SYLLABUS
College of Medicine
AY 2015-2016
Course title and number
Term (e.g., Fall 200X)
Meeting times and location
IMED 864-00T Gastroenterology Hospital Service
Clinical Rotation Offered All Year – 2 weeks or 4 weeks
Report at 7:30 to Sid Richardson Auditorium or Doctors Conference Room
for Internal Medicine Morning Report. Following morning Report go to
Desk 3B, third floor of the clinic and ask for Dr. Pfanner.
Course Description and Prerequisites
The Faculty will strive to:
1. Reinforce the clinical diagnostic skills obtained by the student during his third year clerkship in
medicine
2. Introduce the student to the specialized diagnostic procedures relating to gastrointestinal
disorders with emphasis on their indications and interpretations
3. Familiarize the student with the management of some of the more commonly encountered
gastrointestinal disorders
Instructor Information
Elective Director
Timothy Pfanner, M.D.
Name
254-724-3098
Telephone number
tpfanner@sw.org
Email address
by appointment
Office hours
Desk 3B, 3rd Floor,
Office location
Maybee Clinic
Coordinator
Martha Chandler
Name
254-724-2607
Telephone number
mschandler@sw.org
Email address
By appointment
Office hours
6th Floor, Brindley
Office location
Circles, Rm 640
Learning Outcomes & Objectives
COM Competency Based Learning Objectives: http://medicine.tamhsc.edu/academicaffairs/curriculum/objectives/
Principles and Guidelines for Curriculum Development:
http://medicine.tamhsc.edu/policies/pdf/curriculum-principles-guidelines.pdf
Course Objective:
1. Carry out the initial history and
physical examination and plan
the diagnostic work-up for the
more common gastrointestinal
disorders
Date Created/Revised: 4/22/2015 By: msc
COM Competency
Based Learning
Objectives
(CBLO):
PC1: Obtain both
complete and
system-focused
medical histories
that include
psychosocial and
behavioral
determinants of
health
Taught (T)
and/or
Evaluated (E):
Taught and
Evaluated
Evaluation:
Clinical
Performance
Rating/Checklist
PC2: Perform both
complete and
system-focused
physical
examinations
PC3: Develop
appropriate
differential
diagnoses by
integrating
collected clinical
information
PC4: Develop
contextual and
individualized
diagnostic and
treatment plans
based upon
collected clinical
information
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC6: Recognize
common
immediately lifethreatening
conditions and
initiate therapy
PC12: Educate
patients in
personalized health
maintenance
PC13: Perform
basic health risk
assessment and
formulate
appropriate
screening plans
PC14: Properly
utilize clinical,
laboratory,
radiologic, and
pathologic
examinations to
diagnose and treat
common maladies
PC15: Formulate
preventive,
curative,
rehabilitative, and
palliative
therapeutic
strategies for
common disorders
Date Created/Revised: 4/22/2015 By: msc
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
ICS1: Demonstrate
effective listening
skills
ICS2: Discuss
diagnostic and
treatment options in
a manner
comprehensible to
the patient
ICS3:
Communicate
effectively with
patients, patients'
family members,
peers, and other
members of the
health care team
ICS4: Educate
patients, patients'
family members,
peers, and other
members of the
health care team at
an appropriate level
using appropriate
technologies
ICS5: Maintain
accurate medical
records
PROF1:
Demonstrate an
understanding of
legal and ethical
principles
governing the
physician-patient
relationship
PROF2: Display
honesty, integrity
and ethical
behavior
PROF3: Act in the
patient's best
interest and serve
as a patient
advocate
PROF4: Treat
patients and
patients' family
members
respectfully and
compassionately,
regardless of age,
disability, gender,
race, ethnicity,
culture, religion,
sexual preference,
and socioeconomic status
Date Created/Revised: 4/22/2015 By: msc
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
2. Recognize the normal
anatomical structures on flat
plates of the abdomen, upper
and lower gastrointestinal
series, plus x ray studies of the
biliary system
3. Discuss the indications for
upper GI endoscopy,
colonoscopy, laparoscopy, liver
biopsy, retrograde cannulation
of the hepatic and pancreatic
ducts systems and list the type
of information available from
these procedures
Date Created/Revised: 4/22/2015 By: msc
PROF5: Respect
the privacy of
patients
MK1: Demonstrate
knowledge of
normal human
structure and
function at the
organ-system,
tissue, cellular and
molecular level;
and of the
interaction of
human systems in
maintaining
homeostasis
MK2: Describe the
basic mechanisms
involved in the
causation of human
disease and their
influence on clinical
presentation and
therapy
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
