During the first and second year of fellowship, fellows maintain a weekly Continuity Clinic in the Center for Advanced Medicine (CAM). Preceptors consist of a core group of full-time faculty, as well as a select group of voluntary (private) faculty with a special interest in ambulatory education. Fellows assume primary responsibility for the patients they see in the practice, including initial consultation, follow up visits, interpretation of testing results, and coordination of care with other specialties. The fellows capitalize on the extensive resources allocated to ambulatory care, including social workers, nutritionists, nurses, and other staff supports (medical assistant, endoscopy liaison, insurance specialists).

To enable graduated learning and better prepare fellows for independent practice, ambulatory clinic for the 3rd year fellows is organized at the faculty practice location. This practice setting provides a novel continuity experience with a special focus on ambulatory decision making and practice management. A dedicated pre-clinic conference further supports the transition to independent practice.

Each fellow also maintains a once monthly continuity IBD Clinic located in the Feinstein Center for Inflammatory Bowel Disease. Fellows see new and established patients with complex diagnostic and management issues related to IBD. The multidisciplinary IBD Center offers a wide array of support services to patients, including dieticians, endostomal therapists, surgeons, social workers, psychologists, clinical pharmacologists, nurses and nurse practitioners, research coordinators, and administrative staff.

Endoscopy training occurs throughout the entire three year fellowship, with increasing time on outpatient endoscopy occurring during the last 18 months of the fellowship. Dedicated inpatient endoscopy rotations provide focused training and experience in endoscopic procedures on hospitalized patients. Additional rotations with the advanced endoscopy faculty provide experience in endoscopic mucosal resection, stricture dilation, and radiofrequency ablation. Fellows gain significant experience with chromoendoscopy through working with IBD faculty. Rotations at the Bronx VA provided significant training in outpatient endoscopy. During the scholarly time (2nd and 3rd year), fellows are expected to perform one day of outpatient endoscopy per week. These endoscopy sessions can occur with faculty preceptors at the hospital with high-acuity outpatients, or with full-time faculty during their scheduled sessions at the ambulatory surgical center (ASC).