University Hospital is a major tertiary and primary care facility with 747 beds and over 30,000 admissions each year. The medical services consist of 160 beds divided among a variety of general medicine and subspecialty services. In each unit, doctors, nurses, students, clinical pharmacists and support staff work as a team to promote unified and comprehensive care for every patient. Each medical service is a mixture of patients - some admitted to the care of the teaching attending and others admitted by faculty attending. The medical residents provide the patients' primary care under the supervision of either the private or teaching attending. Subspecialty fellows serve as consultants and participate in specialized care, but do not serve as primary care providers on the inpatient services.
In January 1993, the new Baltimore VA Medical Center opened adjacent to University Hospital. Both hospitals are conveniently connected by a walkway that facilitates integration of educational and clinical activities. The VA Medical Center is a 324-bed facility with a fully digitalized radiology department and computer system that gives physicians ready access to clinical data, discharge summaries and laboratory results as well as online order entry. The Baltimore facility is one of two VA Medical Centers in the country with two large federally funded programs in geriatrics -- Geriatric Research Education Clinical Center and a Claude D. Pepper Older Americans Independence Center. It is currently ranked in the top five among the VA Medical Centers in VA-funded research. The Baltimore VA Medical Center serves as the central referral hospital for GI problems for an area serving West Virginia, central Pennsylvania, Maryland and Delaware.
Union Memorial Hospital is a 278-bed facility four miles from the University of Maryland campus in northeast Baltimore city. Founded in 1854, the hospital provides a range of primary care and subspecialty services. Fellows participate as inpatient consultants and in the outpatient practice of the full-time staff gastroenterologists.
Fellows participate in a variety of outpatient clinic rotations. Continuity clinics are held at the University of Maryland Medical Center and at the VA Medical Center, with a total of approximately 4,650 patient visits per year (3,500 VA, 1,150 UMMC). These clinics provide fellows with extensive experience in outpatient management of common gastrointestinal problems. Fellows may also join faculty members in their outpatient practice in Gastroenterology or Hepatology. Each clinical faculty members sees outpatients in the Faculty Practice Office or in the AeroDigestive Center (ADC) on a referral basis. The ADC is a multidisciplinary center located in University Hospital that includes the Inflammatory Bowel Disease (IBD) Program and the Heartburn and Dyspepsia Program.
Approximately 7,300 procedures are performed per year in the Division of Gastroenterology. There are two combined inpatient/outpatient endoscopy facilities, one at UMMC and one at the Baltimore VAMC. Both units have state-of-the-art video endoscopy equipment, endoscopic ultrasound, and a full array of equipment for advanced therapeutic endoscopy, including therapeutic ERCP, biliary manometry, laser, and photodynamic therapy. The facilities serve as regional tertiary care endoscopic referral centers with high volumes of advanced cases. Esophageal manometry and 24 hour pH monitoring are performed in the AeroDigestive Center. Other procedures performed include wireless capsule endoscopy and percutaneous liver biopsy.
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