The Gastroenterology Division at McMaster is very committed to providing a supportive and comprehensive learning experience for undergraduate medical learners. Gastroenterology continues to be a popular elective rotation with many students rotating through the St. Joseph’s Healthcare and Hamilton Health Sciences clinics and hospitals. Gastroenterology, as a Specialty Selective, also forms one of the core clerkship rotations in Medicine. During their rotations in GI, students have the opportunity to work both in the inpatient and outpatient settings. They are introduced to the specific diagnostic and therapeutic procedures performed in Gastroenterology including learning how to perform a paracentesis and having the opportunity to observe endoscopic procedures. In hosting undergraduate learners in Gastroenterology, it is our aim to provide a dynamic and exciting learning environment with enthusiastic teachers experienced in treating a wide breadth of GI conditions in a diverse population of patients.
A weekly research progress reports, one individual’s project is presented, and the educational activity emphasizes data interpretation, analysis, review of background knowledge as well as presentation performance feedback. Weekly research journal club sessions are a 100% trainee-driven activity. The educational activity involves the presentation of a research or clinical manuscript, evaluation of background data, and critical review. The JC is co-chaired by two trainees, who learn organizational and moderating skills. Presenters learn how to critically appraise and evaluate a scientific article. All attendees are expected to read and evaluate the manuscript and ask, at least, one question. Independent lab meetings are held weekly by each lab, where technical issues, research progress as well as practice MSc and Ph.D. defence talks are held as needed. A course in microbiome analysis is aimed at instructing trainees in the use of custom R scripts to perform standard 16S microbiome analysis. Attendees learn to perform Beta-diversity using different distance matrices, along with its statistical testing, as well as Alpha-diversity analysis using different measures. Attendees learned to generate taxonomic tables at any taxonomic level. Attendees also learned how to use the scripts to perform statistical analysis on the taxonomic tables or other data table users may have. Implemented statistical tools optionally includes detection of outliers at different Inter-Quartile ranges, use of False Discovery Rate at different Q values, minimal taxonomic percentage filtering, and data transformation to obtain normality. Furthermore, attendees learned to perform correlations between any table provided, such as a taxonomic percentage table and a clinical data table. Graphically, attendees learned how to perform PCoA graphics, bar graphs of bacterial composition for the whole microbiome and boxplots and/or dot plots for individual bacteria with p-values automatically annotated in the graphics. In addition, attendees learned how to generate graphics of correlation tables, along with graphics for each two-variable correlations. Finally, attendees learned how to improve graphic quality using vector-based design software.
The Adult Gastroenterology Training Program is a two-year program accredited by the Royal College of Physicians and Surgeons of Canada. The program is based at the McMaster Campus of Hamilton Health Sciences (HHS), but also involves St. Joseph’s Hospital and the Juravinski and General Campuses of HHS. At all sites, trainees benefit from clinical and educational collaboration with the Departments of Surgery, Radiology, and Pathology. Trainees benefit from the rich training environment of the Michael DeGroote School of Medicine with world-renowned expertise in Clinical Epidemiology and Biostatistics.
Postgraduate trainees are able to rotate to two different GI inpatient units which provide a rich exposure to a number of GI presentations including GI bleeding, liver disease, inflammatory bowel disease and pancreatic disease. Our faculty provide endoscopy training to Adult GI, Paediatric GI and General Surgery trainees. The Farncombe Family Digestive Health Research Institute leads an internationally acclaimed program of bench-to-bedside research with highly respected faculty. The Adult Gastroenterology Training Program takes pride in providing an experience that is individualized to the trainee’s career goals and interests while fulfilling RCPSC goals and objectives. Each trainee receives strong mentorship and career counselling from members of the faculty. Trainees are encouraged to undertake a third year of clinical or research training, which may include postgraduate training in Health Research Methodology through the Department of Clinical Epidemiology and Biostatistics.
In summary, the Adult Gastroenterology Training Program at McMaster University provides the structure and flexibility to accommodate both the individual needs of our trainees and the demands of our ever-changing patient populations.