Program Summary

Introduction and Background

Established in 1920, Virginia Mason is an award-winning, non-profit organization offering a network of primary and specialty care clinics throughout the Puget Sound region and two hospitals, a 336-bed hospital in Seattle and a 222-bed hospital in Yakima. The Digestive Disease Institute at Virginia Mason was established to bring our accomplished group of digestive disease specialists and investigators together in a highly collaborative environment.

Our active benign pancreas program is internationally renowned and sees approximately 1,300 patients every year. The Digestive Disease Institute at Virginia Mason has created the Pancreas Research Fellowship in keeping with the Institute's mission to optimize patient care through innovations in research, education, and a multidisciplinary approach to treatment of digestive and liver diseases.

Shayan Irani, MD, Pancreas Research Fellowship Program Director, works closely with Digestive Disease Institute Executive Director Richard Kozarek, MD, to ensure a valuable educational experience. Pancreas research fellows work with business analysts and multidisciplinary providers as well as program faculty.

Program Faculty

Supervision and mentoring will be provided by Shayan Irani, MD, Fellowship Director, and other faculty (listed below) depending upon specific areas of engagement. These faculty members are part of the Digestive Disease Institute and include surgeons, gastroenterologists, pathologists and radiologists with expertise in the treatment and research of digestive disease. 

Shayan Irani, MD, Pancreas Research Fellowship Program Director
Richard Kozarek, MD, Executive Director, Digestive Disease Institute
Andrew Ross, MD, Director, Therapeutic Endoscopy Center of Excellence
Blaire Burman, MD, Director, Training and Education
Alexander Kuo, MD, Fellowship Director
Michael Gluck, MD, Chief of Medicine and Therapeutic Endoscopist
Scott Helton, MD, Director, Liver, Pancreas & Biliary Surgical Center of Excellence
Russell Dorer, MD, PhD, GI Pathologist
Hejin Hahn, MD, GI Pathologist
David Coy, MD, GI Radiologist


Duration of Fellowship

The duration of training is one year. This duration of time can be modified in special circumstances to two years.

Number of Positions

One.

Prerequisites for Training

Trainees for the Pancreas Research Fellowship must have an MD degree and have completed at least three years of residency. Non-native speakers of English must take and submit TOEFL scores. We cannot consider applicants with J1 visa status. Applications from international applicants eligible for an H1-B visa will be considered.

Salary

The Pancreas Research Fellow will receive a competitive salary and benefits at the regionally-determined PGY-4 level or higher, depending on level of training. Additionally, the Fellow is entitled to a $2,000 conference stipend.

Expected Products

  1. At least three publications on Virginia Mason research/clinical results in peer-reviewed journals per year, co-authored with mentoring supervisor.
  2. Presentations of research at a minimum of one national or international meeting.

Program Goal

The goal of the Pancreas Research Fellowship program is to provide a unique and challenging experience for the fellow to:

  1. Perform meaningful, supervised research and engage in scholarly activities. The fellow will not participate in clinical patient care.
  2. Examine records from a population of pancreas patients in the context of a high-volume inpatient service, outpatient clinic and outpatient treatment center.
  3. Learn a multidisciplinary team approach to medical research. Fellows are expected to shadow and observe the work of major providers in six main areas including diagnostic radiology, gastroenterology, surgery, and pathology — and serve as valued and important contributors to the team.
  4. Study, analyze and publish on pancreas disease, with a focus on benign pancreatic conditions.

Objectives
By the end of the fellowship year, the fellow will be able to:

Medical Knowledge

  • Demonstrate understanding and application of medical knowledge in the assessment of pancreas disease clinical data.
  • Apply knowledge of medical literature to evaluation of clinical data and profiles of patients with pancreas disease.
  • Use medical knowledge and analytical thinking to develop manuscripts that will contribute significantly to the literature.

Research Skills

  • Design and execute scientific research projects.
  • Apply knowledge of Human Subjects Research ethics and institutional review board requirements to submission of projects for approval.
  • Apply various statistical methods to analysis of clinical data.
  • Use Access or other database skills to report from and analyze data.

Interpersonal Skills, Communication Skills and Professionalism

  • Complete assigned tasks, including documentation, reliably and in a timely manner.
  • Demonstrate integrity, respect for others, honesty and compassion.
  • Set a tone of respect and collegiality for individuals and the team.

Expected Activity

1. Design and complete at least three research projects in benign pancreas disease. If a project cannot be finished before the Fellow graduates, the project will be continued by the incoming Fellow, who then becomes a co-author.

a. Identify a topic/project — meet with a member of the faculty to identify/confirm potential topic, data needed or available, and knowledge necessary to investigate further.

