Gastroenterology, Hepatology

and Nutrition (GIHN) Module

MDR 614

October 29 to December 10

Syllabus 2012

Course Coordinator:

Amar R. Deshpande, M.D.

Asst Professor of Medicine

Division of Gastroenterology

CRB 310G

305-243-8644

Welcome to the Gastroenterology-Hepatology-Nutrition module! This 6-week course will integrate basic cellular and molecular processes with the corresponding organs as well as emphasize the pathophysiologic mechanisms of disease that affect the gastrointestinal system on a more clinical level.

In thefirst week of the module, we willcover the basic embryology and histology of the GI tract as well as the principles of gut secretion and absorption; we will also address absorption of minerals and vitamins and pathologic states in their excess and deficiency. In the second week, we continue to address macronutrient assimilation and motility as well as other pertinent concepts in nutrition; the basic structure and function of the liver are discussed as well. The third week will begin with a test on Monday, November 12, covering the first two weeks of material, the ‘basic science’ part of the course. In the second part of the module, the goal is to provide clinical application to the processes covered in the first two weeks. In the third week we will cover diseases of the pancreas and upper GI tract; topics in the fourth week (truncated due to Thanksgiving) cover lower GI tract diseases. In the fifth week, we will review pathology of the GI tract and clinical liver diseases. The sixth week has a potpourri of topics, including pathology of the extra-GI tract organs, bariatrics, surgical diseases, pediatric issues, radiology, and clinical reviews of prior topics. The final Friday morning will be a required Pathology lab run by Dr. Carmen Gomez and her Pathology colleagues. The second test is on the following Monday, December 10.

Most of the information will be presented in a series of 50 minute PowerPoint presentations followed by a 10 minute break, in the 3rd floor auditorium; these lectures are from 9am to 12pm. Dr. Deshpande will be available each morning prior to the first lecture for any questions. There will be 4 Small Groups on Monday afternoonsin which a faculty or fellow mentor will go over case presentations of relevant disease processes covered the previous week; you will receive the small group materials the prior week so you can review the casesbefore meeting with your group. There is 1 Small Group in the first part of the course (Week 2) and 3 more in the clinical portion (Weeks 4, 5, and 6). There will also be 2 panels of patients during the course that occur prior to the last 2 Small Groups, 1 with patients with inflammatory bowel disease and 1 with patients with cirrhosis. The Small Groups, patient panels, and aforementioned Pathology lab are all required sessions, and attendance will be taken. As with other modules, some Wednesdays from 11-12 are dedicated to the Doctoring longitudinal course; Tuesday, Wednesday, and Thursday afternoons are also for Doctoring. At the end of each week, Dr. Deshpande will conduct a review of that week’s material; this will also be a forum to address questions and potential issues from that week. Friday afternoons are for independent study.

There is no required textbook for the gastroenterology module, but if you feel you need additional reading material to support the didactics, we have a fewrecommended resources for you. For the basic science aspects of the module, you can consultGastrointestinal Physiology, 7th edition - Mosby Physiology Monograph Series by Leonard R. Johnson. For the clinical part, you can useHandbook of Gastroenterology, handbook to the textbook’s 4th edition by Tadataka Yamada. A book that can be used throughout the course is Lecture Notes: Gastroenterology and Hepatology by Anton Emmanuel and Stephen Inns. The BRS physiology series is also a good resource for mechanisms of disease. Obviously, there are myriad sources of information on the Internet; make sure you are comfortable with a website’s sources and validity before completely trusting the data.

Students are encouraged to come to lecture, but attendance is only mandatory for the small groups, panels, pathology lab, and tests. Anyone who desires an excused absence due to a known conflict must speak with Dr. Deshpande at the beginning of the course; even excused deviations may result in reporting, but this is mostly for documentation. The PowerPoint presentations, videos of the lectures, learning objectives, and in some cases additional reading material are all available online.

Students will be evaluated in two multiple-choice examinations, one after 2 weeks and the other at the end of the course. The 2nd test is NOT cumulative; it only covers material addressed in the 2nd part of the module, but much of what is learnt in the first 2 weeks forms the foundation of understanding that which is discussed in the final 4 weeks. Each exam will have about 20questionsper week of material and will take 2-3hours. Questions on the exams will be largely based on information emphasized in the learning objectives of each lecture. The dates and times of the examinations are final; they are Monday, November 12 at 9am and Monday, December 10 at 9am. We will have a 1-hour review after each test. Anyone who needs special accommodations (after gaining approval from administration) must speak with Dr. Deshpande at the beginning of the course. Procedures for missed exams are described in the academic policies contained in the Medical Students Rights and Responsibilities Handbook.