ICS2: Discuss
diagnostic and
treatment options in
a manner
comprehensible to
the patient
PROF1:
Demonstrate an
understanding of
legal and ethical
principles
governing the
physician-patient
relationship
PROF3: Act in the
patient's best
interest and serve
as a patient
advocate
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC14: Properly
utilize clinical,
laboratory,
radiologic, and
pathologic
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
4. Discuss the indications for
proctosigmoidoscopy and
observe proctosigmoidoscopy
carried out by staff
Date Created/Revised: 4/22/2015 By: msc
examinations to
diagnose and treat
common maladies
ICS2: Discuss
diagnostic and
treatment options in
a manner
comprehensible to
the patient
ICS3:
Communicate
effectively with
patients, patients'
family members,
peers, and other
members of the
health care team
ICS4: Educate
patients, patients'
family members,
peers, and other
members of the
health care team at
an appropriate level
using appropriate
technologies
MK1: Demonstrate
knowledge of
normal human
structure and
function at the
organ-system,
tissue, cellular and
molecular level;
and of the
interaction of
human systems in
maintaining
homeostasis
MK2: Describe the
basic mechanisms
involved in the
causation of human
disease and their
influence on clinical
presentation and
therapy
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC9: Perform
technical
procedures
including:
venipuncture and
arterial puncture;
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
5. Discuss the indications for
surgery and its management in
the more commonly
encountered gastrointestinal
disorders
Date Created/Revised: 4/22/2015 By: msc
insertion of
intravenous, central
venous, and
urethral catheters;
insertion of a
nasogastric tube;
lumbar puncture;
basic suturing; and
basic airway
management
PC14: Properly
utilize clinical,
laboratory,
radiologic, and
pathologic
examinations to
diagnose and treat
common maladies
PROF6: Work with
other health
professionals in a
collaborative
fashion
MK1: Demonstrate
knowledge of
normal human
structure and
function at the
organ-system,
tissue, cellular and
molecular level;
and of the
interaction of
human systems in
maintaining
homeostasis
MK2: Describe the
basic mechanisms
involved in the
causation of human
disease and their
influence on clinical
presentation and
therapy
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC9: Perform
technical
procedures
including:
venipuncture and
arterial puncture;
insertion of
intravenous, central
venous, and
urethral catheters;
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
6. Discuss the initial laboratory
work up and therapeutic
program for a patient with
gastrointestinal hemorrhage,
cholelithiasis, jaundice, peptic
ulcer, diverticular disease, and
the more commonly
encountered gastrointestinal
disorders
Date Created/Revised: 4/22/2015 By: msc
insertion of a
nasogastric tube;
lumbar puncture;
basic suturing; and
basic airway
management
PC14: Properly
utilize clinical,
laboratory,
radiologic, and
pathologic
examinations to
diagnose and treat
common maladies
PROF6: Work with
other health
professionals in a
collaborative
fashion
MK1: Demonstrate
knowledge of
normal human
structure and
function at the
organ-system,
tissue, cellular and
molecular level;
and of the
interaction of
human systems in
maintaining
homeostasis
MK2: Describe the
basic mechanisms
involved in the
causation of human
disease and their
influence on clinical
presentation and
therapy
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC9: Perform
technical
procedures
including:
venipuncture and
arterial puncture;
insertion of
intravenous, central
venous, and
urethral catheters;
insertion of a
nasogastric tube;
lumbar puncture;
basic suturing; and
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
7. Plan a treatment program for a
patient with the more common
gastrointestinal disorders
Date Created/Revised: 4/22/2015 By: msc
basic airway
management
PC9: Perform
technical
procedures
including:
venipuncture and
arterial puncture;
insertion of
intravenous, central
venous, and
urethral catheters;
insertion of a
nasogastric tube;
lumbar puncture;
basic suturing; and
basic airway
management
PC14: Properly
utilize clinical,
laboratory,
radiologic, and
pathologic
examinations to
diagnose and treat
common maladies
PROF6: Work with
other health
professionals in a
collaborative
fashion
PC12: Educate
patients in
personalized health
maintenance
PC4: Develop
contextual and
individualized
diagnostic and
treatment plans
based upon
collected clinical
information
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC10: Discuss the
principles of pain
management and