2016-2017 Initial Benign Pancreas Research Projects

Topic: Endoscopic and Surgical Approaches to Post-Whipple Pancreaticojejunal Strictures
Mentor: Richard Kozarek, MD

Topic: Comparison of Axios Stents vs. Standard Dual Modality Drainage with Pigtail Stents
Mentor: Shayan Irani, MD

Topic: Long-term Follow-Up for Papillectomy Patients for Ampullary Adenomas
Mentor: Shayan Irani, MD

Topic: Update on Endoscopic Management of Disconnected Duct Syndrome
Mentor: Shayan Irani, MD

Topic: Long-term Experience with Distal Common Bile Duct Strictures in Chronic Pancreatitis
Mentor: Shayan Irani, MD

Topic: Virginia Mason Pancreatic Cyst Experience - EUS Focus
Mentor: Ian Gan, MD

Topic: Virginia Mason Pancreatic Cyst Experience - Surgical Resection Focus
Mentor: Adnan Alseidi, MD

Topic: Acute Pancreaticobiliary Fistulas: Etiology and Medical Management
Mentor: Adnan Alseidi, MD

Topic: Incidence of Diabetes Mellitus in Pancreatic Necrosis - Percent Necrosis & Drainage Modality
Mentor: Michael Gluck, MD

Topic: Case Series of Patients with Pancreas Cancer Presenting with WON
Mentor: Michael Gluck, MD

Topic: Quality of Life in Patients with Chronic Abdominal Pain from Calcific Pancreatitis Treated with ESWL and Surgery
Mentor: Scott Helton, MD    


b. Formulate a hypothesis — using the knowledge you have gained, formulate a hypothesis about a cause or effect of the phenomenon, or the relationship of the phenomenon to some other phenomenon.

c. Test the hypothesis — plan and carry out tests of the hypothesis, including gathering and sorting data as needed.

d. Analyze the data — use proper mathematical analysis to see if the results of the experiment support or refute the hypothesis.

e. Draft a manuscript — use AMA formatting to draft a publishable academic research article; provide initial and subsequently improved drafts to faculty member to receive input for improvement; identify appropriate peer-reviewed journals for submission

f. Submit manuscript — follow publisher guidelines for submitting manuscript, make changes in response to reviewer feedback, and re-submit in a timely manner.

2. Interact daily with supervisor to identify next steps on research plan(s), collaborate on analysis and submission, enhance research methodology, perform statistical review, and build on database creation and analysis skills.

3. Work with GI physicians, DDI business analysts, and multidisciplinary providers to determine appropriate inclusion/exclusion criteria for use in building robust databases.

4. Participate actively in the regularly scheduled GI Cancer, GI Pathology and GI Radiology conferences (tumor boards) and Journal Club.

GI Cancer Conference — Every other Tuesday, 5-6 p.m., Rad-Onc Conference Room
Bi-weekly cancer conference focuses on gastrointestinal cancers. Faculty and fellows from gastroenterology, hepatology, surgery, pathology, interventional radiology and oncology meet weekly to present, review and discuss the medical conditions and treatment options of individual patients with gastrointestinal and pancreaticobiliary cancers. Consensus recommendations for further evaluation and treatment for each patient are documented and communicated to patients and treating physicians.

GI Pathology Conference — 4th Thursday of month 7:30-8:30 a.m., Pathology Conference Room 
Meet monthly with pathologists, radiologists, and gastroenterologists to review biopsy specimens. Some biopsies have been performed by the Radiology Department, referral hospitals and/or referral physicians. The number of biopsies reviewed will vary. For any patient who has an autopsy, the results will be discussed during the conference as well. All explants will be reviewed during pathology conference.

GI Radiology Conference - 3rd Wednesday of month 7:30-8:30 a.m., Correa A Conference Room
Faculty, gastroenterologists, surgeons, general radiologists, interventional radiologists and fellows meet monthly to review computed tomography, magnetic resonance, angiograms and ultrasonography on selected patients to be discussed. Indications, contra-indications, limitations, and complications of all radiologic procedures pertinent to the subspecialty of pancreatic disease are also discussed.

Journal Club – 1st, 2nd, 3rd Thursday of month, 7:30-8:30 a.m., Correa C Conference Room
Providers meet weekly to discuss the latest news from literature published for physicians and health care providers.  

Conference Schedule:

Name

Conference
Director

Occurrence

Location

Medical Grand Rounds

Nitsche

Friday, 7:30-8:30 a.m.

Volney-Richmond Auditorium

AHPBA Grand Rounds 

Alseidi 

1st Wednesday, every month, 8:30 a.m.

Rad/Onc Conference Room

GI Journal Club

Irani             

1st, 2nd, 3rd Thursday, every month, 7:30 a.m.

Correa C

GI / Pathology

Dorer/Gan

Regularly 4th Thursday, every month, 7:30 a.m.

Pathology Conference Room

GI / Radiology

Gan

3rd Wednesday, every month, 7:30 a.m.

Correa B

GI M&M

Ross

1st Wednesday, every month, 7:30 a.m.

Correa B

GI Cancer Conference

Thirlby

Every other Tuesday (alternating weeks with Liver), 5 p.m.

Rad/Onc Conference Room

Liver Cancer Conference

Helton

Every other Tuesday, 5 p.m.

Rad/Onc Conference Room


Evaluation and Feedback
The fellow will meet with the Program Director weekly and will receive regular verbal and written evaluations at intervals to be determined throughout the fellowship year. The fellow will be expected to provide confidential assessment and feedback about the program and faculty. DDI faculty, research support staff, DDI business analysts, and other staff who interact with the fellow may also be asked periodically to evaluate the Fellow. Assessment will focus on the key areas above.