It is expected that by the end of this module, you will have a strong basic knowledge of the structure, function, and pathophysiologic manifestations of disorders that affect the gastrointestinal system. I look forward to a great module with you all.

Sincerely,

Amar R. Deshpande and the

Gastroenterology-Nutrition-Hepatology (GIHN) Module faculty

Policy for Attendance

Students are expected to attend lectures but they are not mandatory. Attendance is mandatory for the small groups, panels, pathology lab, and examinations.

The test schedule is as follows:

Exam 1: Monday, November 12, 20129:00 AM -11:00 AM

Exam 2: Monday, December 10, 20129:00 AM - 12:00 PM

Grading Policy

The tests are not cumulative. The final grade will be determined combining the scores of the two tests, weighted based on amount of material covered; test 1 will be worth one-third and test 2 two-thirds of the final grade. Unexcused absences for small groups, panels, or pathology lab will result in a 1 point reduction from the final score for each session missed.

Passing Grade: It is anticipated that a passing grade for the module will be a score of 70%; the actual cutoff point will depend upon the final grade distribution. Dr. Deshpande will review the distribution of grades after the final exam and make a determination regarding the lowest possible passing score for the course.

Failing Grade: = <70% (unless adjusted as discussed above)

D Grade: Depending upon the final grade distribution, a grade of D may be assigned to any student whose performance is close to a failing grade. This could result in a recommendation by the course coordinator for the student to perform remedial work.

Remedial Work

Permission to perform remedial work and the date for the remediation must be approved by both the course coordinator and the promotions committee.

Policy for Missed Test

All students are expected to sit for the examinations at the scheduled times. Students need to notify the Course Coordinator and the Office of Student Affairsof their absence BEFORE exams. Acceptable unplanned reasons for missing an exam include a death in the family or personal illness. All absences need to be communicated to the course coordinator and approved.

Small Groups Assignments

Students will go to the 5th floor lab rooms according to their society nameson the Monday afternoons listed on the schedule. The cases will be facilitated by a faculty or fellow mentor, and each case will be emailed to the class on the week before the following Monday’s small group; you are expected to have perused the case and be prepared to discuss it.

Teaching Faculty:

Course Coordinator:

Amar R. Deshpande, MD

Division of Gastroenterology

305-243-8644

Office of CurriculumContact Person:

Cindy Santana

2nd Year Curriculum Manager

305-243-6180

Instructors:

Jamie Barkin, MD

Division of Gastroenterology

305-674-2240

Pablo Bejarano, MD

Department of Pathology

305-585-6303

Kalyan (Ram) Bhamidimari, MD

Division of Hepatology

305-243-4615

Thomas Champney, PhD

Department of Cell Biology and Anatomy

305-243-6942

Gavriel David, PhD

Department of Physiology and Biophysics

305-243-6270

Gary Danton, MD

Department of Radiology

305-585-7500

Nestor De La Cruz-Muñoz, MD

Department of Surgery

305-243-2424

George Garcia, MD

Department of Surgery

305-585-1461

Monica Garcia, MD

Department of Pathology

305-585-6520

Kellie Henderson, PharmD

Department of Surgery

305-585-6651

Melissa Kaplan, RD

Sylvester Cancer Center

305-243-4198

Atil Kargi, MD

Division of Endocrinology

305-243-3139

David Kerman, MD

Division of Gastroenterology

305-243-8644

Ralf Landgraf, PhD

Department of Biochemistry and Molecular Biology

305-243-5815

Amber Langshaw, MD

Department of Pediatrics

305-243-6426

Cynthia Levy, MD

Division of Hepatology

305-243-5787

Paul Martin, MD

Divison of Hepatology

305-243-4615

Clara Milikowski, MD

Department of Pathology

305-585-3638

Baharak Moshiree, MD

Division of Gastroenterology

305-243-8644

Christopher O’Brien, MD

Division of Hepatology

305-243-5787

Adam Peyton, DO

Division of Hepatology

305-243-2147

Laurence Sands, MD

Department of Surgery

305-243-9110

Eugene Schiff, MD

Division of Hepatology

305-243-5787

Jacques Simkins-Cohen, MD

Division of Infectious Diseases

305-243-4598

Daniel Sussman, MD

Division of Gastroenterology

305-243-8644

Amy Wiesenberg, RD

Department of Nutrition Services

305-585-5298

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