formulate a basic
multidisciplinary
care plan
ICS2: Discuss
diagnostic and
treatment options in
a manner
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
8. Interpret the following tests of
gastrointestinal function: Acid
and pancreatic secretion
studies, liver function studies,
small intestinal function tests,
esophageal manometry and
apply them to the management
of patients with gastrointestinal
disease
Date Created/Revised: 4/22/2015 By: msc
comprehensible to
the patient
ICS4: Educate
patients, patients'
family members,
peers, and other
members of the
health care team at
an appropriate level
using appropriate
technologies
PROF2: Display
honesty, integrity
and ethical
behavior
MK1: Demonstrate
knowledge of
normal human
structure and
function at the
organ-system,
tissue, cellular and
molecular level;
and of the
interaction of
human systems in
maintaining
homeostasis
MK2: Describe the
basic mechanisms
involved in the
causation of human
disease and their
influence on clinical
presentation and
therapy
MK4: Apply
evidenced-based
methods to clinical
problem solving
PC5: Interpret the
results of
commonly used
laboratory and
radiologic studies
PC9: Perform
technical
procedures
including:
venipuncture and
arterial puncture;
insertion of
intravenous, central
venous, and
urethral catheters;
insertion of a
nasogastric tube;
lumbar puncture;
basic suturing; and
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
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basic airway
management
PC13: Perform
basic health risk
assessment and
formulate
appropriate
screening plans
PC15: Formulate
preventive,
curative,
rehabilitative, and
palliative
therapeutic
strategies for
common disorders
ICS2: Discuss
diagnostic and
treatment options in
a manner
comprehensible to
the patient
ICS3:
Communicate
effectively with
patients, patients'
family members,
peers, and other
members of the
health care team
ICS4: Educate
patients, patients'
family members,
peers, and other
members of the
health care team at
an appropriate level
using appropriate
technologies
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Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
Clinical
Performance
Rating/Checklist
Taught and
Evaluated
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Performance
Rating/Checklist
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Textbooks (Required and Recommended Resources)
1. Specific literature references: interpretation of GI function studies; indications and value to be
obtained from proctosigmoidoscopy, upper GI endoscopy, colonoscopy, cannulation,
laparoscopy, and liver biopsies, and interpretation of stool films and culture, and liver and
intestinal biopsies.
2. Teaching film of: upper GI series; colon series; biliary tract series; pancreatography; plain x-rays
of the abdomen; endoscopy normal appearances and common pathological abnormality; liver
scan, ultra sound, and CAT scans
Date Created/Revised: 4/22/2015 By: msc
Grading Policies
GRADING SCALE
Satisfactory
70-100
Unsatisfactory
69 and below
Should the course director determine remediation is required, the remediation plan will be at the
discretion of the course director and on a case by case basis depending on the issues involved.
Remediation plans could entail some (or all) of the following examples: Additional clinical shifts,
research papers, presentations, article reviews, exams, directed reading, web-based modules, etc. If the
student performance results in a failure of the elective, it will be recommended that the elective be taken
again in its entirety.
Attendance and Make-up Policies
The Department of Internal Medicine adheres to attendance policies and duty hours as set forth in the
College of Medicine Student Handbook, http://student-rules.tamu.edu/rule07 . In the case of personal
illness, critical illness within your immediate family, family death, or other circumstances where you will
not be able to participate in required activities, you must contact the Internal Medicine Medical Education
Coordinator and contact the attending Faculty. Students who miss more than 20% of a 4th year elective
for any reason (2 weekdays during a two-week rotation or 4 weekdays during a 4-week rotation), will
require a remediation plan. The Course Director will consider student attendance and remediation if the
student is requesting extended time off during interview season.
Learning Materials and Activities
1. Will be assigned at least two new patients per week for work up and follow them through their
hospital course.
2. Will meet at least one hour per week with gastrointestinal fellow or staff physician for the
interpretation of GI radiological films.
