MUSC Advanced Endoscopy Fellowship 2012: Dr Shyam Menon

The advanced endoscopy fellowship has been a fantastic opportunity to visit the well-known MUSC endoscopy unit and I am grateful to BSG for supporting it. The fellowship has required a lot of planning and organisation and I thank everyone involved in making it successful. I am very grateful to Dr. Peter Cotton for hosting us and overseeing the fellowship.

The MUSC GI unit is located in a state-of-the-art building by the picturesque Ashley River with a panoramic view of Charleston harbour. The endoscopy unit is large and spacious, with purpose-built ERCP and EUS facilities. Although our programme was tailored to our specific interests, we watched a diverse range of therapeutic endoscopic procedures during our stay. A striking difference in endoscopic practice for me, was the use of anaesthesia for therapeutic endoscopy.

This clearly made a significant difference to the quality of ERCP and EUS procedures and greatly enhanced the training opportunity for the GI fellows. The sedation / anaesthesia is delivered by nurse anaesthetists, who undergo a lengthy training program prior to certification and are independent practitioners. I was impressed at their speed and efficiency, with minimum turnaround times between cases.

Our programme also included visits to tumour board (MDT) and histology meetings and I was struck by the obvious similarities with our system. We were given a comprehensive overview of the US healthcare system by MUSC administrators and visited the adjacent VA (Veterans Affairs) hospital, which is a parallel healthcare system similar to the NHS.

We had many informed discussions with the faculty and I have learnt a great deal from my experience at MUSC. My highlight of the fellowship was the overall warmth with which we were received and the positive attitude of the staff. Finally, we were privileged to be invited to Dr. Cotton’s home on Dewees Island, a beautiful, eco-friendly private community and had a great time exploring Charleston. Thanks once again to the BSG for giving me this opportunity.