacation

Each fellow will be given 4 weeks of vacation per academic year. 

The third year of fellowship is dedicated to consolidating the skills necessary for independent practice as a competent gastroenterologist. Fellows continue to refine their clinical judgment, procedural expertise, and ability to manage complex cases with greater autonomy. The curriculum also offers increased elective time, allowing fellows to tailor their training toward specific career interests.

Key components of the third year include:

• Hepatology rotations that strengthen expertise in the management of advanced liver disease across both inpatient and outpatient settings
• Advanced therapeutic endoscopy exposure, building upon skills gained during the second year
• A mandatory one-month rotation at a small access hospital or rural location, providing firsthand experience in rural gastroenterology and community-based practice
• Additional elective time to explore subspecialty areas of interest and align training with career goals

By the conclusion of the third year, fellows are well prepared to enter independent practice or pursue advanced subspecialty training.

Each academic year is divided into thirteen 4-week blocks. For third-year fellows, this includes:

Eleven clinical blocks

• 4 blocks in hepatology (combined inpatient and outpatient) at MHMMC-Portland
• 3 blocks of elective
• 2 blocks on the inpatient gastroenterology service as a procedure fellow at MaineHealth Maine Medical Center – Portland (MHMMC-Portland)
• 1 block pancreaticobiliary
• 1 block at a rural small access hospital in Maine

Two non-clinical blocks

• 1 block of dedicated research
• 1 block of vacation

Fellows also attend a weekly half-day continuity clinic and participate in GI Conferences throughout the year.

Hepatology at MaineHealth Maine Medical Center-Portland

Four blocks of the third year are devoted to hepatology. Fellows gain valuable knowledge and skills in the care of patients with advanced liver disease. This is a mixed inpatient and outpatient experience. Approximately a third of the time is devoted to inpatient hepatology consults at MHMMC-Portland, half of the time in outpatient clinic at the Adult Specialty Care Clinic-Portland (an office building on MHMMC-Portland’s campus), and the remainder of the time devoted to a mixture of one-half day of outpatient endoscopy on hepatology patients, fellows’ continuity clinic, and educational activities. The fellow presents patients during bedside rounds with the hepatology attending. The fellow is supervised by a hepatology attending in the clinic at the Adult Specialty Care Clinic-Portland. The half day of endoscopy is with a hepatologist within the gastroenterology suite located on MHMMC-Portland and allows the fellow to perform endoscopies on mostly hepatology patients (e.g. variceal band ligation treatment).

Elective

Third-year fellows are allotted three blocks of elective time, designed to provide concentrated exposure to areas of special interest. Electives may focus on a gastroenterology subspecialty (e.g. motility, inflammatory bowel disease) or on a related discipline (e.g. body radiology, colorectal surgery, pediatric gastroenterology/nutrition).

Most electives take place at MHMMC-Portland or MHMMC-Biddeford, though outside electives may be arranged on a case-by-case basis. Fellows meet with the program director early in the academic year to discuss interests and plan their elective experience.

Gastroenterology Consult Service – Procedure Fellow (MaineHealth Maine Medical Center-Portland)

In the third year, two blocks are devoted to an intensive inpatient rotation at MaineHealth Maine Medical Center – Portland, the system’s flagship Level I trauma and tertiary care hospital in downtown Portland. This procedure-focused rotation builds on the consult-heavy experience of the first year, with fellows performing the majority of inpatient procedures on the general gastroenterology service.

All procedures are performed under the direct supervision of a GI attending. The service is led by a consult fellow along with advanced practice providers (APPs). The procedure fellow provides cross-coverage for the consult fellow when needed. APPs manage an independent patient panel and support service coverage during fellows’ continuity clinic, didactics, or absences due to illness or leave. Their role is structured to enhance patient care while ensuring fellows remain the primary learners on the service.

Pancreaticobiliary Service – MHMMC Portland

In the third year, fellows spend one block on the hospital-based pancreaticobiliary service, which provides care for both inpatients and outpatients. While the rotation emphasizes pancreaticobiliary disease, fellows are also exposed to a broad range of advanced therapeutic endoscopy performed by the same team. This includes procedures such as endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), endoscopic mucosal resection (EMR), and complex polypectomies.

Fellows manage inpatient pancreaticobiliary consults independent of the general gastroenterology service and also participate in outpatient procedures. They work closely with an attending physician and share the service with an advanced practice provider (APP). The APP maintains an independent patient panel and may provide cross-coverage when the fellow is attending continuity clinic, didactics, or is unavailable due to illness or leave. Importantly, APP responsibilities are structured to support patient care while ensuring fellows remain fully engaged in procedural and consultative learning.

A unique strength of this rotation is that there is no fourth-year advanced endoscopy fellow at MHMMC. This means third-year fellows gain direct, high-yield exposure to advanced procedures without competition, creating an outstanding early training experience in therapeutic endoscopy.

Small Access Hospital / Rural Gastroenterology Rotation

Because much of Maine’s population lives in rural communities, the fellowship places a strong emphasis on preparing fellows to care for patients in these settings. To support this objective, all fellows complete a mandatory one-month rural gastroenterology rotation at a small access hospital.

During this experience, fellows practice in both the inpatient and outpatient environments, gaining valuable exposure to the unique challenges and opportunities of rural medicine. The rotation is designed to promote progressive autonomy while maintaining close supervision and faculty support.

Fellows continue their continuity clinic during this month, with all patient visits conducted virtually to avoid unnecessary travel to MHMMC–Biddeford. They also remain fully engaged in the fellowship’s weekly didactic curriculum, participating remotely in all educational conferences.

This rotation provides an important perspective on gastroenterology practice across diverse care settings, helping fellows prepare for independent practice in both urban and rural environments.

Fellows’ Continuity Clinic at MaineHealth Maine Medical Center-Biddeford

Each week the fellow participates in their continuity clinic experience in Biddeford, ME. This clinic is located in the same clinic where the GI fellows participate in the SMHC GI attending’s clinic. This consists of a half-day and the average patient panel number for the third-year fellow is 8 patients. This clinic experience represents equally both male and female patients and disease presentation to encompass the full breadth and depth of gastroenterology.

Research

During the third year, each fellow is allotted one dedicated research block. As the final year of fellowship, this is the time when fellows are expected to present their scholarly work and bring projects to completion.

Completion of at least one scholarly project is a requirement for graduation. At MaineHealth, research is closely tied to clinical practice, with most projects focusing on patient care. Common avenues include case reports, chart reviews, systematic reviews, and quality improvement initiatives.

Fellows present their work internally within MaineHealth and are strongly encouraged to pursue publication or presentation at regional and national gastroenterology and hepatology conferences. This provides valuable experience in disseminating scholarly work and prepares fellows for academic and community-based careers alike.

Vacation

Each fellow will be given 4 weeks of vacation per academic year.