3. Will observe all special procedures, proctosigmoidoscopy, upper GI endoscopy, colonoscopy,
retrograde cannulation, laparoscopy, and liver biopsy on his patients and others whom the staff
feel will be instructive.
4. Will present his patients on staff rounds and conferences whenever they are to be discussed.
5. Will spend four hours per week in the GI physiology lab observing the performances of the
various tests of GI function, one hour per week with the Fellow or staff physician discussing their
interpretation
Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides
comprehensive civil rights protection for persons with disabilities. Among other things, this legislation
requires that all students with disabilities be guaranteed a learning environment that provides for
reasonable accommodation of their disabilities. If you believe you have a disability requiring an
accommodation, please contact Disability Services, in Cain Hall, Room B118, or call 845-1637. For
additional information visit http://disability.tamu.edu
Any student with a disability who needs accommodation should inform the instructor at the beginning of
the course.
Academic Integrity
Date Created/Revised: 4/22/2015 By: msc
For additional information please visit: http://aggiehonor.tamu.edu
“An Aggie does not lie, cheat, or steal, or tolerate those who do.”
College of Medicine
Professionalism and integrity Statement (Academic Honesty and Plagiarism)
All College of Medicine students are required to comply with the student code of conduct and the
academic integrity and honesty standards published in each component’s Student Handbook.
Disciplinary action will be taken in accordance with the policies of each component. Students found
guilty of Academic Dishonesty will receive an “F”/Unsatisfactory in the course. For a full list of actions
qualifying as academic dishonesty, please review the College of Medicine Student Handbook at
http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf.
According to the Aggie Honor System Office, plagiarism is defined as the appropriation of another
person's ideas, processes, results, or words without giving appropriate credit. Intentionally, knowingly, or
carelessly presenting the work of another as one’s own (i.e., without crediting the author or creator).
Plagiarism and other academic misconduct definitions can be viewed on the Aggie Honor System Office
website; http://aggiehonor.tamu.edu/RulesAndProcedures/HonorSystemRules.aspx#definitions.
E-mail Access and FERPA
The College of Medicine is communicating all official information to students through the students’
TAMHSC e-mail accounts. Please check the account frequently during the semester for updates.
This course is supported with web-based and/or e-mail activities. In order to take advantage of these
additional resources and participate fully in the course, you have been assigned an e-mail address by
the Texas A&M Health Science Center. This e-mail address is for internal use only, so that faculty may
communicate with you and the entire class. By registering for this course, you are agreeing to allow
your classmates to have access to this e-mail address. Should you have any questions, please contact
the TAMU’s Office of the Registrar at 979-845-1031.
The Family Educational Rights and Privacy Act of 1974 (FERPA), which the HSC complies fully, is
intended to protect the privacy of education records, to establish the rights of students to inspect and
review their education records and to provide guidelines for the correction of inaccurate or misleading
data through informal and formal hearings. Students also have the right to file complaints with the Family
Educational Rights and Privacy Act Office of the Department of Education in Washington, D.C.,
concerning alleged failures by the HSC to comply with the act.
Mistreatment of Students
The College of Medicine is committed to providing a positive learning environment in which students can
meet their academic goals based on mutual respect in the teacher/learner relationship. Both parties
must be sensitive to the needs of others and differences in gender, race, sexual orientation, religion, age
or disability. As outlined in the Student Handbook under the section titled Standards of Conduct in the
Teacher-Learner Relationship, belittlement, intimidation and humiliation are unacceptable for effective
learning and undermine self-esteem. Breaches involving student mistreatment may result in a faculty or
staff member being sanctioned or the loss of faculty and/or staff appointment. These policies address
student mistreatment involving College of Medicine employees, residents, affiliate staff, or patients.
Mistreatment may be reported through the College of Medicine telephone hotline, 1(855)-397-9835 or
through an online form at http://medicine.tamhsc.edu/current/student-mistreatment-form.html. For a full
list of reporting avenues, please refer to the Student Handbook under the Mistreatment Policy.
Exposure and Occupational Hazard
The Needle Stick Policy and Bloodborne Pathogen Exposure information for Medical Students may be
accessed in the Student Handbook at: http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf
Note: More information is available on the aforementioned topics to all students on the College of
Medicine website.
Date Created/Revised: 4/22/2015 By: msc
Date Created/Revised: 4/22/2015 By: msc