The Division of Gastroenterology and Hepatology at the Johns Hopkins University School of Medicine offers an ACGME–accredited transplant hepatology fellowship for individuals who want to gain expertise in the management of patients with liver disease, including the selection and management of patients who 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.

The goal of the transplant hepatology fellowship is to train physicians for an academic career. Fellows who have completed their training at Johns Hopkins have joined high-ranking academic institutions, and many have assumed leadership positions.

In addition, we offer an ABIM/AASLD-approved pathway for GI fellows to complete transplant hepatology training in the third year of their GI fellowship. To be eligible, fellows need to successfully fulfill all the GI competencies by the end of the second year of the GI fellowship. Offered exclusively to internal GI fellows, this pathway follows the AASLD Transplant Hepatology Pilot, which has been offered at Johns Hopkins since its inception in 2012.

For information on these pathways, please contact Ruhail Kohli, transplant hepatology associate program director, or Tinsay Woreta, transplant hepatology program director (contact information below).

Curriculum

Training occurs under the supervision of 11 hepatologists in inpatient and outpatient settings. On average, the fellows spend six months in inpatient management and six months in an outpatient setting. In addition, the fellows participate in endoscopy with hepatology faculty members.

The fellows closely interact and work with the liver transplant team: hepatologist, transplant surgeons, nurse practitioners, coordinators, social worker, psychologists and administrators. Supervised and coached by the hepatology faculty, the fellows are 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 fellows build autonomy and exercise leadership skills throughout the course of the fellowship year. In addition, the fellows will observe transplant surgery, including organ procurement.

Active clinical research is strongly encouraged for fellows, and the members of the hepatology faculty provide various research opportunities.

Rotations

Inpatient liver transplant: The fellows will spend six months on average 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. The fellow will specifically gain expertise in the management and care of the listed high MELD pre-transplant patients and post-transplant patients, and will develop advanced knowledge in immunosuppressive therapy.

Transplant evaluation clinic: This clinic is held twice a week. The transplant hepatology fellow will be responsible for reviewing patients’ records, interviewing and evaluating the patients in clinic and presenting their cases to the attending hepatologist before finalizing the visit and making final recommendations.

Outpatient hepatology clinic/endoscopy: The fellows attend hepatology specialty clinic (three half-days per week), while on the outpatient rotation. Under the supervision of an attending hepatologist, the fellows 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. During the outpatient block, the fellows participate in endoscopy under the supervision of the attending hepatologists.

Research: Each fellow will have ample research experience. Under the supervision of a mentor, the fellow will work on an original research project. Dedicated research time is provided during the outpatient blocks.

Conferences

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.

Program Length

The program length is one year.

How to Apply

For information on how to apply, please contact:

Linda Welch

Fellowship Coordinator
Phone: 410-955-2635
Johns Hopkins Hospital
1830 E. Monument St.
Ste 431
Baltimore, MD 21205