Advanced Endoscopy Fellowship

The advanced endoscopic training program provides trainees with critical, supervised instruction to ensure quality care for patients.  Although the Lahey Advanced Endoscopy Fellowship is a procedural focused fellowship, endoscopic decision making, technical proficiency, and patient management are equally important, and these skills will be emphasized repeatedly during the training period. The advanced endoscopy fellow will spend the majority of time performing advanced procedures under the direct supervision from the supervising physician.  A half day per week will be spent performing general GI procedures as an attending physician depending on visa status. The advanced endoscopy fellow will work with the general gastroenterology fellows to arrange inpatient procedures and facilitate procedures from our busy referral practice. There is no inpatient pancreaticobiliary service. In addition to clinical responsibilities, participation in clinical research is expected. 

Conferences

1. Bi-monthly advanced endoscopy conference;  
2. Weekly tumor board;  
3. Monthly GI Morbidity and Mortality Conference; 
4. Weekly GI Journal Club conference;
5. Weekly GI Core Curriculum conference. 

The goal of the Advanced Endoscopy Fellowship is to teach cognitive and technical aspects of advanced endoscopy which includes:  

- Understanding disease processes, presentation and management; 

- Interpretation of radiographic data;  

- Appropriate recommendation of advanced endoscopic procedures based on findings from consultations and in consideration of specific indications, contraindications, and diagnostic/ therapeutic alternatives 

- Understanding the indications and contraindications for procedures;  

- Performance of specific procedures safely, completely, and expeditiously;  

- Pre- and post-procedure care of patients;  

- Recognition and management of complications;  

- Appropriate documentation and reporting;  

- Appropriate communication with the patient and the multidisciplinary team;  

- Endoscopic research, presentation and publication 
 
The advanced endoscopy fellow is expected to perform all aspects of advanced diagnostic and therapeutic endoscopy techniques including:  

- Diagnostic endoscopic ultrasound 

- Endoscopic retrograde cholangiopancreatography: management of biliary stones and strictures, papillectomy, complex ERCPs, ERCP in post- surgical anatomy, ductoscopy (Spyglass), management of pancreatic duct stones 

- Management of dysplastic Barrett’s esophagus and early esophageal cancer with training in endoscopic mucosal resection, radiofrequency ablation, and cryotherapy 

- Endoluminal stenting: esophagus, gastroduodenal, colonic 

- Management of GI strictures: use of stents, dilating balloons, and bougies 

- Endoscopic mucosal resection: esophagus, stomach, small intestine, colon  

- Small bowel enteroscopy (both antegrade and retrograde): single balloon enteroscopy 

- Endoscopy in post-surgical anatomy: esophagectomy, gastrectomy, Whipple resections, gastric bypass, liver transplant, intestinal resections  

- Therapeutic endoscopic ultrasound: celiac plexus blockade and neurolysis, pancreatic pseudocyst drainage and necrosectomy, EUS-guided pancreaticobiliary drainage, fiducial marker placement, tumor ablation, FNA/FNB, EUS-guided coiling and glueing of gastric varices 

- Third space endoscopy which includes Per Oral Endoscopic Myotomy (POEM), Endoscopic Submucosal Dissection (ESD), Zenker’s Diverticulotomy (ZPOEM), endoscopic gastric pyloromyotomy (GPOEM) 

Mena Bakhit, M.D.
Advanced Endoscopy Fellowship Program Director

Mena Bakhit, M.D. trained as a gastroenterology fellow at Brown University/Rhode Island Hospital and did his advanced endoscopic fellowship at Thomas Jefferson University Hospital. Dr. Bakhit’s interests include interventional EUS, complex ERCPs, large upper and lower endoscopic mucosal resections.  

Haider Rahman, M.D. trained as a gastroenterology fellow at Albany Medical Center and did his advanced endoscopic fellowship at Virginia Commonwealth University.  Dr. Rahman’s interests include interventional EUS, complex ERCPs, large upper and lower endoscopic mucosal resections, balloon enteroscopy, management of Barrett's esophagus. 

Khaldoon Khirfan, M.D. trained as a gastroenterology fellow at University of New Mexico and did his advanced endoscopy fellowship at the University of California Irvine. Interests include third space (ESD/POEM/Z-POEM), endohepatology and anti-reflux procedures.  

Lindsey Sullivan, PA, trained at Gastroenterology Associates of Northern Virginia and Cambridge Health Alliance. She joined Lahey in 2020 with many years of GI experience.