The Division of Gastroenterology and Hepatology at the Johns Hopkins University School of Medicine offers an ACGME–accredited Transplant Hepatology Fellowship training for individuals who want to gain expertise in the management of patients with liver disease, including the selection and management of patients that undergo liver transplantation.
The Liver Transplant Program at the Johns Hopkins Hospital is the oldest program in Maryland. Since its inception in 1986, more than 1,000 patients have been transplanted with excellent survival rates.
This one-year fellowship is offered to individuals who have completed a three-year fellowship in gastroenterology. After completion of this fellowship, fellows will have gained expertise in the field of general and transplant hepatology, fulfilling the transplant hepatology milestones and competencies set forth by the American Board of Internal Medicine (ABIM), the American Council for Graduate Medical Education (ACGME) and the United Network for Organ Sharing (UNOS).
The goal of the transplant hepatology fellowship is to train physicians for an academic career. It has an excellent success rate. Fellows who have completed their training at Johns Hopkins have joined high-ranking academic institutions, and many have assumed leadership positions.
Recently, a liver transplant pilot fellowship was devised by AASLD, and approved by ABIM and ACGME, that allows third-year GI fellows to enroll in transplant hepatology training during their third year of GI training, after successfully fulfilling the GI competencies by the end of their second year. This pilot year is only offered to internal GI fellow candidates who have satisfied the GI competencies and is not offered to second-year fellows from other institutions. Johns Hopkins has been participating in this pilot program since its inception in July 2012. For further information on this pilot transplant fellowship, please contact the Liver Transplant Program Director, Ayman Koteish, M.D. Contact information is below.
Ayman Koteish, M.D.
The Johns Hopkins Hospital
720 Rutland Ave
Baltimore, MD 212205
The training occurs under the supervision of six hepatologists in both the inpatient and outpatient settings. The fellow attends two half-day clinics per week: a pre-transplant evaluation clinic and a post-transplant continuity clinic. During the outpatient rotation months (six months per year), the fellow will also attend three half-day hepatology clinics with a designated hepatologist. The fellow will have a chance to rotate with all of the faculty members. The fellow will also perform liver biopsies with a liver faculty member.
The fellow will also closely interact and work with the liver transplant team: surgeons, nurse practitioners, coordinators, social worker, psychologists and administrators. Supervised and coached by the hepatology faculty, the fellow will be the point person for the transplant team, leading the weekly selection meeting and morning transplant rounds when on the inpatient service. By assuming these tasks, the fellow will build autonomy and exercise leadership skills throughout the course of the fellowship year.
The fellow will be given opportunities to observe a liver harvest, as well as transplantation surgeries. This will not only enrich the fellow’s knowledge but will also ascertain their understanding of the technicalities and challenges of the transplant surgery and will help them better communicate indications, risks and benefits of liver transplantation to patients.
Active clinical research is strongly encouraged for fellows, and the members of the hepatology faculty provide various research opportunities.
Inpatient Liver Transplant: The fellow will spend six months on the liver inpatient service. During this rotation, the fellow will be responsible for managing post-transplant patients on the hepatology service, and patients admitted to the transplant surgery floor in anticipation of transplantation or immediately post-transplantation.
Transplant Evaluation Clinic: This clinic is held twice a week. The transplant hepatology fellow will be responsible for reviewing all of the patient’s records, interviewing and evaluating the patients in clinic and presenting their cases to the attending hepatologist before finalizing the visit and making final recommendations.
The fellow works with the transplant patients and the transplant coordinators to ensure that the transplant evaluation is completed. Since many of the patients are subsequently admitted to the inpatient service for further management, the fellow will coordinate the patient’s care with both the attending hepatologist and transplant surgeons. The fellow will specifically gain expertise in the management and care of the pre-transplant and post-transplant patients and develop advanced knowledge in immunosuppressive therapy.
Outpatient Hepatology Clinic: The fellow will attend hepatology specialty clinic (three half days per week), while on the outpatient rotation. Under the supervision of an attending hepatologist, the fellow will evaluate new patient referrals, as well as manage follow-up and post-transplant patients. The fellow coordinates the patient’s care with the attending hepatologist, transplant surgeons and the referring physician.
Research: Each fellow will have ample research experience. Under the supervision of a mentor, the fellow will work on an original research project.
These conferences are mandatory for transplant hepatology fellows regardless of which rotation they are on:
- Weekly journal club
- Weekly research meeting
- Weekly transplant hepatology didactics
- Weekly transplant selection meeting
- Weekly GI/hepatology grand rounds
- Weekly liver tumor board meeting
- Monthly liver transplant M&M and pathology
The fellows are also encouraged and welcome to attend other GI/liver conferences to make the most of their learning experience.
The program length is one year.
How to Apply
For information on how to apply, please contact:
Johns Hopkins Hospital
1830 E Monument St
Baltimore, MD 21205