Fellows undergo intensive clinical training during year one including upper endoscopy, colonoscopy, PEG tube placement, and esophageal dilatation. During clinical time, fellows rotate at Vanderbilt Medical Center, Nashville VA , and Vanderbilt GI Clinic. Each fellow has two continuity clinics; one at VUMC and the other at the VA. Second and third years are tailored to the interests of the individual fellow. There is weekly journal club, GI grand rounds, and clinical case conference.