The fellowship program is structured to involve a number of key rotations that change monthly. Clinical fellows spend time on the Consultative Service, Hepatology, Inflammatory Bowel Diseases, Nutrition, Endoscopy, Weiss Memorial Hospital and Advanced Therapeutic Endoscopy. Fellows in the clinical program will complete a first and second year of intensive clinical work with early focus on an area of special interest. During the first year of training, emphasis is placed on acquisition of endoscopy skills. Most first year fellows spend four months learning and performing upper endoscopy, colonoscopy and flexible sigmoidoscopy in a high volume endoscopy unit. They work with skilled clinical faculty, with emphasis placed on development of superior endoscopic skills. Second and third year fellows spend 2-3 months per year in this rotation. 3 months Hepatology and Nutrition. All fellows spend 1-2 months per year at Weiss hospital where they see patients with a full spectrum of gastrointestinal disorders. At Weiss, they are an integral part of outpatient clinic care; the inpatient consultation service and participate in a full spectrum of endoscopic procedures. Finally, all GI fellows have continuity clinics with assigned faculty, approximately one half day per week throughout most of their clinical training. Fellows on average have 24 months of clinical training during their 36 months of fellowship. The remaining time includes vacation and research investigation.